Impact of serum vitamin D on the response and prognosis in breast cancer patients treated with neoadjuvant chemotherapy

Eriko Tokunaga,Wakako Tajiri,Yumiko Koi,Hideki Ijichi,Chinami Koga,Kenichi Taguchi,Yoshiaki Nakamura,Takanobu Masuda,Shinji Ohno,Masahiro Okamoto

doi:10.1007/s12282-021-01292-3

Abstract

BackgroundSeveral studies have recently reported that the relationships between serum vitamin D and the prognosis or the pathological response to neoadjuvant chemotherapy (NAC) in breast cancer. However, there are no data regarding the clinical impacts of the vitamin D in Japanese breast cancer patients so far.Patients and methodsIn the present study, a total of 250 patients with clinical Stage I–III primary breast cancer who were treated with NAC and subsequently underwent definitive surgery were included. Serum 25-hydroxvitamin D (25(OH)D) levels were evaluated using blood samples obtained before NAC.ResultsThe serum 25(OH)D was positively associated with age, and the serum 25(OH)D was significantly higher in postmenopausal women than that in pre/peri-menopausal women. Serum 25(OH)D level was not associated with the achievement of pathological complete response (pCR) in this cohort. The low 25(OH)D levels were significantly associated with shorter time to distant recurrence (TTDR). According to the univariate analysis, high clinical stage before NAC (cStage III) and low serum 25(OH)D level were significantly associated with the shorter TTDR, and pCR was significantly associated with the longer TTDR. According to a multivariate analysis, low serum 25(OH)D level were independent poor prognostic factors for TTDR.ConclusionsThe low 25(OH)D levels were significantly associated with poorer prognosis in Japanese women with operable breast cancer patients treated with NAC.

Highlights

Vitamin D is a fat-soluble secosteroid with well-established effects on calcium homeostasis, and it is the precursor to the potent steroid hormone calcitriol [1, 2]
We examined the relationships between the serum vitamin D (25(OH)D) levels and the pathological responses to neoadjuvant chemotherapy (NAC) and the subsequent prognosis in Japanese women with operable breast cancer
There were no significant associations between the serum 25(OH)D levels and the pathological complete response (pCR) rate after NAC, the low serum 25(OH)D was significantly associated with the poor prognosis

Summary

Introduction

Vitamin D is a fat-soluble secosteroid with well-established effects on calcium homeostasis, and it is the precursor to the potent steroid hormone calcitriol [1, 2]. Pathological complete response (pCR) is associated with improved prognosis. This association appears stronger in the HER2+ /hormone receptor (HR)—or TNBC subtype [13, 14]. A statistically significant association between 25(OH)D level at baseline and pCR in patients with receiving NAC has been reported [15, 16]. Other studies reported that there was no effect of serum 25(OH) D levels on the pathologic complete response (pCR) in neoadjuvant settings [17,18,19]. There are few studies on the association between serum vitamin D levels and the clinicopathological features and the prognosis of the Japanese women with breast cancer. Serum 25(OH)D levels were defined as ‘sufficient’ if serum 25(OH)D ≥ 20 ng/mL and ‘insufficient’ if serum 25(OH)D < 20 ng/mL [2, 19]

Patients and methods

Results

Discussion