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. 2021 Jul 15;21(1):815.
doi: 10.1186/s12885-021-08563-4.

Changes in vitamin D and calcium metabolism markers in patients undergoing adjuvant chemotherapy for breast cancer

Marie Viala  1 , Nelly Firmin  2   3 , Célia Touraine  4 , Stéphane Pouderoux  2 , Manon Metge  5 , Lobna Rifai  6 , Gilles Romieu  2 , Hélène de Forges  7 , Lise Roca  4 , Séverine Guiu  2   3 , Véronique D'Hondt  2   3 , William Jacot  2   3
Affiliations

Changes in vitamin D and calcium metabolism markers in patients undergoing adjuvant chemotherapy for breast cancer

Marie Viala et al. BMC Cancer. .

Abstract

Background: Changes in calcium metabolism and calcium urinary excretion during chemotherapy have not been thoroughly assessed in patients with early breast cancer (EBC), a population who frequently present vitamin D insufficiency. As hypercalciuria is a classical contra-indication to vitamin D (VD) supplementation, this study evaluated changes in VD and calcium metabolism parameters in patients with EBC undergoing adjuvant chemotherapy (CT).

Methods: In patients with EBC who received six cycles of adjuvant CT, VD and calcium parameters were monitored at inclusion, and then every 3 weeks, at each CT cycle initiation. The primary endpoint was the percentage of patients showing hypercalciuria during adjuvant CT (between Day 1, Cycle 1 [D1C1] and Day 1, Cycle 6 [D1C6]).

Results: The primary endpoint could be evaluated in 82 patients. Most patients (n = 66, 80.5%) had VD insufficiency (< 30 ng/mL) at baseline. Hypercalciuria was detected in 29 patients (35.4%; 95% CI: 25.6-46.5) between D1C1 and D1C6, but was not clinically significant in any of the affected patients. The percentage of hypercalciuria events was not different between patients with sufficient and insufficient baseline VD levels (34.8% vs. 37.5%), and between patients who received or not VD supplementation (37.5% vs. 34.5%,).

Conclusions: This comprehensive study on VD and calcium parameter changes in patients with EBC during adjuvant chemotherapy shows that hypercalciuria is a frequent abnormality in this setting, although asymptomatic. Therefore, it should not be considered as a limitation for high dose VD supplementation in this population.

Trial registration: EudraCT:2014-A01454-43 . Registered 29 august 2016.

Keywords: Adjuvant chemotherapy; Breast cancer; Hypercalciuria; Vitamin D deficiency.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Cumulative number (A and C) and percentage (B and D) of patients with EBS with at least one occurrence of hypercalciuria during chemotherapy. In A and B, patients were divided in two groups (vitamin D sufficient, n = 16, and insufficient, n = 66) using the baseline serum vitamin D level cut-off of 30 ng/mL (75 nmol/L). C and D present the same data for the whole population (n = 82)
Fig. 2
Fig. 2
PTH (A), calcium (B) and phosphorus (C) levels changes during chemotherapy according to the serum baseline vitamin D concentration. Patients were divided in two groups (vitamin D sufficient, n = 16, and insufficient, n = 66) using the baseline serum vitamin D level cut-off of 30 ng/mL (75 nmol/L)
Fig. 3
Fig. 3
Predicted (solid lines) and observed (dashed lines) vitamin D serum concentration during chemotherapy. Patients were divided in two groups: vitamin D sufficient (n = 16, black lines) and insufficient (n = 66, grey lines) using the baseline serum vitamin D level cut-off of 30 ng/mL (75 nmol/L)
See this image and copyright information in PMC

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