Vitamin D Levels in Patients With High-Risk Resected Melanoma
Posted: Thursday, September 20, 2018
Vitamin D levels did not seem to correlate with known prognostic markers, nor did they predict survival or recurrence in patients with stage IIB to IIIC melanoma who participated in the phase III AVAST-M adjuvant melanoma randomized trial. This research was published by Astrid Lipplaa, MD, of the Leiden University Medical Center in Leiden, The Netherlands, and colleagues, in the British Journal of Cancer. However, there was some evidence of benefit for patients with stage II disease treated with bevacizumab; the disease-free interval improved with higher prerandomization vitamin D levels for these patients compared with the control arm.
Studies evaluating vitamin D levels in patients at the time of a melanoma diagnosis have consistently identified an inverse correlation with Breslow thickness and a known prognostic factor. However, vitamin D in advanced melanoma has been less well studied.
Serum vitamin D levels were measured in 341 patients from the trial with resected stage IIB to IIIC melanoma. Samples were collected after surgery, prior to study randomization, and then again at 3 and 12 months. Vitamin D levels were compared with patient demographics, known melanoma prognostic factors, disease-free interval, and overall survival.
The median prerandomization vitamin D level was 56.5 nmol/L. Levels did not significantly vary over 12 months and did not differ significantly for Breslow thickness, tumor ulceration, or disease stage, nor did they predict for disease-free interval or overall survival, according to the investigators.
“Overall, vitamin D levels did not predict for subsequent relapse or survival. These findings contrast with stronger reported associations with melanoma stage at diagnosis and may reflect changes in biological effects of vitamin D at later stages of the disease,” Dr. Lipplaa and colleagues concluded.