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De Smedt J, Van Kelst S, Janssen L, Marasigan V, Boecxstaens V, Bogaerts K, Belmans A, Vanderschueren D, Vandenberghe K, Bechter O, Aura C, Lambrechts D, Strobbe T, Emri G, Nikkels A, Garmyn M. High-dose vitamin D supplementation does not improve outcome in a cutaneous melanoma population: results of a randomized double-blind placebo-controlled study (ViDMe trial). Br J Dermatol 2024; 191:886-896. [PMID: 38913652 DOI: 10.1093/bjd/ljae257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Observational studies in cutaneous melanoma (CM) have indicated an inverse relationship between levels of 25-hydroxyvitamin D and Breslow thickness, in addition to a protective effect of high 25-hydroxyvitamin D levels on clinical outcome. OBJECTIVES To evaluate whether high-dose vitamin D supplementation in curatively resected CM reduces melanoma relapse. METHODS In a prospective randomized double-blind placebo-controlled trial, 436 patients with resected CM stage IA to III (8th American Joint Committee on Cancer staging) were randomized. Among them, 218 received a placebo while 218 received monthly 100 000 IU cholecalciferol for a minimum of 6 months and a maximum of 42 months (treatment arm). Following randomization, patients were followed for a median of 52 months, with a maximum follow-up of 116 months. The primary endpoint was relapse-free survival. Secondary endpoints were melanoma-related mortality, overall survival, and the evolution of 25-hydroxyvitamin D serum levels over time. RESULTS In our population (mean age 55 years, 54% female sex) vitamin D supplementation increased 25-hydroxyvitamin D serum levels after 6 months of supplementation in the treatment arm by a median 17 ng mL-1 [95% confidence interval (CI) 9-26] compared with 0 ng mL-1 (95% CI 6-8) in the placebo arm (P < 0.001, Wilcoxon test) and remained at a steady state during the whole treatment period. The estimated event rate for relapse-free survival at 72 months after inclusion was 26.51% in the vitamin D supplemented arm (95% CI 19.37-35.64) vs. 20.70% (95% CI 14.26-29.52) in the placebo arm (hazard ratio 1.27, 95% CI 0.79-2.03; P = 0.32). After adjusting for confounding factors (including baseline stage, body mass index, age, sex and baseline season), the hazard ratio was 1.20 (95% CI 0.74-1.94, P = 0.46). The number of deaths from progression of CM and nonmelanoma-related deaths was similar in both the vitamin D supplemented and placebo groups (deaths from progression of CM, n = 10 and n = 11, respectively; nonmelanoma-related deaths, n = 3 and n = 2, respectively). No major adverse events were observed during the study. CONCLUSIONS In patients with CM, monthly high-dose vitamin D supplementation was safe, resulted in a sustained increase in 25-hydroxyvitamin D levels during the treatment period, but did not improve relapse-free survival, melanoma-related death or overall survival.
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Affiliation(s)
- Julie De Smedt
- Laboratory of Dermatology, Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
| | - Sofie Van Kelst
- Laboratory of Dermatology, Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
| | - Laudine Janssen
- Laboratory of Dermatology, Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
| | - Vivien Marasigan
- Department of Surgery, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Veerle Boecxstaens
- Oncological Surgery, Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
| | - Kris Bogaerts
- Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), KU Leuven, Leuven, Belgium
| | - Ann Belmans
- Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), KU Leuven, Leuven, Belgium
| | - Dirk Vanderschueren
- Clinical and Experimental Endocrinology, Department of Chronical Illness and Metabolism, KU Leuven, UZ Leuven, Leuven, Belgium
| | | | - Oliver Bechter
- Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
| | - Claudia Aura
- Conway Institute of Biomolecular and Biomedical Research, Pathology, University College Dublin, Ireland
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics, VIB-KU Leuven, Leuven, Belgium
| | - Tinne Strobbe
- Department of Dermatology, Imeldaziekenhuis, Bonheiden, Belgium
| | - Gabriella Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Arjen Nikkels
- CHU Sart Tilman, University of Liège, Department of Dermatology, Liège, Belgium
| | - Marjan Garmyn
- Laboratory of Dermatology, Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
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Domżalski P, Piotrowska A, Tuckey RC, Zmijewski MA. Anticancer Activity of Vitamin D, Lumisterol and Selected Derivatives against Human Malignant Melanoma Cell Lines. Int J Mol Sci 2024; 25:10914. [PMID: 39456696 PMCID: PMC11506961 DOI: 10.3390/ijms252010914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 09/30/2024] [Accepted: 10/07/2024] [Indexed: 10/28/2024] Open
Abstract
Despite the recent development of improved methods of treating melanoma such as targeted therapy, immunotherapy or combined treatment, the number of new cases worldwide is increasing. It is well known that active metabolites of vitamin D3 and lumisterol (L3) exert photoprotective and antiproliferative effects on the skin, while UV radiation is a major environmental risk factor for melanoma. Thus, many natural metabolites and synthetic analogs of steroidal and secosteroidal molecules have been tested on various cancer cells and in animal models. In this study, we tested the anti-melanoma properties of several natural derivatives of vitamin D3 and L3 in comparison to 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). A significant decrease in melanoma cell proliferation and cell mobility was observed for selected derivatives, with (25R)-27-hydroxyL3 showing the highest potency (lowest IC50) in A375 cells but lower potency in SK-MEL-28 cells, whereas the parent L3 failed to inhibit proliferation. The efficacy (% inhibition) by 1,24,25(OH)3D3 and 1,25(OH)2D3 were similar in both cell types. 1,25(OH)2D3 showed higher potency than 1,24,25(OH)3D3 in SK-MEL-28 cells, but lower potency in A375 cells for the inhibition of proliferation. As for 1,25(OH)2D3, but not the other derivatives tested, treatment of melanoma cells with 1,24,25(OH)3D3 markedly increased the expression of CYP24A1, enhanced translocation of the vitamin D receptor (VDR) from the cytoplasm to the nucleus and also decreased the expression of the proliferation marker Ki67. The effects of the other compounds tested were weaker and occurred only under certain conditions. Our data indicate that 1,24,25(OH)3D3, which has undergone the first step in 1,25(OH)2D3 inactivation by being hydroxylated at C24, still shows anti-melanoma properties, displaying higher potency than 1,25(OH)2D3 in SK-MEL-28 cells. Furthermore, hydroxylation increases the potency of some of the lumisterol hydroxy-derivatives, as in contrast to L3, (25R)-27(OH)L3 effectively inhibits proliferation and migration of the human malignant melanoma cell line A375.
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Affiliation(s)
- Paweł Domżalski
- Department of Histology, Medical University of Gdansk, 1a Debinki, 80-211 Gdansk, Poland; (P.D.); (A.P.)
| | - Anna Piotrowska
- Department of Histology, Medical University of Gdansk, 1a Debinki, 80-211 Gdansk, Poland; (P.D.); (A.P.)
| | - Robert C. Tuckey
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia;
| | - Michał A. Zmijewski
- Department of Histology, Medical University of Gdansk, 1a Debinki, 80-211 Gdansk, Poland; (P.D.); (A.P.)
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Slominski RM, Kim TK, Janjetovic Z, Brożyna AA, Podgorska E, Dixon KM, Mason RS, Tuckey RC, Sharma R, Crossman DK, Elmets C, Raman C, Jetten AM, Indra AK, Slominski AT. Malignant Melanoma: An Overview, New Perspectives, and Vitamin D Signaling. Cancers (Basel) 2024; 16:2262. [PMID: 38927967 PMCID: PMC11201527 DOI: 10.3390/cancers16122262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 06/09/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Melanoma, originating through malignant transformation of melanin-producing melanocytes, is a formidable malignancy, characterized by local invasiveness, recurrence, early metastasis, resistance to therapy, and a high mortality rate. This review discusses etiologic and risk factors for melanoma, diagnostic and prognostic tools, including recent advances in molecular biology, omics, and bioinformatics, and provides an overview of its therapy. Since the incidence of melanoma is rising and mortality remains unacceptably high, we discuss its inherent properties, including melanogenesis, that make this disease resilient to treatment and propose to use AI to solve the above complex and multidimensional problems. We provide an overview on vitamin D and its anticancerogenic properties, and report recent advances in this field that can provide solutions for the prevention and/or therapy of melanoma. Experimental papers and clinicopathological studies on the role of vitamin D status and signaling pathways initiated by its active metabolites in melanoma prognosis and therapy are reviewed. We conclude that vitamin D signaling, defined by specific nuclear receptors and selective activation by specific vitamin D hydroxyderivatives, can provide a benefit for new or existing therapeutic approaches. We propose to target vitamin D signaling with the use of computational biology and AI tools to provide a solution to the melanoma problem.
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Affiliation(s)
- Radomir M. Slominski
- Department of Rheumatology and Clinical Immunology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Tae-Kang Kim
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Zorica Janjetovic
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Anna A. Brożyna
- Department of Human Biology, Institute of Biology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, 87-100 Torun, Poland;
| | - Ewa Podgorska
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Katie M. Dixon
- School of Medical Sciences, The University of Sydney, Sydney, NSW 2050, Australia; (K.M.D.); (R.S.M.)
| | - Rebecca S. Mason
- School of Medical Sciences, The University of Sydney, Sydney, NSW 2050, Australia; (K.M.D.); (R.S.M.)
| | - Robert C. Tuckey
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia;
| | - Rahul Sharma
- Department of Biomedical Informatics and Data Science, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - David K. Crossman
- Department of Genetics and Bioinformatics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Craig Elmets
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Chander Raman
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
| | - Anton M. Jetten
- Cell Biology Section, NIEHS—National Institutes of Health, Research Triangle Park, NC 27709, USA;
| | - Arup K. Indra
- Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Corvallis, OR 97331, USA
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrzej T. Slominski
- Department of Dermatology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (T.-K.K.); (Z.J.); (E.P.); (C.E.); (C.R.)
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Pathology and Laboratory Medicine Service, Veteran Administration Medical Center, Birmingham, AL 35233, USA
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Harrer DC, Lüke F, Pukrop T, Ghibelli L, Gerner C, Reichle A, Heudobler D. Peroxisome proliferator-activated receptorα/γ agonist pioglitazone for rescuing relapsed or refractory neoplasias by unlocking phenotypic plasticity. Front Oncol 2024; 13:1289222. [PMID: 38273846 PMCID: PMC10808445 DOI: 10.3389/fonc.2023.1289222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
A series of seven clinical trials on relapsed or refractory (r/r) metastatic neoplasias followed the question: Are networks of ligand-receptor cross-talks that support tumor-specific cancer hallmarks, druggable with tumor tissue editing approaches therapeutically exploiting tumor plasticity? Differential recombinations of pioglitazone, a dual peroxisome-proliferator activated receptorα/γ (PPARα/γ) agonist, with transcriptional modulators, i.e., all-trans retinoic acid, interferon-α, or dexamethasone plus metronomic low-dose chemotherapy (MCT) or epigenetic modeling with azacitidine plus/minus cyclooxygenase-2 inhibition initiated tumor-specific reprogramming of cancer hallmarks, as exemplified by inflammation control in r/r melanoma, renal clear cell carcinoma (RCCC), Hodgkin's lymphoma (HL) and multisystem Langerhans cell histiocytosis (mLCH) or differentiation induction in non-promyelocytic acute myeloid leukemia (non-PML AML). Pioglitazone, integrated in differentially designed editing schedules, facilitated induction of tumor cell death as indicated by complete remission (CR) in r/r non-PML AML, continuous CR in r/r RCCC, mLCH, and in HL by addition of everolimus, or long-term disease control in melanoma by efficaciously controlling metastasis, post-therapy cancer repopulation and acquired cell-resistance and genetic/molecular-genetic tumor cell heterogeneity (M-CRAC). PPARα/γ agonists provided tumor-type agnostic biomodulatory efficacy across different histologic neoplasias. Tissue editing techniques disclose that wide-ranging functions of PPARα/γ agonists may be on-topic focused for differentially unlocking tumor phenotypes. Low-dose MCT facilitates targeted reprogramming of cancer hallmarks with transcriptional modulators, induction of tumor cell death, M-CRAC control and editing of non-oncogene addiction. Thus, pioglitazone, integrated in tumor tissue editing protocols, is an important biomodulatory drug for addressing urgent therapeutic problems, such as M-CRAC in relapsed or refractory tumor disease.
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Affiliation(s)
- Dennis Christoph Harrer
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Florian Lüke
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
- Division of Personalized Tumor Therapy, Fraunhofer Institute for Toxicology and Experimental Medicine, Regensburg, Germany
| | - Tobias Pukrop
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), University Hospital Regensburg, Regensburg, Germany
| | - Lina Ghibelli
- Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | - Christopher Gerner
- Department of Analytical Chemistry, Faculty of Chemistry, University of Vienna, Vienna, Austria
| | - Albrecht Reichle
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Daniel Heudobler
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), University Hospital Regensburg, Regensburg, Germany
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Neagu M, Dobre EG. New Insights into the Link Between Melanoma and Obesity. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1460:851-867. [PMID: 39287874 DOI: 10.1007/978-3-031-63657-8_28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
The significant increase in the incidence of obesity represents a global health crisis. Obesity is actually a multi-organ disease affecting the entire organism; hence, skin is no exception. As the functional alterations in the adipose tissue are contributing factors to many diseases, including cancer, recently, the link between the development of melanoma skin cancer and obesity gains increased attention. Besides several other factors, the increase of adipose stromal/stem cells (ASCs) impacts cancer progression. Moreover, increased production of cytokines and growth factors done by ASCs induces tumorigenesis and metastasis. The chronic inflammatory state that is sustained by this metabolic imbalance favors skin malignancies, melanoma included. Cutaneous melanoma, as an aggressive skin cancer, has both intrinsic and extrinsic risk factors where sun exposure and lifestyles are the main environmental factors inducing this skin cancer. With the advent of recent targeted and immune-based therapies in melanoma, the link between obesity and the efficacy of these therapies in melanoma remains controversial. A recent molecular relationship between the melanocortin pathway appending to both melanin synthesis and obesity was established. The biology of adipokines, molecules secreted by the adipose tissue, is linked to inflammation, and their molecular pathways can be involved in angiogenesis, migration, invasion, and proliferation of melanoma cells. In melanoma cells, among the most noticeable metabolic reprogramming characteristics is an increased rate of lipid synthesis. Lipid mediators impact classical oncogenic pathways, affecting melanoma progression. The chapter will tackle also the practical implications for melanoma prevention and treatment, namely, how metabolic manipulation can be exploited to overcome immunosuppression and support immune checkpoint blockade efficacy.
