What did the research discover?
This study examined whether low vitamin D levels before chemotherapy increase the risk of developing chemotherapy-induced peripheral neuropathy (CIPN) in patients receiving paclitaxel for early-stage breast cancer. CIPN is a common and painful side effect of chemotherapy that affects nerves, leading to tingling, numbness, and pain, sometimes lasting for years.
Researchers analyzed data from 1,191 female breast cancer patients in a large phase III clinical trial (SWOG S0221) and measured vitamin D levels before treatment. They found:
- Patients with vitamin D insufficiency (≤20 ng/mL) had a higher risk of severe CIPN (20.7% vs. 14.2% in those with sufficient vitamin D).
- Even after adjusting for factors like age and chemotherapy dose, low vitamin D remained a significant risk factor for developing CIPN.
- In mouse experiments, a vitamin D-deficient diet caused nerve hypersensitivity and made the mice more sensitive to paclitaxel-induced nerve damage.
This study validates vitamin D insufficiency as a modifiable risk factor for CIPN and suggests that low vitamin D may contribute to racial disparities, as Black patients had higher rates of vitamin D deficiency and CIPN.
How can I apply this information?
If you are undergoing chemotherapy with paclitaxel, this study suggests that checking your vitamin D levels before treatment could help identify if you are at higher risk for nerve damage. Vitamin D supplementation may be a potential strategy to prevent CIPN, but more clinical trials are needed to confirm this.
Since vitamin D is a low-cost and widely available supplement, patients with low vitamin D levels may consider talking to their doctor about whether supplementation could help reduce their risk of chemotherapy-related nerve damage and improve long-term treatment outcomes.
Source:
Chen CS, Zirpoli G, Barlow WE, Budd GT, McKiver B, Pusztai L, Hortobagyi GN, Albain KS, Damaj MI, Godwin AK, Thompson A. Vitamin D Insufficiency as a Risk Factor for Paclitaxel-Induced Peripheral Neuropathy in SWOG S0221. Journal of the National Comprehensive Cancer Network. 2023 Nov 1;21(11):1172-80.https://pmc.ncbi.nlm.nih.gov/articles/PMC10976748/
