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25-hydroxyvitamin D serum levels in patients with high risk resected melanoma treated in an adjuvant bevacizumab trial

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Lipplaa, Astrid, Fernandes, Ricardo, Marshall, Andrea, Lorigan, Paul, Dunn, Janet A., Myers, Kevin A, Barker, Emily, Newton-Bishop, Julia, Middleton, Mark R. and Corrie, Pippa G. (2018) 25-hydroxyvitamin D serum levels in patients with high risk resected melanoma treated in an adjuvant bevacizumab trial. British Journal of Cancer, 119 . pp. 793-800. doi:10.1038/s41416-018-0179-6

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Official URL: http://doi.org/10.1038/s41416-018-0179-6

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Abstract

Background

Studies evaluating a relationship of vitamin D in patients with primary melanoma have consistently identi fi ed an inverse correlation with Breslow thickness, but an inconsistent impact on survival. Vitamin D in later stages of melanoma has been less studied.

Methods

Vitamin D was measured in serum from 341 patients with resected stage IIB – IIIC melanoma recruited to the AVAST-M adjuvant melanoma randomised trial, collected prior to randomisation, then at 3 and 12 months. Vitamin D levels were compared with patient demographics, known melanoma prognostic factors, disease-free interval (DFI) and overall survival (OS).

Results

A total of 73% patients had stage III melanoma, 32% were enroled (and therefore tested) >1 year after primary melanoma diagnosis. Median pre-randomisation vitamin D level was 56.5 (range 12.6 – 189.0 nmol/L). Vitamin D levels did not signi fi cantly vary over 12 months ( p = 0.24). Individual pre-randomisation vitamin D levels did not differ signi fi cantly for Breslow thickness, tumour ulceration, or disease stage. Neither did pre-randomisation vitamin D predict for DFI (HR = 0.98 per 10 nmol/L increase; 95% con fi dence interval (CI) 0.93 – 1.04, p = 0.59) or OS (HR = 0.96 per 10 nmol/L increase, 95% CI 0.90 – 1.03, p = 0.31). For stage II patients, DFI improved with higher pre-randomisation vitamin D levels for those on bevacizumab (HR = 0.74 per 10 nmol nmol/L increase; 95% CI 0.56 – 0.97), but not for the observation arm (HR = 1.07 per 10 nmol/L increase; 95% CI 0.85 – 1.34).

Conclusions

In this stage II/III melanoma cohort, vitamin D did not correlate with known prognostic markers, nor predict for DFI or OS, but there was some evidence of bene fi t for patients with stage II disease treated with bevacizumab

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Bevacizumab, Melanoma, Clinical trials
Journal or Publication Title: British Journal of Cancer
Publisher: Nature Publishing Group
ISSN: 0007-0920
Official Date: 2 October 2018
Dates:
DateEvent
2 October 2018Published
23 July 2018Available
20 June 2018Accepted
Volume: 119
Page Range: pp. 793-800
DOI: 10.1038/s41416-018-0179-6
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Copyright Holders: The Author(s)
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
C7535/A6408Cancer Research UKhttp://dx.doi.org/10.13039/501100000289
C2195/A8466Cancer Research UKhttp://dx.doi.org/10.13039/501100000289

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