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Affiliation(s)
- Monica Neagu
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, Romania
- Pathology Department, Colentina University Hospital, Bucharest, Romania
- Doctoral School of Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Elena-Georgiana Dobre
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, Romania
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Lesko P, Vlkova B, Kalavska K, De Angelis V, Novotna V, Obertova J, Orszaghova Z, Palacka P, Rejlekova K, Sycova-Mila Z, Kollarik B, Aziri R, Pindak D, Mardiak J, Chovanec M, Celec P, Mego M. Prognostic role of plasma vitamin D and its association with disease characteristics in germ cell tumours. Front Oncol 2023; 13:1149432. [PMID: 37114140 PMCID: PMC10126247 DOI: 10.3389/fonc.2023.1149432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/23/2023] [Indexed: 04/29/2023] Open
Abstract
Background Testicular cancer is the most common malignancy among young men. Vitamin D has pluripotent effects on cancer pathogenesis and plays a role in the metastatic cascade. The aim of this study is to analyze plasma vitamin D in association with clinico-pathological findings and prognosis in patients with germ-cell tumors (GCTs). Methods This study included 120 newly diagnosed and/or relapsed GCT patients treated from April 2013 to July 2020, for whom plasma was available in the biobank. Blood samples were drawn the 1st chemotherapy cycle as well as before the 2nd cycle. Plasma vitamin D was measured using ELISA and correlated with disease characteristics and the outcome. For survival analysis, the cohort was dichotomized into "low" and "high" based on median vitamin D. Results There was no significant difference in vitamin D plasma levels between healthy donors and GCT patients (p = 0.71). Vitamin D level was not associated with disease characteristics except for brain metastases, where patients with brain metastases had a vitamin D level that was 32% lower compared to patients without brain metastases, p = 0.03. Vitamin D was also associated with response to chemotherapy, with an approximately 32% lower value in patients with an unfavorable response compared to a favorable response, p = 0.02. Moreover, low plasma levels of vitamin D were significantly associated with disease recurrence and inferior progression-free survival (PFS), but not with overall survival (OS) (HR = 3.02, 95% CI 1.36-6.71, p = 0.01 for PFS and HR = 2.06, 95% CI 0.84-5.06, p = 0.14 for OS, respectively). Conclusion Our study suggests the prognostic value of pretreatment vitamin D concentrations in GCT patients. Low plasma vitamin D was associated with an unfavorable response to therapy and disease recurrence. However, it remains to be determined whether the biology of the disease confirms a causative role for low vitamin D and whether its supplementation affects the outcome.
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Affiliation(s)
- Peter Lesko
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
- *Correspondence: Peter Lesko,
| | - Barbora Vlkova
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Katarina Kalavska
- Translation Research Unit, Comenius University, National Cancer Institute, Bratislava, Slovakia
| | - Valentina De Angelis
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Vera Novotna
- 1st Department of Oncology, Faculty of Medicine Comenius University (FMCU) and St. Elizabeth Cancer Institute, Bratislava, Slovakia
| | - Jana Obertova
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Zuzana Orszaghova
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Patrik Palacka
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Katarina Rejlekova
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Zuzana Sycova-Mila
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Boris Kollarik
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Ramadan Aziri
- Department of Surgical Oncology, National Institute for Oncology, Bratislava, Slovakia
| | - Daniel Pindak
- Department of Surgical Oncology, National Institute for Oncology, Bratislava, Slovakia
| | - Jozef Mardiak
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Michal Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Peter Celec
- Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Michal Mego
- Translation Research Unit, Comenius University, National Cancer Institute, Bratislava, Slovakia
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Minichsdorfer C, Gleiss A, Aretin MB, Schmidinger M, Fuereder T. Serum parameters as prognostic biomarkers in a real world cancer patient population treated with anti PD-1/PD-L1 therapy. Ann Med 2022; 54:1339-1349. [PMID: 35535695 PMCID: PMC9103267 DOI: 10.1080/07853890.2022.2070660] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) are regarded as a standard of care in multiple malignancies. We hypothesized that serum parameters are of prognostic value in ICI treated patients suffering from solid tumours. METHODS Data from 114 patients treated with ICIs for solid malignancies from 2015 to 2019 at the Medical University of Vienna were collected retrospectively. Data included baseline characteristics, cancer type, serum parameters such as lactate dehydrogenase (LDH), C-reactive protein (CRP), albumin (Alb) and lymphocyte counts as well as overall survival (OS) and progression free survival. Additionally, the Gustave Roussy Immune Score (GRIm score) and the Glasgow prognostic score (GPS) were calculated. Cox regression models including time-dependent effects and strata for tumour type were used. Prognostic factors were pre-selected using a relaxed LASSO approach. RESULTS The majority of patients were male (64.9%). The most common cancer types were non-small cell lung cancer (30.7%) and renal cell carcinoma (21.9%). Increased LDH and CRP were associated with poor 6-month OS (Hazard ratios (HR)=1.16 and 1.06 per 20% LDH/CRP increase; 95% CI 1.07-1.26 and 95% CI 1.03-1.09, respectively; p < .001). Both GRIm Score and GPS had a significant influence on OS (GRIm: HR = 2.84, 95% CI 1.72-4.69; p < .001 for high vs. low; GPS HR 3.57, 95% CI 1.76-7.25; p < .001 for poor vs. good). The proportion of explained variation (PEV) of our full multivariable model was significantly higher compared to the GRIm and GPS (PEV = 29.5% vs. 14.8% and 14.65%). When grouped into quartiles according to the individual 8-weeks change, both increased LDH and CRP correlated with poor OS (LDH (p=.001) and CRP (p < .001)). CONCLUSION The results of this analysis suggest that serum parameters might have prognostic value for the outcome of cancer patients treated with ICI, regardless of the tumour type.Key messagesIn this retrospective analysis, 114 patients with solid tumours were included. The results of this analysis point out that pre-treatment LDH, CRP and albumin levels are strongly prognostic for a poor 6-month OS.In addition to that, a high GRIm-score and poor GPS were associated with a worse OS (GRIm: HR = 2.84, 95% CI 1.72-4.69; p < .001 for high vs. low; GPS HR = 3.57, 95% CI 1.76-7.25; p < .001 for poor vs. good).Pre-treatment serum parameters might have prognostic value for the outcome of cancer patients treated with ICI, regardless of the tumour type.
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Affiliation(s)
- Christoph Minichsdorfer
- Department of Medicine I & CCC, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Andreas Gleiss
- Medical University of Vienna, Center for Medical Statistics, Informatics, and Intelligent Systems Institute of Clinical Biometrics, Wien, Austria
| | | | | | - Thorsten Fuereder
- Department of Medicine I & CCC, Division of Oncology, Medical University of Vienna, Wien, Austria
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Yin WJ, Yu LJ, Wu L, Zhang L, Li Q, Dai FC, Tao RX, Jiang XM, Zhu P. Adequate 25(OH)D moderates the relationship between dietary inflammatory potential and cardiovascular health risk during the second trimester of pregnancy. Front Nutr 2022; 9:952652. [PMID: 35967812 PMCID: PMC9372498 DOI: 10.3389/fnut.2022.952652] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background Pro-inflammatory diets play an important role in developing cardiovascular disease (CVD). Vitamin D has been demonstrated to have an anti-inflammatory effect and promote cardiovascular health (CVH). However, it is unclear whether adequate vitamin D during pregnancy protects against poor CVH caused by pro-inflammatory diets. Objective To investigate the association of pro-inflammatory diets with the cardiovascular risk (CVR) among pregnant women and whether such association was modified by vitamin D status. Methods The study was based on a prospective birth cohort that included 3,713 pregnant women between 16 and 23 gestational weeks. In total, 25(OH)D concentrations and high-sensitivity C-reactive protein (hs-CRP) were measured from the collected blood. The dietary inflammatory potential was evaluated using the empirical dietary inflammatory pattern (EDIP) score based on a validated food frequency questionnaire. Gestational CVR was evaluated using the CVR score based on five “clinical” CVR metrics, including body mass index, blood pressure, total cholesterol, glucose levels, and smoking status. Results The proportion of women with a CVR score >0 was 54.3%. We observed a positive association between the EDIP score and CVR score. Compared with the lowest quartile, the CVR score (β = −0.114, 95% CI, −0.217, −0.011) and hs-CRP levels (β = −0.280, 95% CI, −0.495, −0.065) were lower in the highest quartile (P for trend <0.05). Increased CVR connected with high EDIP score was observed only in women with 25(OH)D concentrations <50 nmol/L (RR = 1.85; 95% CI: 1.35, 2.54). Mediation analysis revealed that the proportion of association between the EDIP score and CVR score mediated by 25(OH)D was 28.7%, and the proportion of the association between 25(OH)D and the CVR score mediated by hs-CRP was 21.9%. Conclusion The higher dietary inflammatory potential was associated with an increased CVR during pregnancy by promoting inflammation. Adequate vitamin D could exert anti-inflammatory effects and modify such association.
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Affiliation(s)
- Wan-Jun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Li-Jun Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Lin Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Lei Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Qiong Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Fei-Cai Dai
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Rui-Xue Tao
- Department of Gynecology and Obstetrics, Hefei First People's Hospital, Hefei, China
| | - Xiao-Min Jiang
- Department of Obstetrics and Gynecology, Anhui Province Maternity and Child Health Hospital, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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9
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De Smedt J, Van Kelst S, Janssen L, Marasigan V, Boecxstaens V, Stas M, Vanderschueren D, Guler I, Bogaerts K, Vandenberghe K, Bechter O, Billen J, Nikkels A, Strobbe T, Emri G, Lambrechts D, Garmyn M. Determinants of 25-hydroxyvitamin D Status in a Cutaneous Melanoma Population. Acta Derm Venereol 2022; 102:adv00692. [PMID: 35312026 PMCID: PMC9609978 DOI: 10.2340/actadv.v102.262] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 12/12/2022] Open
Abstract
Vitamin D status is influenced by well-known determinants, but factors associated with low 25-hydroxyvitamin D levels in the cutaneous melanoma population are not well defined. The aim of this study was to confirm the well-known determinants and to assess new determinants for 25-hydroxyvitamin D levels in a cutaneous melanoma population. In a prospectively included cohort of 387 patients with cutaneous melanoma the association of 25-hydroxyvitamin D levels with sex, age, body mass index, time of blood withdrawal, Fitzpatrick phototype, vitamin D supplementation, score for intensity of lifetime sun exposure, smoking, education level, hair and skin colour, eye colour, total number of benign naevi, freckles and parameters of chronic sun damage was investigated. In addition, 25-hydroxyvitamin D levels were correlated with pathological parameters of the primary tumour and melanoma stage (8th edition of the American Joint Committee on Cancer (AJCC). Univariate and multivariate logistic regressions were performed using R software. The following factors had a significant effect on vitamin D status: body mass index, seasonal time of blood sampling, vitamin D supplementation, and a subtype of skin, and hair colour.
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Affiliation(s)
- Julie De Smedt
- School of Biomedical sciences, Department of Oncology, Catholic University of Leuven, Herestraat 49, 3000 Leuven, Belgium.
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10
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Moro R, Sánchez-Silva A, Aguerralde-Martin M, González-Cuevas R, Peruilh-Bagolini L, Traves V, Manrique-Silva E, Requena C, Nagore E. [Translated article] Prognostic Value of Vitamin D Serum Levels in Cutaneous Melanoma. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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11
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Moro R, Sánchez-Silva A, Aguerralde-Martin M, González-Cuevas R, Peruilh-Bagolini L, Traves V, Manrique-Silva E, Requena C, Nagore E. Prognostic Value of Vitamin D Serum Levels in Cutaneous Melanoma. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:347-353. [PMID: 35623724 DOI: 10.1016/j.ad.2021.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/28/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Vitamin D plays a fundamental role in many metabolic pathways, including those involved in cell proliferation and the immune response. Serum levels of this vitamin have been linked to melanoma risk and prognosis. This study aimed to assess the prognostic value of vitamin D serum level in melanoma. MATERIAL AND METHODS Retrospective, observational, longitudinal, and analytical study of 286 patients with a histologic diagnosis of melanoma in whom serum levels of vitamin D were measured at the time of diagnosis. We analyzed associations between serum level and epidemiologic and clinical variables and pathology findings; we also analyzed the influence of vitamin D on overall survival. An iterative loop was used to identify a vitamin D serum level to test for its an association with survival. RESULTS A vitamin D level less than 9.25ng/mL was associated with a histologic finding of ulceration. After a median follow-up period of 39.4 months, 24 patients (8.4%) had died. The cutoff of 9.25ng/mL was associated with lower overall survival according to both the Kaplan-Meier curves and multivariate Cox regression analysis. CONCLUSION Vitamin D levels less than 9.25ng/mL are associated with ulceration in melanoma and serve as an independent prognostic factor for overall survival in this disease.
