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Patients With Advanced Melanoma May Benefit From Vitamin D Maintenance

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"The analysis showed a statistically significant, positive effect of normal serum vitamin D levels on increasing ORR and PFS as a result of anti-PD‐1 immunotherapy in patients with locally advanced inoperable or metastatic melanoma,” according to a recent study.

Maintaining normal levels of vitamin D “should be a standard procedure allowing the improvement of treatment outcomes” for patients with advanced melanoma who are receiving anti-PD-1 immunotherapy, according to the research team behind a recent study.1

Forgem/Adobe Stock
Forgem/Adobe Stock

Among the study’s 200 participants with inoperable, locally advanced or metastatic melanoma who all received anti-PD-1 immunotherapy via Opdivo (nivolumab) or Keytruda (pembrolizumab), the objective response rate (ORR) among patients with low vitamin D levels which were not supplemented was 36.2%, while the response rate was 56% for patients with either normal baseline levels of vitamin D or those who obtained normal levels via supplementation, according to the study.

The study—which was conducted by a team of Polish researchers and the results of which were published in the journal Cancer—also found that patients with normal vitamin D levels had a median progression-free survival (PFS, the time a patient lives without the disease spreading or becoming worse) of 11.25 months, nearly double the duration of the 5.75-month median PFS among patients with low levels of vitamin D.

In a less stark contrast, the group of participants with normal levels of vitamin D saw an overall survival (OS, the time following treatment when a patient is still alive) of 31.5 months, compared to an OS of 27 months for patients with low levels of vitamin D.

Study participants’ serum vitamin D levels were measured prior to treatment, and every 12 weeks during treatment, the authors noted.

“The analysis showed a statistically significant, positive effect of normal serum vitamin D levels on increasing ORR and PFS as a result of anti-PD‐1 immunotherapy in patients with locally advanced inoperable or metastatic melanoma,” the authors wrote, concluding in that in their opinion, “assessment of vitamin D levels and appropriate vitamin D supplementation should be considered in every patient qualified for treatment with pat-PD-1 immunotherapy.”

Individuals’ daily vitamin D needs depends on their age, according to the National Institutes of Health’s Office of Dietary Supplements, with average daily recommended amounts of 10 micrograms from birth to 12 months, 15 micrograms for ages 1 through 70 as well as pregnant and breastfeeding people, and 20 micrograms for adults ages 71 and older.

Nearly 25% of people “have vitamin D blood levels that are too low or inadequate for bone and overall health,” according to the NIH.

Vitamin D3, the NIH explained on its website, is one of two forms of vitamin D found in supplements, and it may raise levels of vitamin D higher and for longer than vitamin D2.

The authors of the Cancer study noted that effects of vitamin D3, also known as cholecalciferol, include modulating the functions of the immune system and potentially affecting the effectiveness of anti-PD-1 treatments – which, as explained by the American Cancer Society on its website, are immune checkpoint inhibitor which help the body’s immune system find and attack cancer cells.

Reference

  1. Galus Ł, Michalak M, Lorenz M, et al. Vitamin D supplementation increases objective response rate and prolongs progression‐free time in patients with advanced melanoma undergoing anti–PD‐1 therapy. Cancer. 2023;129(13):2047-2055. doi:10.1002/cncr.34718

[This article was originally published by our sister publication, Cure.]

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