Vitamin D Insufficiency Linked to Paclitaxel-Induced Neuropathy

WEDNESDAY, Nov. 8, 2023 (HealthDay News) -- Pretreatment vitamin D insufficiency is associated with an increased incidence of grade ≥3 chemotherapy-induced peripheral neuropathy (CIPN) from paclitaxel, according to a study published in the November issue of the Journal of the National Comprehensive Cancer Network.

Ciao-Sin Chen, Pharm.D., Ph.D., from the University of Michigan College of Pharmacy in Ann Arbor, and colleagues used data and samples from the prospective phase III SWOG S0221 trial that compared paclitaxel-containing chemotherapy regimens for early-stage breast cancer to validate vitamin D insufficiency as a CIPN risk factor. The association between vitamin D insufficiency (≤20 ng/mL) and grade ≥3 sensory CIPN was examined and adjusted for self-reported race, age, body mass index, and paclitaxel schedule.

Overall, 33.3 percent of the 1,191 female participants in the analysis had pretreatment vitamin D insufficiency and 16.4 percent developed grade ≥3 CIPN. The researchers found that the incidence of grade ≥3 CIPN was higher for patients with vitamin D insufficiency versus those with sufficient vitamin D (20.7 versus 14.2 percent; odds ratio, 1.57). After adjustment for age and paclitaxel schedule, the association retained significance (adjusted odds ratio, 1.65), but it did not after adjustment for race. In mouse experiments designed to test the direct effect of vitamin D deficiency, a vitamin D-deficient diet caused mechanical hypersensitivity and sensitized mice to paclitaxel.

"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 authors write.

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