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Affiliation(s)
- R Moro
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Clinica San Carlo, Paderno Dugnano, Italia
| | - A Sánchez-Silva
- Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, Valencia, España
| | - M Aguerralde-Martin
- Máster de Ingeniería de Análisis de Datos, Toma de Decisiones y Mejora de Procesos, Universidad Politécnica de Valencia, Valencia, España
| | - R González-Cuevas
- Servicio de Dermatología, Hospital del Salvador, Santiago, Chile; Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Peruilh-Bagolini
- Facultad de Medicina, Universidad de Chile, Santiago, Chile; Fundación Arturo López Pérez (FALP), Oncologic Institute, Santiago, Chile
| | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - E Manrique-Silva
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - E Nagore
- Máster de Ingeniería de Análisis de Datos, Toma de Decisiones y Mejora de Procesos, Universidad Politécnica de Valencia, Valencia, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
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12
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Altieri B, Barrea L, Modica R, Bottiglieri F, de Cicco F, Muscogiuri G, Circelli L, Savarese G, Di Somma C, Savastano S, Colao A, Faggiano A. Vitamin D deficiency and tumor aggressiveness in gastroenteropancreatic neuroendocrine tumors. Endocrine 2022; 75:623-634. [PMID: 34533768 DOI: 10.1007/s12020-021-02869-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/03/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Data regarding vitamin D status in patients affected by gastroenteropancreatic (GEP) neuroendocrine tumor (NET) are limited and often showing contrasting results. The aim of the study was to evaluate the incidence of vitamin D deficiency (<20 ng/mL) in GEP-NET patients and compare the 25-hydroxyvitamin D (25(OH)D) levels with clinicopathological parameters and clinical outcome. METHODS A retrospective cross-sectional study including 75 low grade (G1-G2) GEP-NETs and 123 healthy controls matched for age, sex, and body mass index, was performed. RESULTS GEP-NET patients had significantly lower 25(OH)D levels compared to controls (17.9 ± 7.8 vs 24.2 ± 7.7 ng/mL, p < 0.0001). Ileal NETs were associated to lower 25(OH)D levels compared to other primary tumor sites (p = 0.049) and small bowel resection posed a significant increased risk of severe vitamin D deficiency (OR = 2.81, 95% CI = 1.25-3.37, p = 0.018). No correlation with somatostatin analogs treatment was found. 25(OH)D levels were significantly lower in G2 compared to G1 GEP-NETs (15.6 ± 7.8 vs 19.9 ± 7.4 ng/mL, p = 0.016) and in patients with progressive disease (12.6 ± 5.7 ng/mL) compared to those with stable disease (mean 21.5 ± 8.2 ng/mL, p = 0.001) or tumor free after surgery (19.6 ± 7.3 ng/mL, p = 0.002). Patients with vitamin D deficiency and insufficiency had shorter progression-free survival compared to those with sufficiency (p = 0.014), whereas no correlation was found with disease-specific survival. CONCLUSIONS Vitamin D deficiency is highly prevalent among GEP-NETs and could be associated with high tumor grade and disease progression. Therefore, the monitoring of 25(OH)D levels is relevant in these patients and vitamin D supplementation should be considered in the management of GEP-NET patients with vitamin D deficiency or insufficiency.
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Affiliation(s)
- Barbara Altieri
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany.
| | - Luigi Barrea
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Roberta Modica
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Filomena Bottiglieri
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Federica de Cicco
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | | | | | - Carolina Di Somma
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, Federico II University, Naples, Italy
- UNESCO Chair "Education for Health and Sustainable Development", Federico II University, Naples, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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13
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Evaluation of Plasma Interleukin-6 in Melanoma Patients as a Prognostic and Checkpoint Immunotherapy Predictive Biomarker. J Invest Dermatol 2021; 142:2046-2049.e3. [PMID: 34952092 DOI: 10.1016/j.jid.2021.12.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/20/2022]
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14
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Martin-Gorgojo A, Gilaberte Y, Nagore E. Vitamin D and Skin Cancer: An Epidemiological, Patient-Centered Update and Review. Nutrients 2021; 13:4292. [PMID: 34959844 PMCID: PMC8709188 DOI: 10.3390/nu13124292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The current vitamin D deficiency epidemic is accompanied by an increase in endemic skin cancer. There are still multiple controversies. This review aims to give practical recommendations regarding vitamin D among people at risk or with a personal history of skin cancer. METHODS Narrative review including human research articles published between 2011 and 2021, elaborated bearing in mind an epidemiological, patient-centered approach. RESULTS Ultraviolet (UV) exposure (neither artificial nor natural) is not the ideal source to synthesize vitamin D. There is conflicting epidemiological evidence regarding vitamin D, non-melanoma skin cancer (NMSC), and cutaneous melanoma (CMM), confounded by the effect of sun exposure and other factors. CONCLUSIONS Current evidence is controversial, and there are no widely applicable strategies. We propose three practical recommendations. Firstly, sun protection recommendations should be kept among people at risk or with a personal history of skin cancer. Secondly, vitamin D should preferably be sourced through diet. In patients with melanoma or at risk of cutaneous cancer, serum vitamin D checks are warranted to detect and avoid its insufficiency.
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Affiliation(s)
| | - Yolanda Gilaberte
- Dermatology Department, Hospital Universitario Miguel Servet, IIS Aragon, 50009 Zaragoza, Spain;
| | - Eduardo Nagore
- Dermatology Department, Universidad Catolica de Valencia, 46001 Valencia, Spain;
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15
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Pellegrini M, D’Eusebio C, Ponzo V, Tonella L, Finocchiaro C, Fierro MT, Quaglino P, Bo S. Nutritional Interventions for Patients with Melanoma: From Prevention to Therapy-An Update. Nutrients 2021; 13:4018. [PMID: 34836273 PMCID: PMC8624488 DOI: 10.3390/nu13114018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/31/2021] [Accepted: 11/08/2021] [Indexed: 12/17/2022] Open
Abstract
Melanoma is an aggressive skin cancer, whose incidence rates have increased over the past few decades. Risk factors for melanoma are both intrinsic (genetic and familiar predisposition) and extrinsic (environment, including sun exposure, and lifestyle). The recent advent of targeted and immune-based therapies has revolutionized the treatment of melanoma, and research is focusing on strategies to optimize them. Obesity is an established risk factor for several cancer types, but its possible role in the etiology of melanoma is controversial. Body mass index, body surface area, and height have been related to the risk for cutaneous melanoma, although an 'obesity paradox' has been described too. Increasing evidence suggests the role of nutritional factors in the prevention and management of melanoma. Several studies have demonstrated the impact of dietary attitudes, specific foods, and nutrients both on the risk for melanoma and on the progression of the disease, via the effects on the oncological treatments. The aim of this narrative review was to summarize the main literature results regarding the preventive and therapeutic role of nutritional schemes, specific foods, and nutrients on melanoma incidence and progression.
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Affiliation(s)
- Marianna Pellegrini
- Department of Medical Sciences, Division of Endocrinology, Diabetes and Metabolism, University of Torino, 10126 Torino, Italy; (M.P.); (C.D.); (V.P.); (S.B.)
| | - Chiara D’Eusebio
- Department of Medical Sciences, Division of Endocrinology, Diabetes and Metabolism, University of Torino, 10126 Torino, Italy; (M.P.); (C.D.); (V.P.); (S.B.)
| | - Valentina Ponzo
- Department of Medical Sciences, Division of Endocrinology, Diabetes and Metabolism, University of Torino, 10126 Torino, Italy; (M.P.); (C.D.); (V.P.); (S.B.)
| | - Luca Tonella
- Department of Medical Sciences, Dermatologic Clinic, University of Torino, 10126 Torino, Italy; (L.T.); (M.T.F.)
| | - Concetta Finocchiaro
- Dietetic and Clinical Nutrition Unit, “Città della Salute e della Scienza” Hospital, 10126 Torino, Italy;
| | - Maria Teresa Fierro
- Department of Medical Sciences, Dermatologic Clinic, University of Torino, 10126 Torino, Italy; (L.T.); (M.T.F.)
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Torino, 10126 Torino, Italy; (L.T.); (M.T.F.)
| | - Simona Bo
- Department of Medical Sciences, Division of Endocrinology, Diabetes and Metabolism, University of Torino, 10126 Torino, Italy; (M.P.); (C.D.); (V.P.); (S.B.)
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16
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Cassano N, Caccavale S, Vena GA, Argenziano G. Body Mass Index and Melanoma Prognosis. Dermatol Pract Concept 2021; 11:e2021106. [PMID: 34631264 DOI: 10.5826/dpc.1104a106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 10/31/2022] Open
Abstract
Introduction Obesity has been suggested as a risk factor in the progression of malignancies, including melanoma. Most studies defined obesity using body mass index (BMI), although the index is considered an imperfect measure of body composition. Objective The aim of this article is to examine whether BMI can impact on the prognosis of cutaneous melanoma, regardless of anti-tumor therapy. The relationship between BMI and specific prognostic factors in melanoma patients has been reviewed. Methods Literature search was conducted on PubMed using the terms "melanoma" and "body mass index" or "obesity". We selected articles, published up to 30 November 2020, examining the prognostic aspects of melanoma. Articles evaluating the risk and incidence of melanoma were excluded as well as studies regarding morbidity and complications following surgical procedures, or those performed in metastatic melanoma patients treated with anti-tumor therapies. Results Mixed results have emerged from studies assessing the clinical outcomes in melanoma patients in relation to BMI. More consistent data seem to support the relationship between BMI and Breslow thickness. Conclusions Studies that focus specifically on the link between obesity and melanoma prognosis are limited; further research is needed to deepen our knowledge on this link.
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Affiliation(s)
- Nicoletta Cassano
- Dermatology and Venereology Private Practice, Bari, Italy.,Dermatology and Venereology Private Practice, Barletta, Italy
| | - Stefano Caccavale
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gino A Vena
- Dermatology and Venereology Private Practice, Bari, Italy.,Dermatology and Venereology Private Practice, Barletta, Italy
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17
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Becker AL, Carpenter EL, Slominski AT, Indra AK. The Role of the Vitamin D Receptor in the Pathogenesis, Prognosis, and Treatment of Cutaneous Melanoma. Front Oncol 2021; 11:743667. [PMID: 34692525 PMCID: PMC8526885 DOI: 10.3389/fonc.2021.743667] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/15/2021] [Indexed: 01/08/2023] Open
Abstract
Melanoma is the malignant transformation of melanocytes and represents the most lethal form of skin cancer. While early-stage melanoma localized to the skin can be cured with surgical excision, metastatic melanoma often requires a multi-pronged approach and even then can exhibit treatment resistance. Understanding the molecular mechanisms involved in the pathogenesis of melanoma could lead to novel diagnostic, prognostic, and therapeutic strategies to ultimately decrease morbidity and mortality. One emerging candidate that may have value as both a prognostic marker and in a therapeutic context is the vitamin D receptor (VDR). VDR is a nuclear steroid hormone receptor activated by 1,25 dihydroxy-vitamin D3 [calcitriol, 1,25(OH)2D3]. While 1,25 dihydroxy-vitamin D3 is typically thought of in relation to calcium metabolism, it also plays an important role in cell proliferation, differentiation, programmed-cell death as well as photoprotection. This review discusses the role of VDR in the crosstalk between keratinocytes and melanocytes during melanomagenesis and summarizes the clinical data regarding VDR polymorphisms, VDR as a prognostic marker, and potential uses of vitamin D and its analogs as an adjuvant treatment for melanoma.
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Affiliation(s)
- Alyssa L. Becker
- Department of Pharmaceutical Sciences, College of Pharmacy, OSU, Corvallis, OR, United States
- John A. Burns School of Medicine at the University of Hawai’i at Mānoa, Honolulu, HI, United States
| | - Evan L. Carpenter
- Department of Pharmaceutical Sciences, College of Pharmacy, OSU, Corvallis, OR, United States
| | - Andrzej T. Slominski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, United States
- Cancer Chemoprevention Program, Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Arup K. Indra
- Department of Pharmaceutical Sciences, College of Pharmacy, OSU, Corvallis, OR, United States
- Knight Cancer Institute, Oregon Health & Science University (OHSU), Portland, OR, United States
- Department of Biochemistry and Biophysics, Oregon State University (OSU), Corvallis, OR, United States
- Linus Pauling Science Center, Oregon State University (OSU), Corvallis, OR, United States
- Department of Dermatology, Oregon Health & Science University (OHSU), Portland, OR, United States
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18
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Johansson H, Spadola G, Tosti G, Mandalà M, Minisini AM, Queirolo P, Aristarco V, Baldini F, Cocorocchio E, Albertazzi E, Zichichi L, Cinieri S, Jemos C, Mazzarol G, Gnagnarella P, Macis D, Tedeschi I, Salè EO, Stucci LS, Bonanni B, Testori A, Pennacchioli E, Ferrucci PF, Gandini S. Vitamin D Supplementation and Disease-Free Survival in Stage II Melanoma: A Randomized Placebo Controlled Trial. Nutrients 2021; 13:nu13061931. [PMID: 34199802 PMCID: PMC8226808 DOI: 10.3390/nu13061931] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/29/2022] Open
Abstract
Patients with newly resected stage II melanoma (n = 104) were randomized to receive adjuvant vitamin D3 (100,000 IU every 50 days) or placebo for 3 years to investigate vitamin D3 protective effects on developing a recurrent disease. Median age at diagnosis was 50 years, and 43% of the patients were female. Median serum 25-hydroxy vitamin D (25OHD) level at baseline was 18 ng/mL, interquartile range (IQ) was 13–24 ng/mL, and 80% of the patients had insufficient vitamin D levels. We observed pronounced increases in 25OHD levels after 4 months in the active arm (median 32.9 ng/mL; IQ range 25.9–38.4) against placebo (median 19.05 ng/mL; IQ range 13.0–25.9), constantly rising during treatment. Remarkably, patients with low Breslow score (<3 mm) had a double increase in 25OHD levels from baseline, whereas patients with Breslow score ≥3 mm had a significantly lower increase over time. After 12 months, subjects with low 25OHD levels and Breslow score ≥3 mm had shorter disease-free survival (p = 0.02) compared to those with Breslow score <3 mm and/or high levels of 25OHD. Adjusting for age and treatment arm, the hazard ratio for relapse was 4.81 (95% CI: 1.44–16.09, p = 0.011). Despite the evidence of a role of 25OHD in melanoma prognosis, larger trials with vitamin D supplementation involving subjects with melanoma are needed.
