Naunyn Schmiedebergs Arch Pharmacol. 2025 Dec 20. doi: 10.1007/s00210-025-04644-4. Online ahead of print.
ABSTRACT
BACKGROUND: Vitamin D regulates cell growth and differentiation, encourages pro-apoptotic effect, stimulates antiangiogenic effect, and affects both innate and adaptive immunity. However, serum vitamin D level could differ between countries according to geographic, genetic, and dietary factors.
AIM OF THE WORK: Cosidering that most studies of relations between vitamin D level and breast cancer were conducted outside Africa and considering the fact that populations differ in sun exposure, dietary habits, and genetic construction, this study aimed to investigate the relationship between serum levels of vitamin D3 and vitamin D- binding protein (VDBP) with pathological response, clinicopathological characteristics, and various biological markers in Egyptian breast cancer patients undergoing neoadjuvant chemotherapy (NACT).
METHODS: A total of 71 female breast cancer patients (mean age: 57 years) were enrolled in this prospective observational study. Fasting blood samples were collected 1 day before and 3 months after initiation of NACT. Serum levels of vitamin D3 and V DBP were quantified using high-performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA), respectively. Tumor expression of Ki-67, HER2, progesterone receptor (PR), and estrogen receptor (ER) was assessed via immunohistochemistry. Serum levels of CA 15-3 and Bcl-2 were also measured.
RESULTS: Complete pathological response (pCR) was achieved in 44 patients (68.7%). A statistically significant increase in both vitamin D3 and VDBP levels was observed following NACT (p < 0.001). Lower pre- and post-treatment levels of vitamin D3 and VDBP were significantly associated with postmenopausal status, higher tumor grade and stage, triple-negative breast cancer subtype, and high Ki-67 expression (p < 0.001). Conversely, higher levels were significantly associated with achieving pCR (p < 0.001). Both vitamin D3 and VDBP levels demonstrated a significant negative correlation with tumor stage and grade (p < 0.001). Among different clinical and laboratory parameters, only triple-negative subtype and baseline vitamin D were significantly predictive for pCR by multivariable analysis (OR 1.488 and 0.506, respectively) and (95% CI 1.109-1.825 and 0.331-0.75, respectively).
CONCLUSION: Serum levels of vitamin D3 and VDBP significantly increased after NACT and were associated with favorable clinicopathological features and pCR. Only triple-negative subtype and baseline vitamin D were significantly predictive for pCR by multivariable analysis. These findings suggest that vitamin D3 and VDBP may serve as potential prognostic indicators in breast cancer management.
PMID:41420735 | DOI:10.1007/s00210-025-04644-4
