Abstract 2125P
Background
Hypovitaminosis D can have a negative impact in patients (pts) with cancer. We hypothesized that systematic vitamin D repletion could improve outcomes in pts receiving immune-checkpoint inhibitors (ICIs).
Methods
We planned a prospective observational study (PROVIDENCE) to investigate vitamin D levels in pts with advanced cancer receiving ICIs (cohort 1 at treatment initiation, cohort 2 during treatment) and the impact of systematic repletion in the case of hypovitaminosis on survival and toxicity outcomes. In an exploratory analysis, we compared clinical outcomes of cohort 1 with a control cohort of pts followed at the participating centers who did not receive systematic vitamin D repletion.
Results
Overall, 164 pts were prospectively recruited. In cohort 1, consisting of 101 pts with 94.1% hypovitaminosis (≤30 ng/ml) at baseline, adequate repletion with cholecalciferol was obtained in 70.1% at the three months re-assessment. Cohort 2 consisted of 63 pts assessed for vitamin D at a median time of 3.7 months since immunotherapy initiation, with no pts having adequate levels (>30 ng/ml). Even in cohort 2, systematic supplementation led to adequate levels in 77.8% of pts at the three months re-assessment. Compared to a retrospective control group of 238 pts without systematic vitamin D repletion, PROVIDENCE cohort 1 showed longer OS and time to treatment failure (TTF), p=0.013 and p=0.017. The IPTW-fitted multivariable Cox regression confirmed the significantly decreased risk of death (HR 0.55, 95%CI: 0.34-0.90) and treatment discontinuation (HR 0.61, 95%CI: 0.40-0.91) for pts from PROVIDENCE cohort 1 in comparison to the control cohort. In the context of longer treatment exposure, the cumulative incidence of any grade irAEs was higher in the PROVIDENCE cohort 1 compared to the control cohort. Nevertheless, pts from cohort 1 experienced a significantly decreased risk of all grade thyroid irAEs than the control cohort (OR 0.16, 95%CI: 0.03-0.85).
Conclusions
The PROVIDENCE study suggests the potential positive impact of early systematic vitamin D supplementation on outcome of pts with advanced cancer receiving ICIs and support adequate repletion as a possible prophylaxis for thyroid irAEs.
Clinical trial identification
Not Applicable
Editorial acknowledgement
Not applicable
Legal entity responsible for the study
University Hospital of Parma.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2085P - Buprenorphine use and cancer outcomes
Presenter: Nosayaba Osazuwa-Peters
Session: Poster session 06
2086P - Management of opioids use disorder in cancer survivors
Presenter: Khalida Berkane
Session: Poster session 06
2087P - Impact of cancer pain on quality of life and financial well-being: A cross-sectional study on symptom management
Presenter: Raffaele Giusti
Session: Poster session 06
2088P - Management of cancer treatment-induced bone loss in patients with breast and hormone sensitive prostate cancer: AIOM survey among Italian oncologists
Presenter: Anna Amela Valsecchi
Session: Poster session 06
2090P - Management of trastuzumab deruxtecan-related nausea and vomiting in real-world practice
Presenter: Luca Licata
Session: Poster session 06
2091P - Dermocosmetics in management of cancer-related skin toxicities: International expert consensus highlighting the key role of oncology nurses
Presenter: Pascale Dielenseger
Session: Poster session 06
2092P - Bone loss in premenopausal Algerian women treated with chemotherapy for early-stage of breast cancer: Evaluation by DXA and identification of associated risk factors
Presenter: MACHEROUM Fatma zohra
Session: Poster session 06
2093P - Bioelectrical Impedance phase angle and obesity as a prognostic indicator in metastatic gastric cancer patients receiving second-line chemotherapy
Presenter: SangUk Han
Session: Poster session 06
2094P - A multicenter phase II trial of the triplet antiemetic therapy with palonosetron, aprepitant and olanzapine for highly emetogenic chemotherapy in breast cancer
Presenter: Shinya Takada
Session: Poster session 06