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Affiliation(s)
- Harriet Johansson
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (V.A.); (D.M.); (B.B.)
- Correspondence: ; Tel.: +39-0294372654
| | - Giuseppe Spadola
- Divisione di Chirurgia del Melanoma, IRCCS Fondazione Istituto Nazionale per lo Studio e la Cura dei Tumori, 20133 Milan, Italy;
| | - Giulio Tosti
- Division of Surgery for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.B.); (I.T.); (E.P.)
| | - Mario Mandalà
- Unit of Medical Oncology, Department of Oncology and Haematology, Papa Giovanni XXIII Cancer Center Hospital, 24127 Bergamo, Italy;
| | - Alessandro M. Minisini
- Department of Oncology, Azienda Sanitaria Universitaria del Friuli Centrale, 33100 Udine, Italy;
| | - Paola Queirolo
- Department of Medical Oncology, IRCCS Ospedale Policlinico San Martino—IST-Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy;
| | - Valentina Aristarco
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (V.A.); (D.M.); (B.B.)
| | - Federica Baldini
- Division of Surgery for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.B.); (I.T.); (E.P.)
| | - Emilia Cocorocchio
- Division of Medical Oncology for Melanoma, Sarcoma and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Elena Albertazzi
- San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | | | - Saverio Cinieri
- Medical Oncology & Breast Unit, Department of Oncology, “Antonio Perrino” Hospital, 72100 Brindisi, Italy;
| | - Costantino Jemos
- Division of Pharmacy, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (C.J.); (E.O.S.)
| | - Giovanni Mazzarol
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Debora Macis
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (V.A.); (D.M.); (B.B.)
| | - Ines Tedeschi
- Division of Surgery for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.B.); (I.T.); (E.P.)
| | - Emanuela Omodeo Salè
- Division of Pharmacy, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (C.J.); (E.O.S.)
| | - Luigia Stefania Stucci
- Section of Medical Oncology, Department of Biomedical Sciences and Clinical Oncology (DIMO), University of Bari ‘Aldo Moro’, 70124 Bari, Italy;
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (V.A.); (D.M.); (B.B.)
| | - Alessandro Testori
- EORTC Melanoma Group, 1200 Brussel, Belgium;
- Skin Oncology Division, Image Rigenerative Clinic, 20121 Milan, Italy
| | - Elisabetta Pennacchioli
- Division of Surgery for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (G.T.); (F.B.); (I.T.); (E.P.)
| | - Pier Francesco Ferrucci
- Biotherapy of Tumors Unit, IEO, Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
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Sun Protective Clothing and Sun Avoidance: The Most Critical Components of Photoprotection in Patients With Melanoma. Dermatol Surg 2021; 47:333-337. [PMID: 32991331 DOI: 10.1097/dss.0000000000002794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Ultraviolet radiation is the main modifiable risk factor for melanoma which can be reduced by avoiding excess sun exposure. OBJECTIVE We sought to explore (1) sun protective practices, (2) effectiveness of these sun protective practices, and (3) vitamin D supplementation in patients with melanoma. METHODS Using the National Health Interview Survey, the authors conducted a cross-sectional analysis to investigate sun protective behaviors and sunburns among adults with melanoma compared with those without skin cancer. We calculated adjusted odds ratio (aOR), 95% confidence interval (95% CI), and p-values using logistic regression. RESULTS Patients with melanoma reported increased use of sun avoidance, shade, sunscreen, long sleeves, and hats, but had similar sunburn rates compared with those without skin cancer. Only sun avoidance and long sleeves were associated with decreased odds of sunburn. Patients with melanoma also reported decreased vitamin D supplementation. CONCLUSION Although it is reassuring that patients with melanoma practice sun protective behaviors, this does not always translate into reduced sunburns. Physicians should emphasize the importance of photoprotection, especially sun avoidance and sun protective clothing, to reduce future melanoma risk.
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20
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Solar UV Exposure and Mortality from Skin Tumors: An Update. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020. [PMID: 32918217 DOI: 10.1007/978-3-030-46227-7_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Solar UV exposure is critical and complex in the etiology and prognosis of skin cancer, particularly cutaneous malignant melanoma. Sun exposure and one of its "derivatives," vitamin D, have been implicated in protection against mortality from melanoma. However, the relationships are inconsistent. At this time, it is not possible to make clear recommendations for or against sun exposure in relationship to melanoma prognosis. However, this relationship deserves continued exploration.
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21
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Wang Z, Wang X, Zou H, Dai Z, Feng S, Zhang M, Xiao G, Liu Z, Cheng Q. The Basic Characteristics of the Pentraxin Family and Their Functions in Tumor Progression. Front Immunol 2020; 11:1757. [PMID: 33013829 PMCID: PMC7461825 DOI: 10.3389/fimmu.2020.01757] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/30/2020] [Indexed: 02/05/2023] Open
Abstract
The pentraxin is a superfamily of proteins with the same domain known as the pentraxin domain at C-terminal. This family has two subgroups, namely; short pentraxins (C-reactive protein and serum amyloid P component) and long pentraxins (neuronal pentraxin 1, neuronal pentraxin 2, neuronal pentraxin receptor, pentraxin 3 and pentraxin 4). Each group shares a similar structure with the pentameric complexes arranged in a discoid shape. Previous studies revealed the functions of different pentraxin family members. Most of them are associated with human innate immunity. Inflammation has commonly been associated with tumor progression, implying that the pentraxin family might also participate in tumor progression. Therefore, we reviewed the basic characteristics and functions of the pentraxin family and their role in tumor progression.
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Affiliation(s)
- Zeyu Wang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Changsha, China
| | - Xing Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Hecun Zou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Ziyu Dai
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Songshan Feng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Mingyu Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Gelei Xiao
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zhixiong Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Changsha, China
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Changsha, China.,Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
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22
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Decreased vitamin D serum levels at melanoma diagnosis are associated with tumor ulceration and high tumor mitotic rate. Melanoma Res 2020; 29:664-667. [PMID: 31469708 DOI: 10.1097/cmr.0000000000000638] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The aim of this study is to evaluate the relation between 25-hydroxyvitamin D levels at diagnosis and pathological characteristics in primary invasive melanoma. A cross-sectional study was designed based on a series of 204 consecutive patients diagnosed of invasive melanomas in the 2013-2017 period at a single institution. 25-hydroxyvitamin D serum levels at diagnosis were assessed, and three groups were defined by vitamin D status: deficiency, insufficiency, and sufficiency. Clinical and pathological characteristics were compared between the groups by Chi-square test. Logistic regression models were performed to evaluate the association between vitamin D status and Breslow thickness, ulceration, and tumor mitotic rate. A significant association between vitamin D levels at diagnosis and location, tumor mitotic rate, and ulceration was found; and a borderline association with Breslow thickness and BMI. Deficient levels were found in 7.8% of patients and increased the risk of presenting ulcerated tumors [odds ratio: 6.8 (95% confidence interval: 1.5-29.7; P = 0.012)] and with a tumor mitotic rate greater than 1 mitosis/mm [odds ratio: 6.0 (95% confidence interval: 1.4-25.1; P = 0.014)]. A marginal increased risk of tumor thickness greater than 1 mm was also observed [odds ratio: 3.7 (95% confidence interval: 1.0-13.9; P = 0.057)]. Our study suggests a role of vitamin D levels in melanoma aggressiveness and raises the question as to whether vitamin D levels should be monitored, or even supplemented, in people with low yearly sun exposure.
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23
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Vitamin D and Cancer Survival: Does Vitamin D Supplementation Improve the Survival of Patients with Cancer? Curr Oncol Rep 2020; 22:62. [PMID: 32495112 DOI: 10.1007/s11912-020-00929-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW Clinical evidence suggesting the beneficial effects of vitamin D on survival of patients with cancer has been accumulating. Recent articles were thoroughly reviewed to determine if there is enough evidence to conclude that vitamin D supplementation improves survival of patients with cancer. RECENT FINDINGS Meta-analyses of observational studies showed that higher blood 25-hydroxyvitamin D levels in patients with cancer at a variety of sites were associated with lower cancer-specific and overall mortalities. Moreover, meta-analyses of randomized clinical trials (RCTs) also suggested that vitamin D supplementation improved the survival of patients with cancer. However, each RCT used in these meta-analyses, as well as very recent RCTs, e.g., the SUNSHINE and the AMATERASU trial, did not show statistical significance in the primary results. For now, compelling evidence that vitamin D supplementation effectively improves survival of patients with cancer is lacking. Thus, confirmatory RCTs are still obligatory for the future.
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24
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Tsai TY, Kuo CY, Huang YC. The association between serum vitamin D level and risk and prognosis of melanoma: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2020; 34:1722-1729. [PMID: 31919907 DOI: 10.1111/jdv.16189] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 12/17/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Vitamin D has antineoplastic effects, but the synthesis of vitamin D requires ultraviolet radiation, a known risk factor for melanoma. OBJECTIVE To investigate the correlations between serum vitamin D levels and risk and prognosis of melanoma. METHODS A systematic review and meta-analysis were conducted. Online databases were searched on 31 Oct 2018. RESULTS Twenty-five studies with a total of 11166 patients with melanoma were included. There was no significant difference in serum vitamin D levels between patients with melanoma and controls [standardized mean difference (SMD), -0.185; 95% confidence interval (CI), -0.533 to 0.162]. However, the prevalence of vitamin D deficiency was significantly higher in patients with melanoma than that in controls (odds ratio, 2.115; 95% CI, 1.151-3.885). In terms of prognosis, serum vitamin D levels were significantly higher in melanoma patients with lower Breslow thickness (≦1 vs. >1 mm: SMD, 0.243; 95% CI, 0.160-0.327). Moreover, melanoma patients with lower vitamin D levels had a significantly higher mortality rate (hazard ratio, 1.558; 95% CI, 1.258-1.931). CONCLUSIONS Vitamin D deficiency is associated with higher Breslow thickness and mortality in melanoma patients.
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Affiliation(s)
- T-Y Tsai
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - C-Y Kuo
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Y-C Huang
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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25
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Hardie CM, Elliott F, Chan M, Rogers Z, Bishop DT, Newton-Bishop JA. Environmental Exposures Such as Smoking and Low Vitamin D Are Predictive of Poor Outcome in Cutaneous Melanoma rather than Other Deprivation Measures. J Invest Dermatol 2020; 140:327-337.e2. [PMID: 31425707 PMCID: PMC6983339 DOI: 10.1016/j.jid.2019.05.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 05/06/2019] [Accepted: 05/08/2019] [Indexed: 01/17/2023]
Abstract
A lack of basic resources within a society (deprivation) is associated with increased cancer mortality, and this relationship has been described for melanoma. We have previously reported the association of smoking and low vitamin D levels with melanoma death. In this study, we further explored the associations of these with melanoma in addition to deprivation and socio-economic stressors. In this analysis of 2,183 population-ascertained primary cutaneous melanoma patients, clinical, demographic, and socio-economic variables were assessed as predictors of tumor thickness, melanoma death and overall death. Using the Townsend deprivation score, the most deprived group did not have thicker tumors compared to the least deprived. Of the World Health Organization 25x25 risk factors for premature death, smoking and body mass index (BMI) were independently associated with thicker tumors. Low vitamin D was also independently associated with thicker tumors. No socio-economic stressors were independent predictors of thickness. Smoking was confirmed as a key predictor of melanoma death and overall death, as were low vitamin D levels, independent of other measures of deprivation. Neither BMI nor the Townsend deprivation score were predictive in either survival analysis. We report evidence for the role of smoking, vitamin D, and BMI in melanoma progression independent of a postcode-derived measure of deprivation.
