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Sub-category:
Quality-of-Life Management
Category:
Patient Care
Meeting:
2008 ASCO Annual Meeting
Abstract No:
9618
Citation:
J Clin Oncol 26: 2008 (May 20 suppl; abstr 9618)
Author(s):
Q. J. Khan, P. S. Reddy, B. F. Kimler, P. Sharma, S. Baxa, A. P. O'dea, C. J. Fabian
Abstract:
Background: Vitamin D (vitD) deficiency is associated with non-specific joint pain and chronic fatigue, and these symptoms are common in women with breast cancer on aromatase inhibitors (AIs). We conducted a prospective study to determine the effect of high dose vitD on joint pain and fatigue in women on adjuvant letrozole. Methods: Postmenopausal women with invasive breast cancer who were candidates for an adjuvant AI. Serum 25 OHD (LC/MS/MS; Quest) was measured at baseline, wk 10 and wk 16 (end of study). At baseline all women started 2.5 mg/d of letrozole and standard dose calcium (1,200 mg/d) + vitD (600 IU/d). At wk 4 women with serum 25 OHD < 40 ng/ml received 50,000 IU of oral vitD3/wk for 12 wks. BFI (fatigue assessment), HAQ II (assessment of disability from joint symptoms), and assessment of severity of joint symptoms were conducted at baseline, wk 4 and wk 16. Results: 60 women participated. At baseline, 63% were vitD insufficient (<32 ng/ml). 49 of 50 women who received high dose vitD had serum 25 OHD levels >32 ng/ml by wk 10. Nine had vitD > 40 ng/ml at baseline and did not get high dose vitD. Despite standard dose Ca + D with initiation of letrozole, serum 25OHD levels dropped in 7 of 9 women (median levels: 46 and 40 ng/ml at wks 0 and 16). Joint pain was more likely to worsen during first 4 wks (letrozole + standard vitD); in contrast, more women had improvement in joint pain during next 12 wks (high dose vitD) (see Table). Similar trend was observed for fatigue. For HAQII, equal number of women improved (37%) vs worsened (32%) in first 4 wks; during next 12 wks, twice as many improved (44%) as worsened (22%); however, results of HAQII were not statistically significant. Conclusions: In breast cancer patients on letrozole, high dose VitD effectively increases serum 25OHD levels and appears to provide clinical relief from symptoms of fatigue, joint pain, and disability from joint pain. With standard dose vitD, serum 25OHD levels do not improve and may even decrease in women on letrozole. Table: Effect of vitamin D on AI associated arthralgias and fatigue | Joint Pain | Fatigue (BFI) | | Week 0-4* | Week 4-16** | Week 0-4* | Week 4-16** | | Improved (% women) | 7 | 23 | 40 | 56 | | Worsened (% women) | 37 | 32 | 53 | 36 | | No change (% women | 56 | 45 | 7 | 8 | | P value | .002 | .09 | .07 | .038 | | *Letrozole initiated at week 0; During 0-4 weeks women on letrozole before high dose vit D; **High dose vit D 50,000 IU initiated at week 4 and continued for 12 weeks. |
Abstract Disclosures
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy
and are designated with a caret symbol (^) here and in the print version.
 Associated Presentation(s):
Other Abstracts in this Sub-Category:
Abstracts by Q. J. Khan :
Presentations by Q. J. Khan :
Educational Book Manuscripts by Q. J. Khan :
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