25-Hydroxyvitamin D levels and survival in advanced pancreatic cancer: findings from CALGB 80303 (Alliance).

Abstract

BACKGROUND:

Data from animal and cell-line models suggest that vitamin D metabolism plays an important role in pancreatic tumor behavior. Although vitamin D deficiency has been implicated in numerous cancers, the vitamin D status of patients with advanced pancreatic cancer and the effect of baseline vitamin D levels on survival are unknown.

METHODS:

Participants in this correlative study (CALGB 151006) were enrolled in CALGB 80303, which was a randomized trial of patients with advanced pancreatic cancer that demonstrated no difference in overall survival (OS) among patients treated with gemcitabine plus placebo vs gemcitabine plus bevacizumab. We measured baseline serum 25-hydroxyvitamin D (25[OH]D) levels and examined associations between baseline 25(OH)D levels and progression-free survival and OS using the Cox rank score test. All statistical tests were two-sided.

RESULTS:

Of 256 patients with available serum, the median 25(OH)D level was 21.7ng/mL (range 4 to 77). 44.5% of patients were vitamin D deficient (25[OH]D <20ng/mL), and 32.4% were insufficient (25[OH]D ≥20 and <30ng/mL). 25(OH)D levels were lower in black patients compared with white patients, and patients of other/undisclosed race (10.7 vs 22.4 vs 20.9ng/mL, P < .001). Baseline 25(OH)D levels were not associated with PFS (HR = 1.00, 95% CI = 0.99 to 1.01, P = .60) or OS (HR = 1.00, 95% CI = 0.99 to 1.01, P = .95).

CONCLUSION:

Vitamin D deficiency was highly prevalent among patients with a new diagnosis of advanced pancreatic cancer. Black patients had statistically significantly lower 25(OH)D levels than white patients. In this cohort of patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy, baseline 25(OH)D levels were not associated with PFS or OS.

• Authors: Katherine Van Loon, Kouros Owzar, Chen Jiang, Hedy L Kindler, Mary F Mulcahy, Donna Niedzwiecki, Eileen M O'Reilly, Charles Fuchs, Federico Innocenti, Alan P Venook, Alliance for Clinical Trials in Oncology
• Journal: Journal of the National Cancer Institute (J Natl Cancer Inst) Vol. 106 Issue 8 (Aug 2014) ISSN: 1460-2105 [Electronic] United States
• PMID: 25099612 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
• Copyright: © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: [email protected].

Chemical References

• Antibodies, Monoclonal, Humanized
• Deoxycytidine
• Vitamin D
• Bevacizumab
• 25-hydroxyvitamin D
• Gemcitabine

Topics

• Adult
• Black or African American (statistics & numerical data)
• Aged
• Antibodies, Monoclonal, Humanized (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bevacizumab
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Disease-Free Survival
• Female
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Pancreatic Neoplasms (blood, complications, drug therapy, mortality, pathology)
• Prevalence
• Randomized Controlled Trials as Topic
• United States (epidemiology)
• Vitamin D (analogs & derivatives, blood)
• Vitamin D Deficiency (blood, complications, epidemiology)
• White People (statistics & numerical data)
• Gemcitabine