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Affiliation(s)
- C M Hardie
- Section of Epidemiology and Biostatistics, Institute of Medical Research at St James's University of Leeds, Leeds, United Kingdom.
| | - F Elliott
- Section of Epidemiology and Biostatistics, Institute of Medical Research at St James's University of Leeds, Leeds, United Kingdom
| | - M Chan
- Section of Epidemiology and Biostatistics, Institute of Medical Research at St James's University of Leeds, Leeds, United Kingdom
| | - Z Rogers
- Section of Epidemiology and Biostatistics, Institute of Medical Research at St James's University of Leeds, Leeds, United Kingdom
| | - D T Bishop
- Section of Epidemiology and Biostatistics, Institute of Medical Research at St James's University of Leeds, Leeds, United Kingdom
| | - J A Newton-Bishop
- Section of Epidemiology and Biostatistics, Institute of Medical Research at St James's University of Leeds, Leeds, United Kingdom
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26
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Vaughan-Shaw PG, Zgaga L, Ooi LY, Theodoratou E, Timofeeva M, Svinti V, Walker M, O'Sullivan F, Ewing A, Johnston S, Din FVN, Campbell H, Farrington SM, Dunlop MG. Low plasma vitamin D is associated with adverse colorectal cancer survival after surgical resection, independent of systemic inflammatory response. Gut 2020; 69:103-111. [PMID: 31023832 PMCID: PMC6943245 DOI: 10.1136/gutjnl-2018-317922] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/04/2019] [Accepted: 03/26/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We assessed the effect of surgical resection of colorectal cancer (CRC) on perioperative plasma vitamin D (25OHD) and C-reactive protein (CRP) level. We investigated the relationship between circulating vitamin D level and CRC survival. DESIGN We sequentially sampled 92 patients undergoing CRC resection, and measured plasma 25OHD and CRP. For survival analyses, we assayed 25OHD and CRP in two temporally distinct CRC patient cohorts (n=2006, n=2100) and investigated the association between survival outcome, circulating vitamin D and systemic inflammatory response. RESULTS Serial sampling revealed a postoperative fall (mean 17.3 nmol/L; p=3.6e-9) in plasma 25OHD (nadir days 1-2). CRP peaked 3-5 days postoperatively (143.1 mg/L; p=1.4e-12), yet the postoperative fall in 25OHD was independent of CRP. In cohort analyses, 25OHD was lower in the 12 months following operation (mean=48.8 nmol/L) than preoperatively (54.8 nmol/L; p=1.2e-5) recovering after 24 months (52.2 nmol/L; p=0.002). Survival analysis in American Joint Committee on Cancer stages I-III demonstrated associations between 25OHD tertile and CRC mortality (HR=0.69; 95% CI 0.46 to 0.91) and all-cause mortality (HR=0.68; 95% CI 0.50 to 0.85), and was independent of CRP. We observed interaction effects between plasma 25OHD and rs11568820 genotype (functional VDR polymorphism) with a strong protective effect of higher 25OHD only in patients with GG genotype (HR=0.51; 95% CI 0.21 to 0.81). We developed an online tool for predicted survival (https://apps.igmm.ed.ac.uk/mortalityCalculator/) that incorporates 25OHD with clinically useful predictive performance (area under the curve 0.77). CONCLUSIONS CRC surgery induces a fall in circulating 25OHD. Plasma 25OHD level is a prognostic biomarker with low 25OHD associated with poorer survival, particularly in those with rs11568820 GG genotype. A randomised trial of vitamin D supplementation after CRC surgery has compelling rationale.
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Affiliation(s)
- P G Vaughan-Shaw
- Cancer Research UK Edinburgh Centre and MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - L Zgaga
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin 24, Republic of Ireland
| | - L Y Ooi
- Cancer Research UK Edinburgh Centre and MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - E Theodoratou
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - M Timofeeva
- Cancer Research UK Edinburgh Centre and MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - V Svinti
- Cancer Research UK Edinburgh Centre and MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - M Walker
- Cancer Research UK Edinburgh Centre and MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - F O'Sullivan
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin 24, Republic of Ireland
| | - A Ewing
- Cancer Research UK Edinburgh Centre and MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - S Johnston
- Specialist Endocrine Laboratory, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - F V N Din
- Cancer Research UK Edinburgh Centre and MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - H Campbell
- Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - S M Farrington
- Cancer Research UK Edinburgh Centre and MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - M G Dunlop
- Cancer Research UK Edinburgh Centre and MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
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27
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Kim H, Giovannucci E. Vitamin D Status and Cancer Incidence, Survival, and Mortality. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1268:39-52. [DOI: 10.1007/978-3-030-46227-7_3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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28
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Befon A, Katoulis AC, Georgala S, Katsampas A, Chardalia V, Melpidou A, Tzanetakou V, Chasapi V, Polydorou D, Desinioti C, Plaka M, Rigopoulos D, Stratigos AJ. Serum Total 25-Hydroxyvitamin D Levels in Patients With Cutaneous Malignant Melanoma: A Case-Control Study in a Low-Risk Southern European Population. Dermatol Pract Concept 2019; 10:e2020010. [PMID: 31921497 DOI: 10.5826/dpc.1001a10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2019] [Indexed: 12/16/2022] Open
Abstract
Background Recent data have shown an inverse association between serum 25-hydroxyvitamin D concentration and incidence of several cancers, including cutaneous malignant melanoma (CMM). In addition, lower serum 25-hydroxyvitamin D levels have been associated with thicker or higher stage melanomas and worse survival in observational studies. Materials and Methods Ninety-nine patients diagnosed with primary CMM and 97 matched healthy controls entered the study. Demographic characteristics, risk factors for CMM, and clinical and histological characteristics were recorded for patients with primary CMM. Total serum 25-hydroxyvitamin D levels of melanoma patients measured by fully automated chemiluminescent vitamin D total immunoassay (Elecsys vitamin D total, Roche) at the time of diagnosis were compared with those of healthy controls. In addition, we tested the association of serum total 25-hydroxyvitamin D levels at melanoma diagnosis with known risk and prognostic factors for CMM. Results Of the melanoma patients, 49 (49.49%) had deficient serum total 25-hydroxyvitamin D levels (<20 ng/mL), 23 (23.23%) had insufficient levels (21-29 ng/mL), and 27 (27.27%) had adequate levels (>30 ng/mL). The median serum total 25-hydroxyvitamin D levels were significantly lower in melanoma patients (20.62 ng/mL) compared with healthy controls (24.71 ng/mL), but statistical significance was not reached (chi-square test, P = 0.051) No statistically significant association was found between serum total 25-hydroxyvitamin D levels and demographic characteristics; risk factors for CMM; prognostic factors, such as Breslow thickness and ulceration; as well as clinical characteristics, such as melanoma stage, clinical type, and location. Conclusions Lower serum 25-hydroxyvitamin D levels were found in our Greek cohort of melanoma patients compared with healthy controls, without reaching, however, statistical significance; these levels were not statistically associated with established risk and prognostic factors for CMM.
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Affiliation(s)
- Angeliki Befon
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Alexander C Katoulis
- Second Department of Dermatology and Venereology, Attikon General University Hospital, National and Kapodistrian University of Athens, Greece
| | - Sofia Georgala
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Andreas Katsampas
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Vasiliki Chardalia
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Aggeliki Melpidou
- Biochemistry Laboratory, Evangelismos General Hospital of Athens, Greece
| | - Vasiliki Tzanetakou
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Vasiliki Chasapi
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Dorothea Polydorou
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Clio Desinioti
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Micaela Plaka
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Dimitris Rigopoulos
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Alexandros J Stratigos
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Syggros Hospital for Skin and Venereal Diseases, Athens, Greece
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Muralidhar S, Filia A, Nsengimana J, Poźniak J, O'Shea SJ, Diaz JM, Harland M, Randerson-Moor JA, Reichrath J, Laye JP, van der Weyden L, Adams DJ, Bishop DT, Newton-Bishop J. Vitamin D-VDR Signaling Inhibits Wnt/β-Catenin-Mediated Melanoma Progression and Promotes Antitumor Immunity. Cancer Res 2019; 79:5986-5998. [PMID: 31690667 DOI: 10.1158/0008-5472.can-18-3927] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/12/2019] [Accepted: 10/01/2019] [Indexed: 11/16/2022]
Abstract
1α,25-Dihydroxyvitamin D3 signals via the vitamin D receptor (VDR). Higher serum vitamin D is associated with thinner primary melanoma and better outcome, although a causal mechanism has not been established. As patients with melanoma commonly avoid sun exposure, and consequent vitamin D deficiency might worsen outcomes, we interrogated 703 primary melanoma transcriptomes to understand the role of vitamin D-VDR signaling and replicated the findings in The Cancer Genome Atlas metastases. VDR expression was independently protective for melanoma-related death in both primary and metastatic disease. High tumor VDR expression was associated with upregulation of pathways mediating antitumor immunity and corresponding with higher imputed immune cell scores and histologically detected tumor-infiltrating lymphocytes. High VDR-expressing tumors had downregulation of proliferative pathways, notably Wnt/β-catenin signaling. Deleterious low VDR levels resulted from promoter methylation and gene deletion in metastases. Vitamin D deficiency (<25 nmol/L ∼ 10 ng/mL) shortened survival in primary melanoma in a VDR-dependent manner. In vitro functional validation studies showed that elevated vitamin D-VDR signaling inhibited Wnt/β-catenin signaling genes. Murine melanoma cells overexpressing VDR produced fewer pulmonary metastases than controls in tail-vein metastasis assays. In summary, vitamin D-VDR signaling contributes to controlling pro-proliferative/immunosuppressive Wnt/β-catenin signaling in melanoma and this is associated with less metastatic disease and stronger host immune responses. This is evidence of a causal relationship between vitamin D-VDR signaling and melanoma survival, which should be explored as a therapeutic target in primary resistance to checkpoint blockade. SIGNIFICANCE: VDR expression could potentially be used as a biomarker to stratify patients with melanoma that may respond better to immunotherapy.
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Affiliation(s)
- Sathya Muralidhar
- University of Leeds School of Medicine, Leeds, United Kingdom
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Anastasia Filia
- Centre for Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | | | - Joanna Poźniak
- University of Leeds School of Medicine, Leeds, United Kingdom
- Laboratory for Molecular Cancer Biology, VIB Center for Cancer Biology, KU Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - Sally J O'Shea
- University of Leeds School of Medicine, Leeds, United Kingdom
- Faculty of Medicine and Health, University College Cork, Cork, Ireland
- Mater Private Hospital Cork, Citygate, Mahon, Cork, Ireland
| | - Joey M Diaz
- University of Leeds School of Medicine, Leeds, United Kingdom
| | - Mark Harland
- University of Leeds School of Medicine, Leeds, United Kingdom
| | | | - Jörg Reichrath
- Center for Clinical and Experimental Photodermatology, The Saarland University Hospital, Homburg, Germany
| | - Jonathan P Laye
- University of Leeds School of Medicine, Leeds, United Kingdom
| | - Louise van der Weyden
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - David J Adams
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom
| | - D T Bishop
- University of Leeds School of Medicine, Leeds, United Kingdom
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Vitamin D Deficiency has a Negative Impact on Cetuximab-Mediated Cellular Cytotoxicity against Human Colon Carcinoma Cells. Target Oncol 2019; 13:657-665. [PMID: 30090970 DOI: 10.1007/s11523-018-0586-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hypovitaminosis D is associated with an adverse prognosis in colon cancer patients, possibly due to the effects of the vitamin on the immune system. Antibody-dependent cell-mediated cytotoxicity (ADCC) significantly contributes to the anti-tumor effects of monoclonal antibodies, including cetuximab, an epidermal growth factor receptor (EGFR)-targeted monoclonal antibody that is frequently added to chemotherapy in the treatment of colon cancer. OBJECTIVE The present study evaluates the association between vitamin D serum levels and the ability of ex vivo NK cells to support cetuximab-mediated ADCC in colon cancer cell lines. METHODS Blood samples were obtained from 124 healthy volunteers and serum vitamin D was determined by RIA. NK cells were isolated from each sample and added to human colorectal carcinoma cells with or without cetuximab, and ADCC was assessed using a colorimetric lactate dehydrogenase assay. RESULTS Correlation analysis indicates a significant, gender- and age-independent association between vitamin D levels and cetuximab-induced ADCC on HT29 cells, where NK cells from samples with vitamin D < 20 ng/mL are significantly less efficient in inducing ADCC. A confirmatory study on two additional colon cancer cell lines yielded similar results. CONCLUSIONS These data suggest that vitamin D supplementation in vitamin-deficient/insufficient colorectal cancer patients could improve cetuximab-induced ADCC.
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Cattaruzza MS, Pisani D, Fidanza L, Gandini S, Marmo G, Narcisi A, Bartolazzi A, Carlesimo M. 25-Hydroxyvitamin D serum levels and melanoma risk: a case-control study and evidence synthesis of clinical epidemiological studies. Eur J Cancer Prev 2019; 28:203-211. [PMID: 29438161 DOI: 10.1097/cej.0000000000000437] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
There is accumulating evidence that the vitamin D pathway may play a role in melanoma. The aim of this study was to investigate the association between 25-hydroxyvitamin D [25(OH)D] serum levels and the risk of cutaneous melanoma. A case-control study with 137 incident cases of melanoma (serum samples collected at the time of diagnosis) and 99 healthy controls (serum samples collected between October and April) was carried out and evaluated in the framework of an evidence synthesis of clinical epidemiological studies on the topic to facilitate comparisons and summarize the scientific evidence produced so far. There was a statistically significant difference in the median levels of serum vitamin D between melanoma patients and healthy controls (18.0 vs. 27.8 ng/ml, P<0.001). Among melanoma patients, 66.2%, compared with 15.2% of healthy controls, had vitamin D deficiency (≤20 ng/ml), whereas vitamin D sufficiency (≥30 ng/ml) was observed in only 7.4% of melanoma patients and in 37.4% of the healthy controls (P<0.001). A multivariate model including age, sex, and BMI showed a statistically significant inverse association between melanoma and vitamin D sufficiency versus deficiency (odds ratio=0.04; 95% confidence interval: 0.02-0.10, P<0.001). Also, vitamin D insufficiency versus deficiency was significantly inversely associated with melanoma (odds ratio=0.13; 95% confidence interval: 0.06-0.27, P<0.001). These results suggest that both deficient and insufficient serum levels of vitamin D are associated with melanoma and that a trend seems to be present with a reduced risk of melanoma when vitamin D approaches normal values.
