Vitamin D Supplementation Improves Pathological Complete Response in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Randomized Clinical Trial
Nutr Cancer. 2025 Mar 17:1-10. doi: 10.1080/01635581.2025.2480854 PDF is behind paywall
Michelle Sako Omodei 1, Jackeline Chimicoviaki 1, Daniel Araujo Brito Buttros 1, Benedito Souza Almeida-Filho 2, Carla Priscila Carvalho-Pessoa 2, Eduardo Carvalho-Pessoa 1 2, Heloisa De Luca Vespoli 1 2, Eliana Aguiar Petri Nahas 1 2
This study aimed to evaluate the effect of vitamin D (VD) supplementation on the pathological complete response (pCR) rate in women with breast cancer (BC) undergoing neoadjuvant chemotherapy (NCT). A randomized clinical trial was conducted with 80 women aged ≥45years with BC who were eligible for NCT. Women were randomized into two groups: VD group, daily supplementation with 2,000IU of cholecalciferol (n = 40) or placebo (n = 40), for 6 months. The primary outcome measure was the pCR rate. Serum 25-hydroxyvitamin-D [25(OH)D] levels were measured after BC diagnosis and the end of NCT. Of the 80 randomized women, 75 completed the NCT and underwent surgery. Baseline 25(OH)D values indicated hypovitaminosis D in both groups (VD: 19.6 ± 5.8 ng/mL and placebo: 21 ± 7.9 ng/mL, p = 0.33). After 6 months, 25(OH)D levels increased in the VD group compared to the placebo group (28 ± 8.7 vs. 20.2 ± 6.1 ng/mL, p = 0.03). The pCR rate was higher in women supplemented with VD when compared than the placebo (43% vs. 24%, p = 0.04).
Adjusted logistic regression showed that women with 25(OH)D levels ≥20ng/mL were more likely to achieve pCR (OR 3.65, 95%CI 1.09-12.8, p = 0.04). Women with BC undergoing NCT who received supplementation with 2,000IU of VD were more likely to achieve a pathological complete response than women in the placebo group.
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Anticipate even better long-term survival if any of 4 changes:
- Started the vitamin D months before the surgery
- Used a larger daily dose of vitamin D
- Had used a loading dose to raise the vitamin D levels in weeks, not months
- Had used a loading dose of vitamin D before the subsequent surgery
Large dose Vitamin D before surgery was found to help by 35 studies
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- Half of Breast Cancer patients opt for vitamin D (German survey) – Jan 2021
- 85 percent less risk of death from Breast Cancer when vitamin D levels higher than 30 ng – May 2012
- Breast Cancer chemotherapy 2.7 X more likely to be successful if not vitamin D deficient – Dec 2017
- Chemotherapy and vitamin D - many studies
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