High prevalence of severe hypovitaminosis D in patients with advanced gastric cancer treated with first-line chemotherapy with or without anti-EGFR-directed monoclonal antibody (EXPAND trial) showing no prognostic impact
Language English Country England, Great Britain Media print-electronic
Document type Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
PubMed
31195354
DOI
10.1016/j.ejca.2019.05.011
PII: S0959-8049(19)30314-4
Knihovny.cz E-resources
- Keywords
- 25-OHD plasma levels, Chemotherapy cetuximab, Gastric cancer, Prognosis, Vitamin D,
- MeSH
- Adenocarcinoma blood drug therapy mortality MeSH
- Capecitabine therapeutic use MeSH
- Cetuximab therapeutic use MeSH
- Cisplatin therapeutic use MeSH
- ErbB Receptors antagonists & inhibitors MeSH
- Antibodies, Monoclonal, Humanized therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Stomach Neoplasms blood drug therapy mortality MeSH
- Vitamin D Deficiency epidemiology MeSH
- Prevalence MeSH
- Prognosis MeSH
- Antineoplastic Combined Chemotherapy Protocols therapeutic use MeSH
- Aged MeSH
- Vitamin D blood MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial, Phase III MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Names of Substances
- Capecitabine MeSH
- Cetuximab MeSH
- Cisplatin MeSH
- EGFR protein, human MeSH Browser
- ErbB Receptors MeSH
- Antibodies, Monoclonal, Humanized MeSH
- Vitamin D MeSH
PURPOSE: The goal of our analysis was to study pretherapeutic circulating 25-OHD plasma levels in patients with previously untreated advanced gastric cancer treated in the randomised controlled phase III Erbitux (cetuximab) in combination with Xeloda (capecitabine) and cisplatin in advanced esophago-gastric cancer (EXPAND) trial (NCT00678535) and to explore whether low 25-OHD plasma levels are associated with worse prognosis and may compromise the clinical efficacy of cetuximab. METHODS: Six hundred thirty patients with available pretherapeutic 25-OHD plasma levels and treated with chemotherapy based on capecitabine and cisplatin, or chemotherapy and cetuximab, were included. The Cox proportional hazard regression model was used to analyse the association between low 25-OHD and survival in both treatment arms. RESULTS: Majority of study patients were found to have severe vitamin D deficiency. No prognostic impact of 25-OHD plasma levels could be found in our patient cohort, and there was no indication of an interference of 25-OHD plasma levels and the efficacy of treatment with the anti-epidermal growth factor receptor monoclonal antibody cetuximab. CONCLUSIONS: Although majority of patients with advanced gastric cancer show hypovitaminosis D deficiency, there is no proof for a negative impact on survival or reduced treatment response. A prospective study is needed to investigate the potential benefit of vitamin D supplementation in this patient cohort during first-line chemotherapy.
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