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Affiliation(s)
| | | | - Laura Fidanza
- Dermatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Sant'Andrea Hospital
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Giovanna Marmo
- Dermatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Sant'Andrea Hospital
| | - Alessandra Narcisi
- Dermatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Sant'Andrea Hospital
| | - Armando Bartolazzi
- Pathology Research Laboratory, Sant'Andrea Hospital, Rome.,Molecular and Cellular Tumor Pathology Laboratory, Cancer Center Karolinska, Karolinska Hospital, Stockholm, Sweden
| | - Marta Carlesimo
- Dermatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Sant'Andrea Hospital
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Ombra MN, Paliogiannis P, Stucci LS, Colombino M, Casula M, Sini MC, Manca A, Palomba G, Stanganelli I, Mandalà M, Gandini S, Lissia A, Doneddu V, Cossu A, Palmieri G. Dietary compounds and cutaneous malignant melanoma: recent advances from a biological perspective. Nutr Metab (Lond) 2019; 16:33. [PMID: 31139235 PMCID: PMC6528337 DOI: 10.1186/s12986-019-0365-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/12/2019] [Indexed: 12/31/2022] Open
Abstract
Cutaneous malignant melanoma is a heterogeneous disease, being the consequence of specific genetic alterations along several molecular pathways. Despite the increased knowledge about the biology and pathogenesis of melanoma, the incidence has grown markedly worldwide, making it extremely important to develop preventive measures. The beneficial role of correct nutrition and of some natural dietary compounds in preventing malignant melanoma has been widely demonstrated. This led to numerous studies investigating the role of several dietary attitudes, patterns, and supplements in the prevention of melanoma, and ongoing research investigates their impact in the clinical management and outcomes of patients diagnosed with the disease. This article is an overview of recent scientific advances regarding specific dietary compounds and their impact on melanoma development and treatment.
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Affiliation(s)
- Maria Neve Ombra
- 1Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Panagiotis Paliogiannis
- 2Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Luigia Stefania Stucci
- 3Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Bari, Italy
| | - Maria Colombino
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Milena Casula
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Maria Cristina Sini
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Antonella Manca
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Grazia Palomba
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
| | - Ignazio Stanganelli
- 5Istituto Scientifico Romagnolo per Studio e Cura Tumori (IRST-IRCCS), Meldola, Italy
| | - Mario Mandalà
- 6Medical Oncology, "Papa Giovanni XXIII" Hospital, Bergamo, Italy
| | - Sara Gandini
- 7Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Amelia Lissia
- 2Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Valentina Doneddu
- 2Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Antonio Cossu
- 2Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Giuseppe Palmieri
- 4Institute of Biomolecular Chemistry, National Research Council, Sassari, Italy
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Markotic A, Langer S, Kelava T, Vucic K, Turcic P, Tokic T, Stefancic L, Radetic E, Farrington S, Timofeeva M, Rudan I, Campbell H, Dunlop M, Kirac I, Zgaga L. Higher Post-Operative Serum Vitamin D Level is Associated with Better Survival Outcome in Colorectal Cancer Patients. Nutr Cancer 2019; 71:1078-1085. [PMID: 30945952 DOI: 10.1080/01635581.2019.1597135] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/10/2019] [Accepted: 03/13/2019] [Indexed: 12/28/2022]
Abstract
25-Hydroxyvitamin D (25-OHD) may have a prognostic value in colorectal cancer (CRC) patients. However, as 25-OHD concentration is strongly impacted by surgery, it is uncertain what is the most reliable time-point for 25-OHD assessment, pre- or post-operative. Therefore, we examined 515 CRC patients (AJCC I-III) who underwent surgery. Blood samples were collected either pre-operatively (n = 286; median = 1 day before surgery) or post-operatively (n = 229; median = 8 days). Serum 25-OHD concentration was determined by liquid chromatography-tandem mass spectrometry. Association between 25-OHD and survival was tested in the whole cohort, followed by stratified analyses in pre- and post-operatively sampled. Median 25-OHD in the cohort was 36.7 nmol/L and median follow-up time was 5.9 years. There were no differences between pre- and post-operative cohort in age, sex, 25-OHD, AJCC stage, or localization of tumor. After adjustment, higher 25-OHD (>50 nmol/L) was associated with better overall survival only in post-operative (HR = 0.53; 95% CI: 0.33-0.84; P = 0.006), but not in pre-operative cohort (HR = 1.13; 95% CI: 0.77-1.65; P = 0.53). In conclusion, higher post-operative 25-OHD levels were associated with better survival outcome in CRC patients, while no such association was found for pre-operative levels. Time-point of blood collection should be addressed carefully in future research as it might affect the prognostic value of 25-OHD in CRC.
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Affiliation(s)
- Antonio Markotic
- Center for Clinical Pharmacology, University Clinical Hospital Mostar , Mostar , Bosnia and Herzegovina
- Laboratory for Molecular Immunology, University of Zagreb School of Medicine , Zagreb , Croatia
| | - Sanja Langer
- Department of Medical Biochemistry in Oncology, University Hospital for Tumors , Zagreb , Croatia
| | - Tomislav Kelava
- Laboratory for Molecular Immunology, University of Zagreb School of Medicine , Zagreb , Croatia
- Department of Physiology, University of Zagreb School of Medicine , Zagreb , Croatia
| | - Katarina Vucic
- Department for Safety and Efficacy Assessment, Agency for Medicinal Products and Medical Devices , Zagreb , Croatia
| | - Petra Turcic
- Department of Pharmacology, University of Zagreb Faculty of Pharmacy and Biochemistry , Zagreb , Croatia
| | - Tomislav Tokic
- University of Zagreb School of Medicine , Zagreb , Croatia
| | - Ljilja Stefancic
- Department for Anaesthesiology and Intensive Care, University Hospital for Tumors , Zagreb , Croatia
| | - Eva Radetic
- University of Zagreb School of Medicine , Zagreb , Croatia
| | - Susan Farrington
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital , Edinburgh , UK
| | - Maria Timofeeva
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital , Edinburgh , UK
| | - Igor Rudan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh , Edinburgh , UK
| | - Harry Campbell
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh , Edinburgh , UK
| | - Malcolm Dunlop
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital , Edinburgh , UK
| | - Iva Kirac
- Department of Surgical Oncology, University Hospital for Tumors , Zagreb , Croatia
| | - Lina Zgaga
- Discipline of Public Health and Primary Care, Institute of Population Health, Trinity College, University of Dublin , Dublin , Ireland
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Campiotti L, Bolzacchini E, Sutter MB, Maresca AM, Grandi AM, Guasti L. Vitamin D and tyrosine kinase inhibitors in chronic myeloid leukemia. Intern Emerg Med 2018; 13:1337-1339. [PMID: 30255465 DOI: 10.1007/s11739-018-1957-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 09/19/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Leonardo Campiotti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy.
- UO Medicina 1, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Viale Borri 57, 21100, Varese, Italy.
| | | | | | | | - Anna Maria Grandi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Luigina Guasti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Weinstein SJ, Mondul AM, Yu K, Layne TM, Abnet CC, Freedman ND, Stolzenberg-Solomon RZ, Lim U, Gail MH, Albanes D. Circulating 25-hydroxyvitamin D up to 3 decades prior to diagnosis in relation to overall and organ-specific cancer survival. Eur J Epidemiol 2018; 33:1087-1099. [PMID: 30073448 PMCID: PMC6195863 DOI: 10.1007/s10654-018-0428-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/17/2018] [Indexed: 12/14/2022]
Abstract
While vitamin D has been associated with improved overall cancer survival in some investigations, few have prospectively evaluated organ-specific survival. We examined the accepted biomarker of vitamin D status, serum 25-hydroxyvitamin D [25(OH)D], and cancer survival in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Of 4616 cancer cases with measured serum 25(OH)D, 2884 died of their cancer during 28 years of follow-up and 1732 survived or died of other causes. Proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between pre-diagnostic 25(OH)D and overall and site-specific survival. Serum 25(OH)D was significantly lower among cases who subsequently died from their malignancy compared with those who did not (medians 34.7 vs. 36.5 nmol/L, respectively; p = 0.01). Higher 25(OH)D was associated with lower overall cancer mortality (HR = 0.76, 95% CI 0.67-0.85 for highest vs. lowest quintile, p-trend < 0.0001). Higher 25(OH)D was related to lower mortality from the following site-specific malignancies: prostate (HR = 0.74, 95% CI 0.55-1.01, p-trend = 0.005), kidney (HR = 0.59, 95% CI 0.35-0.98, p-trend = 0.28), and melanoma (HR = 0.39, 95% CI 0.20-0.78, p-trend = 0.01), but increased mortality from lung cancer (HR = 1.28, 95% CI 1.02-1.61, p-trend = 0.19). Improved survival was also suggested for head and neck, gastric, pancreatic, and liver cancers, though not statistically significantly, and case numbers for the latter two organ sites were small. Higher 25(OH)D status years prior to diagnosis was related to improved survival for overall and some site-specific cancers, associations that should be examined in other prospective populations that include women and other racial-ethnic groups.
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Affiliation(s)
- Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA.
| | - Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Tracy M Layne
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Racheal Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Unhee Lim
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Mitchell H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
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36
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Lipplaa A, Fernandes R, Marshall A, Lorigan P, Dunn J, Myers KA, Barker E, Newton-Bishop J, Middleton MR, Corrie PG. 25-hydroxyvitamin D serum levels in patients with high risk resected melanoma treated in an adjuvant bevacizumab trial. Br J Cancer 2018; 119:793-800. [PMID: 30033445 PMCID: PMC6189120 DOI: 10.1038/s41416-018-0179-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 06/14/2018] [Accepted: 06/20/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Studies evaluating a relationship of vitamin D in patients with primary melanoma have consistently identified 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 significantly vary over 12 months (p = 0.24). Individual pre-randomisation vitamin D levels did not differ significantly 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% confidence 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 benefit for patients with stage II disease treated with bevacizumab.
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Affiliation(s)
- Astrid Lipplaa
- Department of Oncology, University of Oxford, CB2 0QQ, Oxford, United Kingdom
- Leiden University Medical Center, Leiden, The Netherlands
| | - Ricardo Fernandes
- Department of Oncology, University of Oxford, CB2 0QQ, Oxford, United Kingdom
- Division of Medical Oncology, Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Andrea Marshall
- Warwick Clinical Trials Unit, University of Warwick, CV4 7AL, Coventry, United Kingdom
| | - Paul Lorigan
- University of Manchester and Christie NHS Foundation Trust, M20 4BX, Manchester, United Kingdom
| | - Janet Dunn
- Warwick Clinical Trials Unit, University of Warwick, CV4 7AL, Coventry, United Kingdom
| | - Kevin A Myers
- Department of Oncology, University of Oxford, CB2 0QQ, Oxford, United Kingdom
- Experimental Cancer Medicine Centre, OX3 7DQ, Oxford, United Kingdom
| | - Emily Barker
- Cambridge Cancer Trials Centre, Cambridge University Hospitals NHS Foundation Trust, CB2 0QQ, Cambridge, United Kingdom
| | - Julia Newton-Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, LS9 7TF, Leeds, United Kingdom
| | - Mark R Middleton
- Department of Oncology, University of Oxford, CB2 0QQ, Oxford, United Kingdom.
- NIHR Biomedical Research Centre, OX3 7LE, Oxford, United Kingdom.
| | - Pippa G Corrie
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, CB2 0QQ, Cambridge, United Kingdom
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Stucci LS, D'Oronzo S, Tucci M, Macerollo A, Ribero S, Spagnolo F, Marra E, Picasso V, Orgiano L, Marconcini R, De Rosa F, Di Guardo L, Galli G, Gandini S, Palmirotta R, Palmieri G, Queirolo P, Silvestris F. Vitamin D in melanoma: Controversies and potential role in combination with immune check-point inhibitors. Cancer Treat Rev 2018; 69:21-28. [PMID: 29864718 DOI: 10.1016/j.ctrv.2018.05.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 12/17/2022]
Abstract
The role of vitamin D in melanoma is still controversial. Although several Authors described a correlation between vitamin D deficiency and poor survival in metastatic melanoma patients, clinical trials exploring the effects of vitamin D supplementation in this clinical setting were mostly inconclusive. However, recent evidence suggests that vitamin D exerts both anti-proliferative effects on tumor cells and immune-modulating activities, that have been widely explored in auto-immune disorders. On the one hand, vitamin D has been shown to inhibit T-helper17 lymphocytes, notoriously involved in the pathogenesis of immune-related adverse events (iAEs) which complicate immune-checkpoint inhibitor (ICI) treatment. On the other hand, vitamin D up-regulates PDL-1 expression on both epithelial and immune cells, suggesting a synergic effect in combination with ICIs, for which further investigation is needed.
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Affiliation(s)
- Luigia Stefania Stucci
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
| | - Stella D'Oronzo
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy.
| | - Marco Tucci
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
| | - Antonella Macerollo
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London WC1N 3BG, United Kingdom
| | - Simone Ribero
- Department of Medical Sciences Section of Dermatology, University of Turin, Italy
| | - Francesco Spagnolo
- Department of Medical Oncology , Ospedale Policlinico San Martino, Genova, Italy
| | - Elena Marra
- Department of Medical Sciences Section of Dermatology, University of Turin, Italy
| | - Virginia Picasso
- Department of Medical Oncology , Ospedale Policlinico San Martino, Genova, Italy
| | - Laura Orgiano
- Department of Medical Oncology, University of Cagliari, Cagliari, Italy
| | - Riccardo Marconcini
- Department of Oncology, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Istituto Toscano Tumori, Santa Chiara Hospital, Pisa, Italy
| | - Francesco De Rosa
- Immunotherapy-Cell Therapy and Biobank Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Lorenza Di Guardo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giulia Galli
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara Gandini
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Raffaele Palmirotta
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
| | | | - Paola Queirolo
- Department of Medical Oncology , Ospedale Policlinico San Martino, Genova, Italy
| | - Francesco Silvestris
- Medical Oncology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari 'Aldo Moro', Italy
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Sample A, He YY. Mechanisms and prevention of UV-induced melanoma. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2018; 34:13-24. [PMID: 28703311 PMCID: PMC5760354 DOI: 10.1111/phpp.12329] [Citation(s) in RCA: 198] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/06/2017] [Indexed: 02/06/2023]
Abstract
Melanoma is the deadliest form of skin cancer and its incidence is rising, creating a costly and significant clinical problem. Exposure to ultraviolet (UV) radiation, namely UVA (315-400 nm) and UVB (280-315 nm), is a major risk factor for melanoma development. Cumulative UV radiation exposure from sunlight or tanning beds contributes to UV-induced DNA damage, oxidative stress, and inflammation in the skin. A number of factors, including hair color, skin type, genetic background, location, and history of tanning, determine the skin's response to UV radiation. In melanocytes, dysregulation of this UV radiation response can lead to melanoma. Given the complex origins of melanoma, it is difficult to develop curative therapies and universally effective preventative strategies. Here, we describe and discuss the mechanisms of UV-induced skin damage responsible for inducing melanomagenesis, and explore options for therapeutic and preventative interventions.
