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SUNSHINE: Vitamin D Slows Colon Cancer Progression

Published on 08 June 2017 back to previous

In recent years, observational data have shown that higher plasma levels of vitamin D are associated with improved survival in colorectal cancer patients.

Now, for the first time, a randomized trial has shown that disease progression is slowed with high-dose supplements.

The results, from a phase 2 clinical trial known as SUNSHINE, indicate that a high dose of vitamin D supplementation significantly improved progression-free survival (PFS) by about 2 months compared to a low dose.

The trial was conducted in patients with previously untreated metastatic colorectal cancer. All participants received standard treatment with the mFOLFOX6 chemotherapy regimen (ie, folinic acid [leucovorin], fluorouracil, and oxaliplatin) plus bevacizumab. 

This is the first-ever completed randomized trial of the use of vitamin D as a colorectal cancer therapy, said lead author Kimmie Ng, MD, of the Dana Farber Cancer Institute in Boston, Massachusetts, who presented the study here at the American Society of Clinical Oncology (ASCO) 2017 Annual Meeting.

"Patients seemed to do better on the high-dose vitamin D. I am really excited by the data," she told Medscape Medical News.

"A phase 3 trial is warranted," she added.

Another expert expressed similar enthusiasm about the trial. "The findings from this study are incredibly exciting," said Song Yao, PhD, a molecular epidemiologist at Roswell Park Cancer Institute in Buffalo, New York, who was asked for comment.

He pointed out that at the 2015 ASCO Gastrointestinal Cancers Symposium, the same team showed that in an observational study, patients with higher levels of vitamin D survived longer than those with lower levels. "This new study provides the much-needed evidence-based randomized trial design," he commented.

Another clinician already assesses vitamin D levels in colorectal cancer patients.

"I check vitamin D levels and replete vitamin D when necessary for my patients, but we need more data to know if this should be practice changing," said Allyson Ocean, MD, a gastrointestinal oncologist at Weill Cornell Medicine and New York–Presbyterian Hospital in New York City.

She also told Medscape Medical News that the results are "quite intriguing" and that a phase 3 trial is needed.

Dr Ng reported that in the high-dose group (n = 69), the median PFS, which was the primary endpoint, was 13.1 months, compared with 11.2 months for the low-dose group (n = 70). That translated into a 31% reduced relative risk for disease progression in the high-dose group (unadjusted hazard ratio, 0.69; P = .04).

Read the full article from Medscape here.

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