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Vitamin D insufficiency may increase the risk of chemotherapy-induced peripheral neuropathy (CIPN), according to research published in the Journal of the National Comprehensive Cancer Network.
Researchers found that breast cancer patients with vitamin D insufficiency had a higher incidence of grade 3 or higher CIPN after treatment with paclitaxel.
To uncover this finding, the researchers analyzed data from the phase 3 SWOG S0221 trial (ClinicalTrials.gov Identifier: NCT00070564). The trial was designed to compare 6 different dosing schedules of standard doxorubicin plus cyclophosphamide and paclitaxel as adjuvant chemotherapy in patients with early-stage breast cancer.
The study included 1191 patients who had a mean age of 51.1 years. All were women, 83.7% were White, and 52.5% received paclitaxel once every 2 weeks.
A total of 397 patients (33.3%) had pretreatment vitamin D insufficiency, 195 (16.4%) developed grade 3 or higher sensory CIPN, and 204 (17.1%) developed grade 3 or higher sensory or motor CIPN.
In an unadjusted analysis, the risk of CIPN was higher in patients who:
- Had vitamin D insufficiency (odds ratio [OR], 1.57; 95% CI, 1.14-2.15; P =.005)
- Were older (OR, 1.02; 95% CI, 1.01-1.04; P =.005)
- Were Black (vs White, OR, 2.48; 95% CI, 1.57-3.86; P <.001)
- Were a race other than Black or White (OR, 1.84; 95% CI, 1.06-3.07; P =.025)
- Received paclitaxel every 2 weeks (vs weekly, OR, 2.37; 95% CI, 1.73-3.29; P <.001).
When the researchers adjusted for all covariates, the associations remained significant for:
- Older age (adjusted OR [aOR], 1.03; 95% CI, 1.01-1.04; P =.002)
- Black race (aOR, 2.30; 95% CI, 1.39-3.74; P =.001)
- Race other than Black or White (aOR, 1.93; 95% CI, 1.09-3.28; P =.019)
- Receipt of paclitaxel every 2 weeks (aOR, 2.41; 95% CI, 1.74-3.35; P <.001).
In the fully adjusted analysis, the association between pretreatment vitamin D insufficiency and CIPN was no longer significant (aOR, 1.39; 95% CI, 0.98-1.97; P =.066). However, when the researchers adjusted for all covariates except race, the association between vitamin D insufficiency and CIPN was significant (aOR, 1.65; 95% CI, 1.18-2.30; P =.003).
“Vitamin D insufficiency may be a clinically useful biomarker to inform personalized supplementation to reduce CIPN occurrence, improve long-term quality of life, and perhaps enable patients to remain on effective paclitaxel treatment and improve survival,” the researchers concluded.
Disclosures: This research was supported by Amgen, Inc. Please see the original reference for a full list of disclosures.
Reference
Chen CS, Zirpoli G, Barlow WE, et al. Vitamin D insufficiency as a risk factor for paclitaxel-induced peripheral neuropathy in SWOG S0221. J Natl Compr Canc Netw. 2023;21(11):1172-1180.e3. doi:10.6004/jnccn.2023.7062
This article originally appeared on Cancer Therapy Advisor