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Affiliation(s)
- Ashley Sample
- Department of Medicine, Section of Dermatology, University of Chicago, Chicago, IL
- Committee on Cancer Biology, University of Chicago, Chicago, IL
| | - Yu-Ying He
- Department of Medicine, Section of Dermatology, University of Chicago, Chicago, IL
- Committee on Cancer Biology, University of Chicago, Chicago, IL
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Orlow I, Shi Y, Kanetsky PA, Thomas NE, Luo L, Corrales-Guerrero S, Cust AE, Sacchetto L, Zanetti R, Rosso S, Armstrong BK, Dwyer T, Venn A, Gallagher RP, Gruber SB, Marrett LD, Anton-Culver H, Busam K, Begg CB, Berwick M. The interaction between vitamin D receptor polymorphisms and sun exposure around time of diagnosis influences melanoma survival. Pigment Cell Melanoma Res 2017; 31:287-296. [PMID: 28990310 DOI: 10.1111/pcmr.12653] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/28/2017] [Indexed: 12/17/2022]
Abstract
Evidence on the relationship between the vitamin D pathway and outcomes in melanoma is growing, although it is not always clear. We investigated the impact of measured levels of sun exposure at diagnosis on associations of vitamin D receptor gene (VDR) polymorphisms and melanoma death in 3336 incident primary melanoma cases. Interactions between six SNPs and a common 3'-end haplotype were significant (p < .05). These SNPs, and a haplotype, had a statistically significant association with survival among subjects exposed to high UVB in multivariable regression models and exerted their effect in the opposite direction among those with low UVB. SNPs rs1544410/BsmI and rs731236/TaqI remained significant after adjustment for multiple testing. These results suggest that the association between VDR and melanoma-specific survival is modified by sun exposure around diagnosis, and require validation in an independent study. Whether the observed effects are dependent or independent of vitamin D activation remains to be determined.
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Affiliation(s)
- Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yang Shi
- Biostatistics Shared Resource, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Nancy E Thomas
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Li Luo
- Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Sergio Corrales-Guerrero
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anne E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia
| | - Lidia Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Bruce K Armstrong
- School of Global and Population Health, The University of Western Australia, Perth, WA, Australia
| | - Terence Dwyer
- Nuffield Department of Obstetrics and Gynecology, The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Richard P Gallagher
- Cancer Control Research, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Stephen B Gruber
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Loraine D Marrett
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada
| | - Hoda Anton-Culver
- Department of Epidemiology, School of Medicine, University of California at Irvine, Irvine, CA, USA
| | - Klaus Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marianne Berwick
- Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
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- Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
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Ombra MN, Paliogiannis P, Doneddu V, Sini MC, Colombino M, Rozzo C, Stanganelli I, Tanda F, Cossu A, Palmieri G. Vitamin D status and risk for malignant cutaneous melanoma: recent advances. Eur J Cancer Prev 2017; 26:532-541. [PMID: 28125434 PMCID: PMC5627529 DOI: 10.1097/cej.0000000000000334] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 12/07/2016] [Indexed: 01/08/2023]
Abstract
Cutaneous malignant melanoma, whose incidence is increasing steadily worldwide, is the result of complex interactions between individual genetic factors and environmental risk factors. Ultraviolet radiation represents the most important environmental risk factor for the development of skin cancers, including melanoma. Sun exposure and early sunburn during childhood are the principal causes of cutaneous melanoma insurgence in adults, with double the risk relative to a nonexposed population. Consequently, ultraviolet protection has long been recognized as an important measure to prevent such a malignancy. Biological and epidemiological data suggest that vitamin D status could affect the risk of cancer and play a role in cancer prevention by exerting antiproliferative effects. Solar radiations are critical for vitamin D synthesis in humans; however, uncontrolled and intensive sun exposure is dangerous to skin health and may contribute toward the development of cutaneous malignant melanoma. An optimum balance between sun protection and exposure is thus advocated. Additional research is required to confirm the preventive role of vitamin D in melanoma incidence or a positive influence on patient outcome.
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Affiliation(s)
- Maria N. Ombra
- Institute of Food Sciences, National Research Council (CNR), Avellino
| | | | - Valentina Doneddu
- Department of Surgical, Microsurgical and Medical Sciences, University of Sassari
| | - Maria C. Sini
- Institute of Biomolecular Chemistry, National Research Council (CNR), Cancer Genetics Unit, Sassari
| | - Maria Colombino
- Institute of Biomolecular Chemistry, National Research Council (CNR), Cancer Genetics Unit, Sassari
| | - Carla Rozzo
- Institute of Biomolecular Chemistry, National Research Council (CNR), Cancer Genetics Unit, Sassari
| | - Ignazio Stanganelli
- Romagna Scientific Institute for the Study and Cure of Tumors, Skin Cancer Unit, Meldola, Italy
| | - Francesco Tanda
- Department of Surgical, Microsurgical and Medical Sciences, University of Sassari
| | - Antonio Cossu
- Department of Surgical, Microsurgical and Medical Sciences, University of Sassari
| | - Giuseppe Palmieri
- Institute of Biomolecular Chemistry, National Research Council (CNR), Cancer Genetics Unit, Sassari
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Affiliation(s)
- Geraldine Kyle
- Nurse Tutor, Centre for Learning and Development at Tallaght Hospital, Dublin 24, Ireland
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De Smedt J, Van Kelst S, Boecxstaens V, Stas M, Bogaerts K, Vanderschueren D, Aura C, Vandenberghe K, Lambrechts D, Wolter P, Bechter O, Nikkels A, Strobbe T, Emri G, Marasigan V, Garmyn M. Vitamin D supplementation in cutaneous malignant melanoma outcome (ViDMe): a randomized controlled trial. BMC Cancer 2017; 17:562. [PMID: 28835228 PMCID: PMC5569491 DOI: 10.1186/s12885-017-3538-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/09/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Previous studies have investigated the protective effect of vitamin D serum levels, at diagnosis and during the follow-up period after treatment, on melanoma outcome. In the present study we assess whether vitamin D supplementation, in the follow-up period after diagnosis and surgical resection of the primary tumor, has a protective effect on relapse of cutaneous malignant melanoma and whether this protective effect correlates with vitamin D levels in serum and Vitamin D Receptor immunoreactivity in the primary tumor. METHODS/DESIGN This study is a multicenter randomized double blind placebo- controlled phase III trial. Patients between the age of 18 and 80 years diagnosed and treated surgically for a melanoma stage IB-III are eligible for randomization in a 1:1 ratio to active treatment or placebo. The study drug is taken each month and consists of either 100,000 International Unit cholecalciferol or arachidis oleum raffinatum used as a placebo. The primary endpoint is relapse free survival. The secondary endpoints are 25 hydroxyvitamin D3 serum levels at diagnosis and at 6 month intervals, melanoma subtype, melanoma site and stage of melanoma at diagnosis according to the 2009 American Joint Committee on Cancer melanoma staging and classification. At randomization a bloodsample is taken for DNA analysis. The study is approved by the local Ethics Committees. DISCUSSION If we can confirm our hypothesis that vitamin D supplementation after removal of the tumor has a protective effect on relapse of cutaneous malignant melanoma we may reduce the burden of CMM at several levels. Patients, diagnosed with melanoma may have a better clinical outcome and improved quality of life. There will be a decrease in health care costs related to treatment of metastatic disease and there will be a decrease in loss of professional years, which will markedly reduce the economic burden of the disease. TRIAL REGISTRATION Clinical Trial.gov, NCT01748448 , 05/12/2012.
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Affiliation(s)
- J. De Smedt
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - S. Van Kelst
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - V. Boecxstaens
- Oncological and vascular access surgery, Department of surgical oncology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of oncology, KU Leuven, 3000 Leuven, Belgium
| | - M. Stas
- Oncological and vascular access surgery, Department of surgical oncology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of oncology, KU Leuven, 3000 Leuven, Belgium
| | - K. Bogaerts
- KU Leuven, Faculty of Medicine, I-BioStat, 3000 Leuven, Belgium
- Hasselt University, I-BioStat, 3590 Diepenbeek, Belgium
| | - D. Vanderschueren
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - C. Aura
- Translational Cell & Tissue Research, Department of Imaging & Pathology, KU Leuven, 3000 Leuven, Belgium
- Department of Pathology, University Hospitals of Leuven, 3000 Leuven, Belgium
| | - K. Vandenberghe
- Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - D. Lambrechts
- Laboratory for Translational Genetics, Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Vesalius Research Center, VIB, 3000 Leuven, Belgium
| | - P. Wolter
- Department of Hematology and Oncology, CHR Verviers East Belgium, 4800 Verviers, Belgium
| | - O. Bechter
- Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, 3000 Leuven, Belgium
| | - A. Nikkels
- Department of Dermatology, CHU Sart Tilman, University of Liège, 4000 Liège, Belgium
| | - T. Strobbe
- Department of Dermatology, University Hospital Antwerp, 2650 Edegem, Belgium
| | - G. Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, 4012 Hungary
| | - V. Marasigan
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - M. Garmyn
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
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Prognostic factors and outcomes in metastatic uveal melanoma treated with programmed cell death-1 or combined PD-1/cytotoxic T-lymphocyte antigen-4 inhibition. Eur J Cancer 2017. [PMID: 28648699 DOI: 10.1016/j.ejca.2017.05.038] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Uveal melanoma (UM) is an ocular malignancy with high potential for metastatic spread. In contrast to cutaneous melanoma, immunotherapy has not yet shown convincing efficacy in patients with UM. Combined immune checkpoint blockade with checkpoint programmed cell death-1 (PD-1) and checkpoint cytotoxic T-lymphocyte antigen-4 (CTLA-4) inhibition has not been systematically assessed for UM to date. PATIENTS AND METHODS Patients with metastatic UM treated with either PD-1 inhibitor monotherapy or combined PD-1 inhibitor and ipilimumab (an anti-CTLA-4 monoclonal antibody) were included from 20 German skin cancer centres. Records from 96 cases were analysed for treatment outcomes. Clinical and blood parameters associated with overall survival (OS) or treatment response were identified with multivariate Cox regression and binary logistic regression. RESULTS Eighty-six patients were treated with PD-1 inhibitors only (n = 54 for pembrolizumab, n = 32 for nivolumab) with a centrally confirmed response rate of 4.7%. Median OS was 14 months for pembrolizumab-treated and 10 months for nivolumab-treated patients (p = 0.765). Fifteen patients were treated with combined immune checkpoint blockade with partial response observed in two cases. Median OS was not reached in this group. Multivariate Cox regression identified Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.002), elevated serum levels of lactate dehydrogenase (LDH) (p = 0.002) and C-reactive protein (CRP) (p = 0.001), and a relative eosinophil count (REC) <1.5% (p = 0.002) as independent risk factors for poor survival. Patients with elevated CRP and LDH and a REC <1.5% were at highest risk for disease progression and death (p = 0.001). CONCLUSIONS Blood markers predict survival in metastatic UM treated with immune checkpoint blockade. Normal serum levels of LDH and CRP and a high REC may help identify patients with better prognosis.
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Stenehjem JS, Grimsrud TK, Rees JR, Vos L, Babigumira R, Veierød MB, Robsahm TE. A protocol for prospective studies of 25-hydroxyvitamin D, leptin and body mass index in relation to cutaneous melanoma incidence and survival. BMJ Open 2017; 7:e014829. [PMID: 28637727 PMCID: PMC5623373 DOI: 10.1136/bmjopen-2016-014829] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 03/22/2017] [Accepted: 03/31/2017] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The incidence and mortality rates of cutaneous melanoma (CM) are increasing among fair-skinned populations worldwide. Ultraviolet radiation (UVR) is the principal risk factor for CM, but is also the main source of 25-hydroxyvitamin D (25(OH)D), which has been associated with reduced risk and better prognosis of some cancer types. However, both low and high 25(OH)D levels have been associated with increased risk of CM. Obesity as measured by body mass index (BMI) is associated with risk of several cancers and has also been suggested as a risk factor for CM, and may also be related to insufficient 25(OH)D and/or high leptin levels. Moreover, contracting a CM diagnosis has been associated with increased risk of developing second cancer. We aim to study whether low prediagnostic serum levels of 25(OH)D, high prediagnostic levels of BMI and high serum leptin levels influence CM incidence, Breslow thickness and CM mortality, and risk of second cancer and survival after a CM diagnosis. METHODS AND ANALYSIS Cohort and nested case-control studies will be carried out using the population-based Janus Serum Bank Cohort (archival prediagnostic sera, BMI, smoking and physical activity), with follow-up from 1972 to 2014. Additional data will be received from the Cancer Registry of Norway, the national Cause of Death Registry, Statistics Norway (education and occupation) and exposure matrices of UVR. Time-to-event regression models will be used to analyse the cohort data, while the nested case-control studies will be analysed by conditional logistic regression. A multilevel approach will be applied when incorporating group-level data. ETHICS AND DISSEMINATION The project is approved by the Regional Committee for Medical Research Ethics and is funded by the Norwegian Cancer Society. Results will be published in peer-reviewed journals, at scientific conferences and in the news media.
