Department of Medical Oncology, ICM Val d'Aurelle, Montpellier University, F-34298 Montpellier, France.
Institut de Recherche en Cancérologie de Montpellier (IRCM) INSERM U1194, F-34298 Montpellier, France.
Nutrients. 2021 Dec 10;13(12):4429. doi: 10.3390/nu13124429.
Breast cancer (BC) treatments induce vitamin D (VD) insufficiency and bone metabolism changes, resulting in osteoporosis and skeletal morbidity risk. We report the results of a bicentric phase II trial (ClinicalTrials.gov Identifier: NCT04091178) on the safety and efficacy of high-dose oral VD supplementation for VD deficiency correction in 44 patients with early BC treated with adjuvant chemotherapies. Patients received one dose of 100,000 IU 25-OH VD every 3 weeks from day 1 of cycle 1 to day 1 of cycle 5. The primary endpoint was the percentage of patients achieving serum 25-OH VD concentration normalization on day 1 of cycle 6 (D1C6). Secondary endpoints were safety, VD and calcium parameters at baseline and during chemotherapy, and identification of predictive biomarkers of VD normalization on D1C6. On D1C6, 21 patients (47.7%, 95% CI: 33.0-62.8) achieved VD normalization. No VD-related clinical toxicity was reported. However, 13 patients (29.5%) presented asymptomatic grade 1 hypercalciuria, leading to interruption of the high-dose oral VD supplementation in 10, followed by a rapid reduction in serum VD concentration. No baseline clinical factor was predictive of VD normalization on D1C6. This high-dose VD supplementation appears safe and efficient in patients with early BC receiving adjuvant chemotherapy.
乳腺癌(BC)治疗会导致维生素 D(VD)不足和骨代谢变化,从而导致骨质疏松症和骨骼发病率风险增加。我们报告了一项关于在接受辅助化疗的早期 BC 患者中纠正 VD 缺乏症的高剂量口服 VD 补充剂的安全性和有效性的双中心 II 期试验(ClinicalTrials.gov 标识符:NCT04091178)的结果。患者在第 1 周期的第 1 天至第 5 周期的第 1 天,每 3 周接受一次 100,000IU 25-OH VD 剂量。主要终点是第 6 周期第 1 天(D1C6)时达到血清 25-OH VD 浓度正常化的患者百分比。次要终点是安全性、基线和化疗期间的 VD 和钙参数,以及鉴定 D1C6 时 VD 正常化的预测生物标志物。在 D1C6 时,21 名患者(47.7%,95%CI:33.0-62.8)达到了 VD 正常化。没有报告与 VD 相关的临床毒性。然而,13 名患者(29.5%)出现无症状的 1 级高钙尿症,导致 10 名患者中断了高剂量口服 VD 补充剂,随后血清 VD 浓度迅速下降。没有基线临床因素可预测 D1C6 时的 VD 正常化。这种高剂量 VD 补充剂在接受辅助化疗的早期 BC 患者中似乎是安全有效的。