New research in JNCCN suggests a simple and inexpensive option for reducing a major chemotherapy side-effect

PLYMOUTH MEETING, PA [November 7, 2023] — New research in the November 2023 issue of JNCCN—Journal of the National Comprehensive Cancer Network suggests that patients who have insufficient levels of vitamin D before starting paclitaxel treatment are more likely to experience peripheral neuropathy. According to an analysis of 1,191 patients with early-stage breast cancer—using data collected in the SWOG S0221 study—20.7% of patients with vitamin D deficiency experienced at least a grade 3 level of chemotherapy-induced peripheral neuropathy (CIPN), compared to 14.2% of those with sufficient vitamin D levels. The researchers also found that inducing vitamin D deficiency in an accompanying mice model study caused neurotoxicity-like symptoms.

“These results suggest that vitamin D supplementation in patients with lower levels of vitamin D may reduce peripheral neuropathy, and particularly high grade peripheral neuropathy, which would improve these patients’ long-term quality of life,” explained senior researcher Daniel L. Hertz, PharmD, PhD, University of Michigan College of Pharmacy. “There are barely any negative consequences that come from taking steps to increase vitamin D levels. Patients can easily take safe, inexpensive, and widely available over-the-counter supplements.”

Dr. Hertz explained that CIPN is a common side effect of paclitaxel and several other commonly used anticancer drugs. It typically appears as numbness, tingling, and sometimes burning pain in the fingers and toes. CIPN can eventually lead to the loss of sensation in hands and feet. These symptoms are largely untreatable and can sometimes be permanent, so it is critical that patients and oncology health care providers monitor for CIPN during treatment to address the development of treatment-related peripheral neuropathy before symptoms become intolerable. 

The researchers also noted that it is well-established that vitamin D deficiency is more common in self-reported Black patients. This population group is also at higher risk of CIPN. There are additional studies underway to learn more about the role vitamin D supplements may be able to play in improving outcomes for these patients.

“This prospective-retrospective analysis of the SWOG S0221 study has revealed a significant association between vitamin D insufficiency and an increased incidence of chemotherapy induced peripheral neuropathy,” commented Mei Wei, MD, Huntsman Cancer Institute at the University of Utah, who was not involved in this research. “This study finding uncovers a new potential strategy to combat CIPN, thereby improving the quality of life for cancer patients undergoing treatment. It is an exciting step forward in our continuous mission of patient-centered cancer care.”

Dr. Wei, who is a Member of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) Panel for Breast Cancer, added: “We eagerly await the results of the ongoing study ‘Genetic and Inflammatory Biomarkers in Neuropathic Pain Secondary to Chemotherapy (Genie-B)’, led by Dr. Daniel Rotroff, Dr. Joseph Foss, and Dr. Kenward Johnson at Cleveland Clinic. This research holds the promise of shedding future light on the mechanisms underlying CIPN and the potential identification of biomarkers that could predict CIPN incidence.”

To read the entire study, visit JNCCN.org. Complimentary access to “Vitamin D Insufficiency as a Risk Factor for Paclitaxel-Induced Peripheral Neuropathy in SWOG S0221” is available until February 10, 2024.

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About JNCCN—Journal of the National Comprehensive Cancer Network

More than 25,000 oncologists and other cancer care professionals across the United States read JNCCN—Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about innovation in translational medicine, and scientific studies related to oncology health services research, including quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside/BroadcastMed. Visit JNCCN.org. To inquire if you are eligible for a FREE subscription to JNCCN, visit NCCN.org/jnccn/subscribe. Follow JNCCN on Twitter @JNCCN.

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network^® (NCCN^®) is a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to improving and facilitating quality, effective, equitable, and accessible cancer care so all patients can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) provide transparent, evidence-based, expert consensus recommendations for cancer treatment, prevention, and supportive services; they are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine. The NCCN Guidelines for Patients^® provide expert cancer treatment information to inform and empower patients and caregivers, through support from the NCCN Foundation^®. NCCN also advances continuing education, global initiatives, policy, and research collaboration and publication in oncology. Visit NCCN.org for more information.