Observational studyCancer immunology, immunotherapy : CII2023
Systematic vitamin D supplementation is associated with improved outcomes and reduced thyroid adverse events in patients with cancer treated with immune checkpoint inhibitors: results from the prospective PROVIDENCE study.
Observational study in Cancer immunology, immunotherapy : CII, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 19 citations in OpenAlex.
- Pretreatment serum vitamin D levels predict the therapeutic efficacy of atezolizumab plus bevacizumab therapy in advanced hepatocellular carcinoma: a multicenter analysis.International journal of clinical oncology · 2026Article
- Seasonal variation in immune-related adverse events in advanced cancer patients.Cancer immunology, immunotherapy : CII · 2026Article
- Baseline vitamin D status and clinical outcomes in advanced non-small cell lung cancer patients treated with nivolumab.Scientific reports · 2026Article
- The impact of concomitant medications on treatment outcomes in patients with cancer receiving immune checkpoint inhibitors.Nature reviews. Cancer · 2026Review
- Nutritional biomarkers regulating tumor immune microenvironment in osteosarcoma and as predictors of immune checkpoint inhibitor responses.Frontiers in immunology · 2026Review
- Non-pharmacological Supportive Care Interventions during Immunotherapy for People with Cancer: A Systematic Scoping Review and Future Directions.Current oncology reports · 2025Article
- Metabolites as agents and targets for cancer immunotherapy.Nature reviews. Drug discovery · 2025Review
- Therapeutic implications of vitamin D in leukemia: mechanistic and clinical perspectives.Medical oncology (Northwood, London, England) · 2025Review
- Vitamin D, Gut Microbiota, and Cancer Immunotherapy-A Potentially Effective Crosstalk.International journal of molecular sciences · 2025Review
- Vitamin D and Immune Checkpoint Inhibitors in Lung Cancer: A Synergistic Approach to Enhancing Treatment Efficacy.International journal of molecular sciences · 2025Review
- Pre-treatment endocrine-nutritional signatures predict clinical benefit from PD-1/PD-L1 blockade in hematologic malignancies.Frontiers in nutrition · 2025Review
- Immunometabolism in cancer: a systemic perspective.Frontiers in immunology · 2025Review
- Role of Nutrients Regulating Myeloid Derived Suppressor Cells in Cancer: A Scoping Review.Current issues in molecular biology · 2024Article
- Article
- Integrative Oncology Approaches to Supporting Immune Checkpoint Inhibitor Treatment of Solid Tumours.Current oncology reports · 2024Review
- Complementary and Alternative Medicine (CAM) Use in Patients Undergoing Radiotherapy: Sex-specific Prevalence and Associations of Use Based on the S3 Guideline Complementary Medicine in Oncology Questionnaire.In vivo (Athens, Greece)Article
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Authors and funding
28 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypovitaminosis D can have a negative prognostic impact in patients with cancer. Vitamin D has a demonstrated role in T-cell-mediated immune activation. We hypothesized that systematic vitamin D repletion could impact clinical outcomes in patients with cancer receiving immune-checkpoint inhibitors (ICIs).
methodsWe planned a prospective observational study (PROVIDENCE) to assess serum vitamin D levels in patients with advanced cancer receiving ICIs (cohort 1 at treatment initiation, cohort 2 during treatment) and the impact of systematic repletion on survival and toxicity outcomes. In an exploratory analysis, we compared the clinical outcomes of cohort 1 with a control cohort of patients followed at the participating centers who did not receive systematic vitamin D repletion.
resultsOverall, 164 patients were prospectively recruited in the PROVIDENCE study. In cohort 1, consisting of 101 patients 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 patients assessed for vitamin D at a median time of 3.7 months since immunotherapy initiation, with no patients having adequate levels (> 30 ng/ml). Even in cohort 2, systematic supplementation led to adequate levels in 77.8% of patients at the three months re-assessment. Compared to a retrospective control group of 238 patients without systematic vitamin D repletion, PROVIDENCE cohort 1 showed longer overall survival (OS, p = 0.013), time to treatment failure (TTF, p = 0.017), and higher disease control rate (DCR, p = 0.016). The Inverse Probability of Treatment Weighing (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 patients from PROVIDENCE cohort 1 in comparison to the control cohort. In the context of longer treatment exposure, the cumulative incidence of any grade immune-related adverse events (irAEs) was higher in the PROVIDENCE cohort 1 compared to the control cohort. Nevertheless, patients 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).
conclusionThe PROVIDENCE study suggests the potential positive impact of early systematic vitamin D supplementation on outcomes of patients with advanced cancer receiving ICIs and support adequate repletion as a possible prophylaxis for thyroid irAEs.
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