Vitamin D serum level as a predictor of response to immunotherapy for non-small cell lung cancer.

Abstract

e14563 Background: Vitamin D plays a pivotal role in immune system regulation. Immunotherapy is a key treatment modality for patients with advanced-stage non-small cell lung cancer (NSCLC). Identifying factors that influence immunotherapy response is crucial for clinicians. However, the impact of sufficient serum vitamin D levels on treatment outcomes in NSCLC patients remains unknown. Methods: We identified 39 patients with advanced-stage NSCLC from our database who had known serum vitamin D levels prior to immunotherapy with nivolumab. Serum vitamin D levels ³20 ng/mL were classified as sufficient, while levels < 20 ng/mL were classified as insufficient. We analyzed the association between serum vitamin D levels and progression-free survival (PFS) as well as overall survival (OS). Results: The majority of patients (79%) were male, and 62% were older than 65 years. Sixteen patients had sufficient vitamin D levels, while 23 had insufficient levels. The median serum vitamin D level was 17 ng/mL (range: 4-45). Patients in the sufficient vitamin D group were significantly older than those in the insufficient group (Table). The median PFS was longer in patients with sufficient vitamin D levels (10.1 months, 95% CI: 0.1-20.8) compared to those with insufficient levels (4.6 months, 95% CI: 2.9-6.2), though this difference was not statistically significant (p = 0.29). Similarly, the median OS was 17.3 months (95% CI: 3.8-30.9) in the sufficient vitamin D group versus 11.7 months (95% CI: 0.1-23.5) in the insufficient group (p = 0.82). Conclusions: Our findings suggest that sufficient vitamin D levels may be associated with longer survival in advanced-stage NSCLC patients receiving immunotherapy. This potential benefit is notable despite the higher proportion of older patients in the sufficient vitamin D group. Clinical and pathological characteristics of patients (n=39). Characteristics Vitamin D sufficient(³20 ng/mL) Vitamin D insufficient(<20 ng/mL) p-value n (%) n (%) Sex 0.82 Female 3 (19%) 5 (22%) Male 13 (81%) 18 (78%) Age 0.035*  <65 3 (19%) 12 (52%)  ³65 13 (81%) 11 (48%) ECOG performance status 0.51  0 3 (19%) 5 (22%)  1 11 (69%) 12 (52%)  2 2 (12%) 6 (26%) Histologic subgroup 0.44  Squamous cell cancer 5 (31%) 10 (44%)  Adenocancer 11 (69%) 13 (56%) *Patients in the sufficient vitamin D group were significantly older than those in the insufficient group.