The Cardioprotective Effect of Vitamin D in Breast Cancer Patients Receiving Adjuvant Doxorubicin Based Chemotherapy

• Published in: Clinical breast cancer Vol. 22; no. 4; pp. 359 - 366
• Main Authors: El-Bassiouny, Noha A., Helmy, Maged W., Hassan, Mostafa Alaa Eldin, Khedr, Gehan A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2022
• Subjects: Antineoplastic Combined Chemotherapy Protocols - adverse effects; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - etiology; Cardio toxicity; Chemotherapy, Adjuvant - adverse effects; Cyclophosphamide - adverse effects; Doxorubicin; Female; Humans; Interleukin-6 - therapeutic use; Vitamin D; Vitamin D - therapeutic use; Vitamins; Vit D; LVEF; Breast cancer; DOX; Doxorubicin; TNF; IL-6; LDH; Vitamin D; ROS; cTnT; TNBC; Cardio toxicity; DIC
• ISSN: 1526-8209; 1938-0666
• DOI: 10.1016/j.clbc.2022.01.008

•Vitamin D may have cardioprotective effect.•Vitamin D has add-on value in breast cancer patients receiving doxorubicin-based chemotherapy.•Vitamin D reduced Doxorubicin induced cardiotoxicity.•The cardioprotective effects of Vit D may be attributed to the ability of Vit D to decrease the pro-inflammatory IL-6 serum level. The primary objective of this study was to investigate the potential protective effect of Vitamin D (Vit D) on DOX induced cardio toxicity (DIC) in early breast cancer patients receiving adjuvant DOX based chemotherapy (AC). The secondary objective was to investigate the anti–inflammatory effect of Vit D by measuring serum IL-6 and its correlation with cardio toxicity. This study was carried out on 150 newly diagnosed women with breast cancer who were planned to receive four cycles of adjuvant AC chemotherapy regimen (60 mg/m2 DOX and 600 mg/m2 cyclophosphamide) every 21 days. Study patients were randomized 1:1 into a control group treated with AC and a Vit D group treated with AC plus 0.5 µg of Vit D (Bon One 0.5 µg) orally once daily during the whole treatment course. The cardio protective effect of Vit D was assessed by measuring serum levels of Lactate dehydrogenase (LDH), cardiac troponin T (cTnT), and anti–inflammatory Interleukin 6 (IL-6) at baseline, and after 4 cycles of AC in all study patients. Vit D supplementation in Vit D group patients was associated with a significant decrease (P < 0.001) in serum levels of LDH, cTnT, and IL-6 compared to the control group . The present work provides a promising clinical evidence to support the cardio protective effects of Vit D against DIC through attenuating the evoked pro-inflammatory cytokines induced by DOX. The study evaluated the cardioprotective effect of Vit D supplementation on DIC in breast cancer patients receiving adjuvant DOX based chemotherapy. Vit D supplementation was associated with a significant decrease in serum levels of LDH, cTnT, and IL-6. [Display omitted]