Impact of vitamin D on pathological complete response and survival following neoadjuvant chemotherapy for breast cancer: a retrospective study

Abstract

BackgroundThere has been interest in the potential benefit of vitamin D (VD) to improve breast cancer outcomes. Pre-clinical studies suggest VD enhances chemotherapy-induced cell death. Vitamin D deficiency was associated with not attaining a pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC) for operable breast cancer. We report the impact of VD on pCR and survival in an expanded cohort.MethodsPatients from Iowa and Montpellier registries who had serum VD level measured before or during NAC were included. Vitamin D deficiency was defined as < 20 ng/mL. Pathological complete response was defined as no residual invasive disease in the breast and lymph nodes. Survival was defined from the date of diagnosis to the date of relapse (PFS) or date of death (OS).ResultsThe study included 327 women. Vitamin D deficiency was associated with the odds of not attaining pCR (p = 0.04). Fifty-four patients relapsed and 52 patients died. In multivariate analysis, stage III disease, triple-negative (TN) subtype and the inability to achieve pCR were independently associated with inferior survival. Vitamin D deficiency was not significantly associated with survival in the overall sample; however a trend was seen in the TN (5-years PFS 60.4% vs. 72.3%, p = 0.3), and in the hormone receptor positive /human epidermal growth factor receptor 2 negative (HER2-) subgroups (5-years PFS 89% vs 78%, p = 0.056).ConclusionVitamin D deficiency is associated with the inability to reach pCR in breast cancer patients undergoing NAC.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4686-x) contains supplementary material, which is available to authorized users.

Inflammatory Blood Markers as Prognostic and Predictive Factors in Early Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

“…Patients treated with neo-adjuvant chemotherapy for early breast cancer in our institution between January 2005 and September 2013 were included in a clinico-pathological database [ 53 , 54 , 55 ]. The database follow-up has been updated and completed until March 2019.…”

Vitamin D in Triple-Negative and BRCA1-Deficient Breast Cancer—Implications for Pathogenesis and Therapy

“…Viala et al, analyzed the level of vitamin D in breast cancer patients after surgery and during or after neoadjuvant chemotherapy [48]. They noted that deficiency in vitamin D (less than 20 ng/mL 25(OH)D in serum) was not associated with survival in the entire studied population of 327 women, but a positive trend was observed in TNBC cases and in the hormone receptor-positive/HER2-negative subgroup.…”

The Significance of Vitamin D Status in Breast Cancer: A State of the Science Review

“…Table presents a current literature review on the association between vitamin D and breast cancer mortality . This review evaluated recent meta‐analyses, prospective cohort studies, and case‐control studies from 2014 to 2018.…”

“…The triple‐negative subtype is a more aggressive cancer with worse disease‐specific outcomes than other breast cancer subtypes because of distinct molecular subtypes that respond differently to chemotherapy and targeted agents . The studies by de Sousa Almeida‐Filho et al in 2016 and Viala et al in 2018 found that vitamin D deficiency and insufficiency in women were significantly associated with triple‐negative breast cancer (Table ) . Furthermore, Viala et al hypothesized that vitamin D deficiency may clinically affect tumor treatment response given the VDR role in proliferation, apoptosis, and angiogenesis …”

“…The studies by de Sousa Almeida‐Filho et al in 2016 and Viala et al in 2018 found that vitamin D deficiency and insufficiency in women were significantly associated with triple‐negative breast cancer (Table ) . Furthermore, Viala et al hypothesized that vitamin D deficiency may clinically affect tumor treatment response given the VDR role in proliferation, apoptosis, and angiogenesis …”