2 X survival of cancer immotherapy if high level of Vitamin D - meta-analysis

Higher serum vitamin D concentration and supplementation were associated with improved survival outcomes and treatment response in cancer patients receiving immunotherapy: A systematic review and meta-analysis

Nutr Res 2025 Aug 6:141:82-95. doi: 10.1016/j.nutres.2025.08.003 PDF behind paywall

Qian Yang 1, Chi Shu 2, Hong Li 3, Xuan Xie 3, Hong Wu 4, Yanhong Zhou 5, Huanrui Hu 6, Jichun Zhao 6, Chuan Xu 7, Yazhou He 8

Biological evidence has demonstrated the anti-tumor effects of vitamin D, but whether it could predict the effect of cancer immunotherapy remains inconclusive. We hypothesized that higher serum vitamin D concentration and supplementation might be correlated with better prognosis and treatment response among cancer patients receiving immunotherapy. We systematically searched the Medline, Embase, Cochrane Library, PubMed, and Web of Science databases to identify relevant articles from inception to June 19, 2025. We calculated the pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effect model primarily to determine the relationship between vitamin D and prognosis in cancer patients receiving immunotherapy. Thirteen studies involving 2592 cancer patients were included.

Higher vitamin D concentration was associated with improved overall survival (OS) (HR = 0.47 , 95% CI 0.39-0.58, P < .001),

as well as

  • progression-free survival (PFS),

  • event-free survival (EFS), and

  • objective response rate (ORR).

For cancer subtypes, elevated vitamin D concentration was associated with improved OS in lymphoma patients receiving any immunotherapy. All included patients with solid tumors received immune checkpoint inhibitors (ICIs), and showed positive effects of higher vitamin D.

Furthermore, a significant correlation was also observed between vitamin D supplementation and prolonged OS (HR = 0.67, 95% CI 0.47-0.94, P = .022).

Higher vitamin D concentration and supplementation demonstrated improved treatment outcomes to immunotherapy in cancer patients. However, due to limited categories of cancers available, more high-quality studies with multiple cancers and treatment regimens enrolled are warranted before vitamin D supplementation could be administered to further improve the prognosis.

The titles of a few of the references

Prostate cancer immunotherapy: improving clinical outcomes with a multi-pronged approach

Vitamin D in melanoma: controversies and potential role in combination with immune check-point inhibitors

Exploring vitamin D metabolism and function in cancer

Cancer immunotherapy

Immunotherapy in colorectal cancer: rationale, challenges and potential

Immunotherapy approaches for breast cancer patients in 2023

Vitamin D regulates microbiome-dependent cancer immunity


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