Journal article
Serum Vitamin D Levels Affect Pathologic Complete Response in Patients Undergoing Neoadjuvant Systemic Therapy for Operable Breast Cancer
Clinical breast cancer, Vol.18(2), pp.144-149
04/2018
DOI: 10.1016/j.clbc.2017.12.001
PMCID: PMC6140343
PMID: 29290565
Abstract
The impact of serum vitamin D levels on rate of pathologic complete response (pCR) after neoadjuvant chemotherapy in 144 patients with operable breast cancer was retrospectively investigated. Low serum vitamin D levels were associated with not attaining a pCR. Further study of vitamin D supplementation as a means to improve pCR rates is warranted.
There has been increasing interest in the potential benefit of vitamin D in improving breast cancer outcome. Preclinical studies suggest that vitamin D enhances chemotherapy-induced cell death. We investigated the impact of serum vitamin D levels during neoadjuvant chemotherapy (NAC) on the rates of achieving pathologic complete response (pCR) after breast cancer NAC.
Patients from 1 of 2 Iowa registries who had serum vitamin D level measured before or during NAC were included. French patients enrolled onto a previous study of the impact of NAC on vitamin D and bone metabolism were also eligible for this study. Vitamin D deficiency was defined as < 20 ng/mL. pCR was defined as no residual invasive disease in breast and lymph nodes. A Firth penalized logistic regression multivariable model was used.
The study included 144 women. There was no difference between the French and Iowan cohorts with regard to age at diagnosis (P = .20), clinical stage (P = .22), receptor status (P = .32), and pCR rate (P = .34). French women had lower body mass index (mean 24.8 vs. 28.8, P < .01) and lower vitamin D levels (mean 21.5 vs. 27.5, P < .01) compared to Iowan patients. In multivariable analysis, after adjusting for the effects of cohort, clinical stage, and receptor status, vitamin D deficiency increased the odds of not attaining pCR by 2.68 times (95% confidence interval, 1.12-6.41, P = .03).
Low serum vitamin D levels were associated with not attaining a pCR. Prospective trials could elucidate if maintaining vitamin D levels during NAC, a highly modifiable variable, may be utilized to improve cancer outcomes.
Details
- Title: Subtitle
- Serum Vitamin D Levels Affect Pathologic Complete Response in Patients Undergoing Neoadjuvant Systemic Therapy for Operable Breast Cancer
- Creators
- Akiko Chiba - Wake Forest UniversityRachna Raman - Bon Secours Health SystemAlexandra Thomas - Wake Forest UniversityPierre-Jean Lamy - ICM PartnersMarie Viala - ICM PartnersStephane Pouderoux - ICM PartnersSarah L. Mott - Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IAMary C. Schroeder - University of IowaSimon Thezenas - ICM PartnersWilliam Jacot - ICM Partners
- Resource Type
- Journal article
- Publication Details
- Clinical breast cancer, Vol.18(2), pp.144-149
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.clbc.2017.12.001
- PMID
- 29290565
- PMCID
- PMC6140343
- ISSN
- 1526-8209
- eISSN
- 1938-0666
- Language
- English
- Date published
- 04/2018
- Academic Unit
- Pharmacy Practice and Science; Internal Medicine
- Record Identifier
- 9984365891802771
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