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Affiliation(s)
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Judith R Rees
- New Hampshire State Cancer Registry, Lebanon, New Hampshire, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Linda Vos
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | | | - Marit B Veierød
- Oslo Center for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway
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Vitamin D signaling and melanoma: role of vitamin D and its receptors in melanoma progression and management. J Transl Med 2017; 97:706-724. [PMID: 28218743 PMCID: PMC5446295 DOI: 10.1038/labinvest.2017.3] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/22/2016] [Accepted: 12/23/2016] [Indexed: 12/19/2022] Open
Abstract
Ultraviolet B (UVB), in addition to having carcinogenic activity, is required for the production of vitamin D3 (D3) in the skin which supplies >90% of the body's requirement. Vitamin D is activated through hydroxylation by 25-hydroxylases (CYP2R1 or CYP27A1) and 1α-hydroxylase (CYP27B1) to produce 1,25(OH)2D3, or through the action of CYP11A1 to produce mono-di- and trihydroxy-D3 products that can be further modified by CYP27B1, CYP27A1, and CYP24A1. The active forms of D3, in addition to regulating calcium metabolism, exert pleiotropic activities, which include anticarcinogenic and anti-melanoma effects in experimental models, with photoprotection against UVB-induced damage. These diverse effects are mediated through an interaction with the vitamin D receptor (VDR) and/or as most recently demonstrated through action on retinoic acid orphan receptors (ROR)α and RORγ. With respect to melanoma, low levels of 25(OH)D are associated with thicker tumors and reduced patient survival. Furthermore, single-nucleotide polymorphisms of VDR and the vitamin D-binding protein (VDP) genes affect melanomagenesis or disease outcome. Clinicopathological analyses have shown positive correlation between low or undetectable expression of VDR and/or CYP27B1 in melanoma with tumor progression and shorter overall (OS) and disease-free survival (DFS) times. Paradoxically, this correlation was reversed for CYP24A1 (inactivating 24-hydroxylase), indicating that this enzyme, while inactivating 1,25(OH)2D3, can activate other forms of D3 that are products of the non-canonical pathway initiated by CYP11A1. An inverse correlation has been found between the levels of RORα and RORγ expression and melanoma progression and disease outcome. Therefore, we propose that defects in vitamin D signaling including D3 activation/inactivation, and the expression and activity of the corresponding receptors, affect melanoma progression and the outcome of the disease. The existence of multiple bioactive forms of D3 and alternative receptors affecting the behavior of melanoma should be taken into consideration when applying vitamin D management for melanoma therapy.
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Hegedüs L, Padányi R, Molnár J, Pászty K, Varga K, Kenessey I, Sárközy E, Wolf M, Grusch M, Hegyi Z, Homolya L, Aigner C, Garay T, Hegedüs B, Tímár J, Kállay E, Enyedi Á. Histone Deacetylase Inhibitor Treatment Increases the Expression of the Plasma Membrane Ca 2+ Pump PMCA4b and Inhibits the Migration of Melanoma Cells Independent of ERK. Front Oncol 2017; 7:95. [PMID: 28596940 PMCID: PMC5442207 DOI: 10.3389/fonc.2017.00095] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/27/2017] [Indexed: 12/13/2022] Open
Abstract
Several new therapeutic options emerged recently to treat metastatic melanoma; however, the high frequency of intrinsic and acquired resistance among patients shows a need for new therapeutic options. Previously, we identified the plasma membrane Ca2+ ATPase 4b (PMCA4b) as a metastasis suppressor in BRAF-mutant melanomas and found that mutant BRAF inhibition increased the expression of the pump, which then inhibited the migratory and metastatic capability of the cells. Earlier it was also demonstrated that histone deacetylase inhibitors (HDACis) upregulated PMCA4b expression in gastric, colon, and breast cancer cells. In this study, we treated one BRAF wild-type and two BRAF-mutant melanoma cell lines with the HDACis, SAHA and valproic acid, either alone, or in combination with the BRAF inhibitor, vemurafenib. We found that HDACi treatment strongly increased the expression of PMCA4b in all cell lines irrespective of their BRAF mutational status, and this effect was independent of ERK activity. Furthermore, HDAC inhibition also enhanced the abundance of the housekeeping isoform PMCA1. Combination of HDACis with vemurafenib, however, did not have any additive effects on either PMCA isoform. We demonstrated that the HDACi-induced increase in PMCA abundance was coupled to an enhanced [Ca2+]i clearance rate and also strongly inhibited both the random and directional movements of A375 cells. The primary role of PMCA4b in these characteristic changes was demonstrated by treatment with the PMCA4-specific inhibitor, caloxin 1c2, which was able to restore the slower Ca2+ clearance rate and higher motility of the cells. While HDAC treatment inhibited cell motility, it decreased only modestly the ratio of proliferative cells and cell viability. Our results show that in melanoma cells the expression of both PMCA4b and PMCA1 is under epigenetic control and the elevation of PMCA4b expression either by HDACi treatment or by the decreased activation of the BRAF-MEK-ERK pathway can inhibit the migratory capacity of the highly motile A375 cells.
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Affiliation(s)
- Luca Hegedüs
- Department of Thoracic Surgery, Ruhrlandklinik, University Clinic Essen, Essen, Germany.,Department of Pathophysiology and Allergy Research, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Rita Padányi
- 2nd Institute of Pathology, Semmelweis University, Budapest, Hungary
| | - Judit Molnár
- 2nd Institute of Pathology, Semmelweis University, Budapest, Hungary
| | - Katalin Pászty
- Molecular Biophysics Research Group of the Hungarian Academy of Sciences, Department of Biophysics, Semmelweis University, Budapest, Hungary
| | - Karolina Varga
- 2nd Institute of Pathology, Semmelweis University, Budapest, Hungary.,MTA-SE-NAP Brain Metastasis Research Group of the Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - István Kenessey
- 2nd Institute of Pathology, Semmelweis University, Budapest, Hungary
| | - Eszter Sárközy
- 2nd Institute of Pathology, Semmelweis University, Budapest, Hungary
| | - Matthias Wolf
- Department of Medicine I, Institute of Cancer Research, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Michael Grusch
- Department of Medicine I, Institute of Cancer Research, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Zoltán Hegyi
- Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - László Homolya
- Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Clemens Aigner
- Department of Thoracic Surgery, Ruhrlandklinik, University Clinic Essen, Essen, Germany
| | - Tamás Garay
- Molecular Oncology Research Group of the Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Balázs Hegedüs
- Department of Thoracic Surgery, Ruhrlandklinik, University Clinic Essen, Essen, Germany.,Molecular Oncology Research Group of the Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - József Tímár
- 2nd Institute of Pathology, Semmelweis University, Budapest, Hungary.,Molecular Oncology Research Group of the Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Enikö Kállay
- Department of Pathophysiology and Allergy Research, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Ágnes Enyedi
- 2nd Institute of Pathology, Semmelweis University, Budapest, Hungary.,Molecular Oncology Research Group of the Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
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Vaughan-Shaw PG, O'Sullivan F, Farrington SM, Theodoratou E, Campbell H, Dunlop MG, Zgaga L. The impact of vitamin D pathway genetic variation and circulating 25-hydroxyvitamin D on cancer outcome: systematic review and meta-analysis. Br J Cancer 2017; 116:1092-1110. [PMID: 28301870 PMCID: PMC5396104 DOI: 10.1038/bjc.2017.44] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/20/2017] [Accepted: 01/26/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D has been linked with improved cancer outcome. This systematic review and meta-analysis investigates the relationship between cancer outcomes and both vitamin D-related genetic variation and circulating 25-hydroxyvitamin D (25OHD) concentration. METHODS A systematic review and meta-analysis of papers until November 2016 on PubMed, EMBASE and Web of Science pertaining to association between circulating vitamin D level, functionally relevant vitamin D receptor genetic variants and variants within vitamin D pathway genes and cancer survival or disease progression was performed. RESULTS A total of 44 165 cases from 64 studies were included in meta-analyses. Higher 25OHD was associated with better overall survival (hazard ratio (HR=0.74, 95% CI: 0.66-0.82) and progression-free survival (HR=0.84, 95% CI: 0.77-0.91). The rs1544410 (BsmI) variant was associated with overall survival (HR=1.40, 95% CI: 1.05-1.75) and rs7975232 (ApaI) with progression-free survival (HR=1.29, 95% CI: 1.02-1.56). The rs2228570 (FokI) variant was associated with overall survival in lung cancer patients (HR=1.29, 95% CI: 1.0-1.57), with a suggestive association across all cancers (HR=1.26, 95% CI: 0.96-1.56). CONCLUSIONS Higher 25OHD concentration is associated with better cancer outcome, and the observed association of functional variants in vitamin D pathway genes with outcome supports a causal link. This analysis provides powerful background rationale to instigate clinical trials to investigate the potential beneficial effect of vitamin D in the context of stratification by genotype.
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Affiliation(s)
- P G Vaughan-Shaw
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
| | - F O'Sullivan
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin 24, Republic of Ireland
| | - S M Farrington
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
| | - E Theodoratou
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH164UX, UK
| | - H Campbell
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH164UX, UK
| | - M G Dunlop
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
| | - L Zgaga
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin 24, Republic of Ireland
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Del Puerto C, Navarrete-Dechent C, Molgó M, Borzutzky A, González S. Vitamin D axis and its role in skin carcinogenesis: a comprehensive review. ACTA ACUST UNITED AC 2016. [DOI: 10.1186/s41241-016-0006-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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O'Shea SJ, Davies JR, Newton-Bishop JA. Vitamin D, vitamin A, the primary melanoma transcriptome and survival. Br J Dermatol 2016; 175 Suppl 2:30-34. [PMID: 27667313 PMCID: PMC5053247 DOI: 10.1111/bjd.14919] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 12/21/2022]
Abstract
Survival from melanoma is influenced by several, well-established clinical and histopathological factors, e.g. age, Breslow thickness and microscopic ulceration. We (the Section of Epidemiology and Biostatistics, University of Leeds) have carried out research to better understand the biological basis for these observations. Preliminary results indicated a protective role for vitamin D in melanoma relapse and that higher vitamin D was associated with thinner primary melanomas. Funding from the British Skin Foundation enabled JNB to establish a study of the effects of vitamin A in melanoma. The results suggested that vitamin A could reduce the protective effect of vitamin D in terms of overall survival. Therefore, we propose that vitamin D3 supplementation alone might be preferable to combined multivitamin preparations, where vitamin D supplementation is deemed to be appropriate. Proving a causal link between vitamin D and melanoma-specific survival is challenging. We have shown limited evidence of causation in a Mendelian randomization experiment (described in more detail later). Recent work in Leeds has also shown that higher vitamin D may be protective for microscopic ulceration. Taken together, vitamin D appears to be associated with less aggressive primary melanomas and may itself influence outcome. We continue to explore the role of vitamin D in melanoma survival and the optimum levels that might be crucial.
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Affiliation(s)
- S J O'Shea
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Cancer Genetics Building, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - J R Davies
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Cancer Genetics Building, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK
| | - J A Newton-Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Cancer Genetics Building, St. James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
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Reichrath J, Zouboulis CC, Vogt T, Holick MF. Targeting the vitamin D endocrine system (VDES) for the management of inflammatory and malignant skin diseases: An historical view and outlook. Rev Endocr Metab Disord 2016; 17:405-417. [PMID: 27447175 DOI: 10.1007/s11154-016-9353-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Vitamin D represents one of the major driving factors for the development of life on earth and for human evolution. While up to 10-20 % of the human organism's requirements in vitamin D can be obtained by the diet (under most living conditions in the USA and Europe), approximately 90 % of all needed vitamin D has to be photosynthesized in the skin through the action of the sun (ultraviolet-B (UV-B)). The skin represents a key organ of the human body's vitamin D endocrine system (VDES), being both the site of vitamin D synthesis and a target tissue for biologically active vitamin D metabolites. It was shown that human keratinocytes possess the enzymatic machinery (CYP27B1) for the synthesis of the biologically most active natural vitamin D metabolite 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), representing an autonomous vitamin D3 pathway. Cutaneous production of 1,25(OH)2D3 may exert intracrine, autocrine, and paracrine effects on keratinocytes and on neighboring cells. Many skin cells (including keratinocytes, sebocytes, fibroblasts, melanocytes, and skin immune cells) express the vitamin D receptor (VDR), an absolute pre-requisite for the mediation of genomic effects of 1,25(OH)2D3 and analogs. VDR belongs to the superfamily of trans-acting transcriptional regulatory factors, which includes the steroid and thyroid hormone receptors as well as the retinoid X receptors (RXR) and retinoic acid receptors (RAR). Numerous studies, including cDNA microarray analyses of messenger RNAs (mRNAs), indicate that as many as 500-1000 genes may be regulated by VDR ligands that control various cellular functions including growth, differentiation, and apoptosis. The observation that 1,25(OH)2D3 is extremely effective in inducing the terminal differentiation and in inhibiting the proliferation of cultured human keratinocytes has resulted in the use of vitamin D analogs for the treatment of psoriasis. This review gives an historical view and summarizes our present knowledge about the relevance of the VDES for the management of inflammatory and malignant skin diseases.
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Affiliation(s)
- Jörg Reichrath
- Center for Clinical and Experimental Photo-Dermatology and Department of Dermatology, The Saarland University Hospital, Kirrbergerstr, 66421, Homburg, Germany.
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Thomas Vogt
- Center for Clinical and Experimental Photo-Dermatology and Department of Dermatology, The Saarland University Hospital, Kirrbergerstr, 66421, Homburg, Germany
| | - Michael F Holick
- Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University Medical Center, 85 E Newton St M-1013, Boston, MA, 02118, USA
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