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- Title
Pretreatment vitamin D level and response to neoadjuvant chemotherapy in women with breast cancer on the I- SPY trial ( CALGB 150007/150015/ACRIN6657).
- Authors
Clark, Amy S.; Chen, Jinbo; Kapoor, Shiv; Friedman, Claire; Mies, Carolyn; Esserman, Laura; DeMichele, Angela
- Abstract
Laboratory studies suggest that vitamin D (vitD) enhances chemotherapy-induced cell death. The objective of this study was to determine whether pretreatment vitD levels were associated with response to neoadjuvant chemotherapy ( NACT) in women with breast cancer. Study patients ( n = 82) were enrolled on the I- SPY TRIAL, had HER2-negative tumors, and available pretreatment serum. VitD levels were measured via DiaSorin radioimmunoassay. The primary outcome was pathologic residual cancer burden ( RCB; dichotomized 0/1 vs. 2/3). Secondary outcomes included biomarkers of proliferation, differentiation, and apoptosis (Ki67, grade, Bcl2, respectively) and 3-year relapse-free survival ( RFS). Mean and median vitD values were 22.7 ng/mL ( SD 11.9) and 23.1 ng/mL, respectively; 72% of patients had levels deemed 'insufficient' (<30 ng/mL) by the Institute of Medicine ( IOM). VitD level was not associated with attaining RCB 0/1 after NACT (univariate odds ratio [ OR], 1.01; 95% CI, 0.96-1.05) even after adjustment for hormone receptor status ( HR), grade, Ki67, or body mass index ( BMI). Lower vitD levels were associated with higher tumor Ki67 adjusting for race ( OR, 0.95; 95% CI, 0.90-0.99). VitD level was not associated with 3-year RFS, either alone (hazard ratio [HzR], 0.98; 95% CI, 0.95-1.02) or after adjustment for HR, grade, Ki-67, BMI, or response. VitD insufficiency was common at the time of breast cancer diagnosis among women who were candidates for NACT and was associated with a more proliferative phenotype. However, vitD levels had no impact on tumor response to NACT or short-term prognosis.
- Subjects
BREAST cancer treatment; THERAPEUTIC use of vitamin D; DISINTEGRATION of microorganisms; ADJUVANT treatment of cancer; CANCER in women
- Publication
Cancer Medicine, 2014, Vol 3, Issue 3, p693
- ISSN
2045-7634
- Publication type
Article
- DOI
10.1002/cam4.235