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While this study must be regarded as preliminary because inflammatory markers were found to be an unsuitable primary endpoint in our setting, the CARPAN trial provides the basis for a robust sample size calculation: a conclusive study of L-Carnitine benefits ought to enrol 148 patients in each arm to show a survival benefit with 90% power, and would need 157 patients in each arm to demonstrate an improvement in tumor fatigue

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Ai-Ping Wang for critical reading of the manuscript and Editage (www.editage.cn) for English language editing

doi: 10.1038/ni1507