Publication: Vitamin D Supplementation and Survival of Patients with Non–small Cell Lung Cancer: A Randomized, Double-Blind, Placebo-Controlled Trial
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| Title | Vitamin D Supplementation and Survival of Patients with Non–small Cell Lung Cancer: A Randomized, Double-Blind, Placebo-Controlled Trial |
| Topic | Vitamin D |
| Author | Akiba, T, Morikawa, T, Odaka, M, Nakada, T, Kamiya, N, Yamashita, M, Yabe, M, Inagaki, T, Asano, H, Mori, S, Tsukamoto, Y, Urashima, M |
| Year | 2018 |
| Journal | Clinical Cancer Research |
| DOI | https://doi.org/10.1158/1078-0432.CCR-18-0483 |
Author's Abstract The abstract and the information and conclusions contained therein were written by the authors of the publication.
| Purpose: Higher serum 25-hydroxyvitamin D (25(OH) D) levels are reportedly associated with better survival in early-stage non–small cell lung cancer (NSCLC). There- fore, whether vitamin D supplementation can improve the prognosis of patients with NSCLC was examined (UMIN000001869).
Patients and Methods: A randomized, double-blind trial comparing vitamin D supplements (1,200 IU/day) with placebo for 1 year after operation was conducted. The primary and secondary outcomes were relapse-free survival (RFS) and overall survival (OS), respectively. Prespecified subgroup analyses were performed with stratification by stage (early vs. advanced), pathology (adenocarcinoma vs. others), and 25(OH)D levels (low, <20 ng/mL vs. high, ≥20 ng/mL). Polymorphisms of vitamin D receptor (VDR) and vitamin D–binding protein (DBP) and survival were also examined. Results: Patients with NSCLC (n = 155) were randomly assigned to receive vitamin D (n = 77) or placebo (n = 78) and followed for a median of 3.3 years. Relapse and death occurred in 40 (28%) and 24 (17%) patients, respectively. In the total study population, no significant difference in either RFS or OS was seen with vitamin D compared with the placebo group. However, by restricting the analysis to the subgroup with early- stage adenocarcinoma with low 25(OH)D, the vitamin D group showed significantly better 5-year RFS (86% vs. 50%, P = 0.04) and OS (91% vs. 48%, P = 0.02) than the placebo group. Among the examined polymorphisms, DBP1 (rs7041) TT and CDX2 (rs11568820) AA/AG genotypes were markers of better prognosis, even with multivariate adjustment. Conclusions: In patients with NSCLC, vitamin D supplementation may improve survival of patients with early-stage lung adenocarcinoma with lower 25(OH)D levels. |
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