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According to a new study led by researchers at Dana-Farber Cancer Institute, clinical trial patients with metastatic colorectal cancer who had high levels of vitamin D in their bloodstream prior to treatment with chemotherapy and targeted drugs, survived longer, on average, than patients with lower levels of the vitamin. Those findings were reported today at the 2015 American Society of Cancer Oncology (ASCO) Gastrointestinal Cancers Symposium in San Francisco.
The research, based on data from more than 1,000 patients with metastatic colorectal cancer who enrolled in a phase 3 clinical trial of chemotherapy plus biologic therapies, adds to vitamin D’s already impressive luster as a potential cancer-inhibiting agent. In the study, patients with the highest blood levels of vitamin D survived for a median period of 32.6 months, compared to 24.5 months for those with the lowest levels.
“This is the largest study that has been undertaken of metastatic colorectal cancer patients and vitamin D,” said the study’s lead author, Kimmie Ng, MD, MPH, a medical oncologist in the Gastrointestinal Cancer Treatment Center at Dana-Farber. “It’s further supportive of the potential benefits of maintaining sufficient levels of vitamin D in improving patient survival times.”
The study didn’t examine whether there is a biological cause-and-effect relationship between higher vitamin D levels and extended survival. As a result, researchers said, it’s too early to recommend vitamin D as a treatment for colon cancer. Ng and colleagues at Dana-Farber are conducting clinical trials to further investigate whether vitamin D supplementation is useful in treating the cancer.
In the study, researchers measured blood levels of 25-hydroxyvitamin D, a substance produced in the liver from vitamin D, in 1,043 patients when they enrolled in a phase 3 trial of three different drug combinations for newly diagnosed, advanced colorectal cancer. Patient vitamin D levels ranged from an average of 8 nanograms/milliliter (ng/mL) in the lowest group to an average of 27.5 ng/mL in the highest group. The average level in all the patients was 17.2 ng/mL. Current practice guidelines from the Endocrine Society define vitamin D deficiency as having less than 20 ng/mL.
Researchers divided the patients into five groups based on vitamin D levels. On average, those with the highest levels survived 33 percent longer than those with the lowest (32.6 months vs. 24.5 months). Higher vitamin D levels were also associated with longer time to disease progression (12.2 months vs. 10.1 months).
Because high vitamin D levels can be a reflection of a healthy lifestyle (good nutrition, plenty of outdoor physical activity), researchers controlled for factors such as diet, obesity, and level of physical activity. Even then, the relationship between elevated vitamin D levels and extended survival held firm, Ng observed.
The research was supported by grants from the National Cancer Institute of the National Institutes of Health (K07 CA148894, R01 CA149222, CA31946, CA33601).
The senior author of the study is Jeffrey Meyerhardt, MD, MPH, of Dana-Farber. Co-authors are Kaori Sato, MS, Robert J. Mayer, MD, and Charles S. Fuchs, MD, MPH, of Dana-Farber; Alan Venook, MD, of the University of California at San Francisco; Bruce Hollis, PhD, of the Medical University of South Carolina; Donna Niedzwiecki, PhD, and Cynthia Ye, PhD, of Duke University; I-Wen Chang, MD, of Wayne Memorial Hospital, Goldsboro, N.C.; Bert O’Neil, MD, of Indiana University Hospital; Federico Innocenti, MD, PhD, of the University of North Carolina; Heinz-Josef Lenz, MD, of the University of Southern California; and Charles Blanke, MD, of Oregon Health and Science University.