Vitamin D status in patients with stage IV colorectal cancer: Findings from intergroup trial N9741

Kimmie Ng, Daniel J. Sargent, Richard M. Goldberg, Jeffrey A. Meyerhardt, Erin M. Green, Henry Clement Pitot, Bruce W. Hollis, Michael N. Pollak, Charles S. Fuchs

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Purpose Previous studies have suggested that higher plasma 25-hydroxyvitamin D3 [25(OH)D] levels are associated with decreased colorectal cancer risk and improved survival, but the prevalence of vitamin D deficiency in advanced colorectal cancer and its influence on outcomes are unknown. Patients and Methods We prospectively measured plasma 25(OH)D levels in 515 patients with stage IV colorectal cancer participating in a randomized trial of chemotherapy. Vitamin D deficiency was defined as 25(OH)D lower than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as ≥ 30 ng/mL. We examined the association between baseline 25(OH)D level and selected patient characteristics. Cox proportional hazards models were used to calculate hazard ratios (HR) for death, disease progression, and tumor response, adjusted for prognostic factors. Results Among 515 eligible patients, 50% of the study population was vitamin D deficient, and 82% were vitamin D insufficient. Plasma 25(OH)D levels were lower in black patients compared to white patients and patients of other race (median, 10.7 v 21.1 v 19.3 ng/mL, respectively; P < .001), and females compared to males (median, 18.3 v 21.7 ng/mL, respectively; P = .0005). Baseline plasma 25(OH)D levels were not associated with patient outcome, although given the distribution of plasma levels in this cohort, statistical power for survival analyses were limited. Conclusion Vitamin D deficiency is highly prevalent among patients with stage IV colorectal cancer receiving first-line chemotherapy, particularly in black and female patients.

Original languageEnglish (US)
Pages (from-to)1599-1606
Number of pages8
JournalJournal of Clinical Oncology
Volume29
Issue number12
DOIs
StatePublished - Apr 20 2011

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Vitamin D
Colorectal Neoplasms
Vitamin D Deficiency
Calcifediol
Drug Therapy
Survival Analysis
Proportional Hazards Models
Disease Progression
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ng, K., Sargent, D. J., Goldberg, R. M., Meyerhardt, J. A., Green, E. M., Pitot, H. C., ... Fuchs, C. S. (2011). Vitamin D status in patients with stage IV colorectal cancer: Findings from intergroup trial N9741. Journal of Clinical Oncology, 29(12), 1599-1606. https://doi.org/10.1200/JCO.2010.31.7255

Vitamin D status in patients with stage IV colorectal cancer : Findings from intergroup trial N9741. / Ng, Kimmie; Sargent, Daniel J.; Goldberg, Richard M.; Meyerhardt, Jeffrey A.; Green, Erin M.; Pitot, Henry Clement; Hollis, Bruce W.; Pollak, Michael N.; Fuchs, Charles S.

In: Journal of Clinical Oncology, Vol. 29, No. 12, 20.04.2011, p. 1599-1606.

Research output: Contribution to journalArticle

Ng, K, Sargent, DJ, Goldberg, RM, Meyerhardt, JA, Green, EM, Pitot, HC, Hollis, BW, Pollak, MN & Fuchs, CS 2011, 'Vitamin D status in patients with stage IV colorectal cancer: Findings from intergroup trial N9741', Journal of Clinical Oncology, vol. 29, no. 12, pp. 1599-1606. https://doi.org/10.1200/JCO.2010.31.7255
Ng, Kimmie ; Sargent, Daniel J. ; Goldberg, Richard M. ; Meyerhardt, Jeffrey A. ; Green, Erin M. ; Pitot, Henry Clement ; Hollis, Bruce W. ; Pollak, Michael N. ; Fuchs, Charles S. / Vitamin D status in patients with stage IV colorectal cancer : Findings from intergroup trial N9741. In: Journal of Clinical Oncology. 2011 ; Vol. 29, No. 12. pp. 1599-1606.
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T2 - Findings from intergroup trial N9741

AU - Ng, Kimmie

AU - Sargent, Daniel J.

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AU - Meyerhardt, Jeffrey A.

AU - Green, Erin M.

AU - Pitot, Henry Clement

AU - Hollis, Bruce W.

AU - Pollak, Michael N.

AU - Fuchs, Charles S.

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N2 - Purpose Previous studies have suggested that higher plasma 25-hydroxyvitamin D3 [25(OH)D] levels are associated with decreased colorectal cancer risk and improved survival, but the prevalence of vitamin D deficiency in advanced colorectal cancer and its influence on outcomes are unknown. Patients and Methods We prospectively measured plasma 25(OH)D levels in 515 patients with stage IV colorectal cancer participating in a randomized trial of chemotherapy. Vitamin D deficiency was defined as 25(OH)D lower than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as ≥ 30 ng/mL. We examined the association between baseline 25(OH)D level and selected patient characteristics. Cox proportional hazards models were used to calculate hazard ratios (HR) for death, disease progression, and tumor response, adjusted for prognostic factors. Results Among 515 eligible patients, 50% of the study population was vitamin D deficient, and 82% were vitamin D insufficient. Plasma 25(OH)D levels were lower in black patients compared to white patients and patients of other race (median, 10.7 v 21.1 v 19.3 ng/mL, respectively; P < .001), and females compared to males (median, 18.3 v 21.7 ng/mL, respectively; P = .0005). Baseline plasma 25(OH)D levels were not associated with patient outcome, although given the distribution of plasma levels in this cohort, statistical power for survival analyses were limited. Conclusion Vitamin D deficiency is highly prevalent among patients with stage IV colorectal cancer receiving first-line chemotherapy, particularly in black and female patients.

AB - Purpose Previous studies have suggested that higher plasma 25-hydroxyvitamin D3 [25(OH)D] levels are associated with decreased colorectal cancer risk and improved survival, but the prevalence of vitamin D deficiency in advanced colorectal cancer and its influence on outcomes are unknown. Patients and Methods We prospectively measured plasma 25(OH)D levels in 515 patients with stage IV colorectal cancer participating in a randomized trial of chemotherapy. Vitamin D deficiency was defined as 25(OH)D lower than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as ≥ 30 ng/mL. We examined the association between baseline 25(OH)D level and selected patient characteristics. Cox proportional hazards models were used to calculate hazard ratios (HR) for death, disease progression, and tumor response, adjusted for prognostic factors. Results Among 515 eligible patients, 50% of the study population was vitamin D deficient, and 82% were vitamin D insufficient. Plasma 25(OH)D levels were lower in black patients compared to white patients and patients of other race (median, 10.7 v 21.1 v 19.3 ng/mL, respectively; P < .001), and females compared to males (median, 18.3 v 21.7 ng/mL, respectively; P = .0005). Baseline plasma 25(OH)D levels were not associated with patient outcome, although given the distribution of plasma levels in this cohort, statistical power for survival analyses were limited. Conclusion Vitamin D deficiency is highly prevalent among patients with stage IV colorectal cancer receiving first-line chemotherapy, particularly in black and female patients.

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