Vitamin D and Biphosphonate in Neoadjuvant Advanced Breast Cancer

Selma Sakhri

doi:10.31031/ooij.2019.02.000534

Abstract

Vitamin D and calcium deficiency is associated with increased breast cancer risk and decreased breast cancer survival. The purpose of this study is to determine whether the addition of vitD and Zoledronic acid (ZA) to neoadjuvant chemotherapy (NACT) [1,2] gives complete histological responses. We report a prospective evaluation comparing complete pathological response between different biomolecular sub-groups.

Highlights

Preclinical studies support various antitumor effects of vitamin D and Zoledronic acid (Neoazure trial) in breast cancer (BC) such as inhibition of cell proliferation, induction of cell differentiation, promotion of apoptosis, decreasing inflammation with down regulation of cyclooxygenase-2, decreasing of angiogenesis, inhibition of estrogen pathway and inhibition of invasion and metastasis
The higher in the subgroup Her2 / luminal (RH±Her2+) and under Her2+(HR-Her2 +) and the lowest rate was observed in the triple negative group as classified by Sataloff, overall survival was 45.77 months for subgroups (Her2/luminal and in Her2+group) vs 44.11 months for triple negative group
The secondary end point was the overall survival of all patients (N=438), 432 received neoadjuvant chemotherapy+ vitD and zoledronic acid

Summary

Introduction

Preclinical studies support various antitumor effects of vitamin D and Zoledronic acid (Neoazure trial) in breast cancer (BC) such as inhibition of cell proliferation, induction of cell differentiation, promotion of apoptosis, decreasing inflammation with down regulation of cyclooxygenase-2, decreasing of angiogenesis, inhibition of estrogen pathway and inhibition of invasion and metastasis. Due to the increasing concern of the role of vitamin D in the development and prognosis of the BC, it enhances chemotherapy induced cell death by increasing the pathologic complete response (PCR). Because of the intracellular effects on breast cancer cells and the in vitro and in vivo experiments demonstrating enhancement of chemotherapeutic cytotoxicity with vitD pretreatment, we hypothesized that low vitD levels would be associated with impaired response to chemotherapy and more aggressive breast tumor biology resulting in higher relapse rates among women with vitD deficiency (Figure 1 & 2)

Objectives

Methods

Conclusion