Higher Prediagnostic Plasma Vitamin D Levels May Be Associated With Prolonged Survival in Pancreatic Cancer


Key Points

  • Higher plasma vitamin D levels were associated with prolonged survival in patients with pancreatic cancer.
  • Of 30 single-nucleotide polymorphisms, none examined met the significance threshold for association with survival.

In a study reported by Yuan et al in the Journal of Clinical Oncology, higher prediagnostic plasma 25-hydroxyvitamin D [25(OH)D] levels were found to be associated with prolonged overall survival in patients with pancreatic cancer.

Study Details

The study involved data from 493 patients from 5 prospective U.S. cohorts diagnosed with pancreatic cancer from 1984 to 2008. Hazard ratios (HRs) for death were analyzed according to plasma vitamin D levels, with insufficiency defined as < 20 ng/mL, relative insufficiency defined as 20 to 30 ng/mL, and sufficiency defined as > 30 ng/mL, in Cox proportional hazards regression models adjusting for age, cohort, race/ethnicity, smoking, diagnosis year, stage, and blood collection month.

Association With Survival

Overall, the mean prediagnostic plasma level of 25(OH)D was 24.6 ng/mL, with 165 patients (33%) being vitamin D insufficient. Median overall survival was 5 months among patients with insufficiency, 7 months among 212 patients with relative insufficiency, and 8 months among 116 patients with sufficiency.

On multivariate analysis, compared with patients with insufficient vitamin D levels, hazard ratios for death were 0.79 (95% confidence interval [CI] = 0.48–1.29) among those with relative insufficiency (n = 212) and 0.66 (95% CI = 0.49–0.90) among those with sufficiency (P = .01 for trend). The findings were similar after adjustment for body mass index and history of diabetes (HRs = 0.77, 95% CI = 0.46–1.29; and 0.62, 95% CI = 0.44–0.86; P  = .02 for trend). The strongest association was among patients with blood collected within 5 years of diagnosis (HR = 0.58, 95% CI = 0.35–0.98, for sufficiency vs insufficiency).

Evaluation of 30 tagging single-nucleotide polymorphisms in the vitamin D receptor gene showed that none met the significance threshold of P < .002; rs7299460 had the strongest association with survival (HR per minor allele = 0.80, P = .01).

The investigators concluded: “We observed longer overall survival in patients with pancreatic cancer who had sufficient prediagnostic plasma levels of 25(OH)D.”

The study was supported by the National Cancer Institute, Robert T. and Judith B. Hale Fund for Pancreatic Cancer, Perry S. Levy Fund for Gastrointestinal Cancer Research, Pappas Family Research Fund for Pancreatic Cancer, Department of Defense, Lustgarten Foundation, Noble Effort Fund, Peter R. Leavitt Family Fund, and Promises for Purple.

Brian M. Wolpin, MD, MPH, of Dana-Farber Cancer Institute, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.




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