Vitamin D (25-0H D3) status and pathological response to neoadjuvant chemotherapy in stage II/III breast cancer: Data from the NEOZOTAC trial (BOOG 10-01).
Breast. 2015 Nov 21. pii: S0960-9776(15)00230-1. doi: 10.1016/j.breast.2015.10.005. Epub ahead of print
Charehbili A1, Hamdy NA2, Smit VT3, Kessels L4, van Bochove A5, van Laarhoven HW6, Putter H7, Meershoek-Klein Kranenbarg E8, van Leeuwen-Stok AE9, van der Hoeven JJ10, van de Velde CJ8, Nortier JW10, Kroep JR11; Dutch Breast Cancer Research Group (BOOG).
1Leiden University Medical Center, Department of Medical Oncology, The Netherlands; Leiden University Medical Center, Department of Surgery, The Netherlands.
2Leiden University Medical Center, Department of Endocrinology & Metabolic Diseases, The Netherlands.
3Leiden University Medical Center, Department of Pathology, The Netherlands.
4Deventer Ziekenhuis, Department of Clinical Oncology, The Netherlands.
5Zaans Medisch Centrum, Department of Clinical Oncology, The Netherlands.
6Radboud Universiteit Nijmegen/AMC Amsterdam, Department of Medical Oncology, The Netherlands.
7Leiden University Medical Center, Department of Medical Statistics, The Netherlands.
8Leiden University Medical Center, Department of Surgery, The Netherlands.
9Dutch Breast Cancer Research Group (BOOG), The Netherlands.
10Leiden University Medical Center, Department of Medical Oncology, The Netherlands.
11Leiden University Medical Center, Department of Medical Oncology, The Netherlands. Electronic address: j.r.kroep at lumc.nl.
BACKGROUND:
Serum levels of 25-OH vitamin D3 (vitamin D) have been shown to be prognostic for disease-free survival in patients with breast cancer. We investigated the predictive value of these levels for pathological response after neoadjuvant chemotherapy in patients with breast cancer taking part in the NEOZOTAC phase-III trial. Additionally, the effect of chemotherapy on vitamin D levels was studied.
MATERIALS AND METHODS:
Serum vitamin D was measured at baseline and before the last cycle of chemotherapy. The relationship between these measurements and clinical outcome, as defined by pathological complete response in breast and lymph nodes (pCR) was examined.
RESULTS:
Baseline and end of treatment vitamin D data were available in 169 and 91 patients, respectively. Median baseline vitamin D values were 58.0 nmol/L. In patients treated with chemotherapy only, serum vitamin D levels decreased during neoadjuvant chemotherapy (median decrease of 16 nmol/L, P = 0.003). The prevalence of vitamin D levels < 50 nmol/L increased from 38.3% at baseline to 55.9% after chemotherapy. In the total population, baseline and end of therapy vitamin D levels were not related to pathological response. No associations were found between pCR and vitamin D level changes.
CONCLUSION:
The significant decrease in vitamin D post-neoadjuvant chemotherapy suggests that vitamin D levels should be monitored and in case of decrease of vitamin D levels, correction may be beneficial for skeletal health and possibly breast cancer outcome.
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