Impact of vitamin D deficiency and inflammatory biomarkers on pathological response to neoadjuvant chemotherapy in breast cancer
CLINICAL & TRANSLATIONAL ONCOLOGY, cilt.28, sa.7, ss.2625-2637, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 28 Sayı: 7
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s12094-025-04194-4
- Dergi Adı: CLINICAL & TRANSLATIONAL ONCOLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, DIALNET, Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.2625-2637
- Gazi Üniversitesi Adresli: Evet
Özet
Background Pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) is a surrogate for long-term outcomes in breast cancer, yet response rates vary widely. Biomarkers are needed to predict efficacy. Vitamin D, through its receptor-mediated diverse biological effects on tumor biology and immune regulation, has been suggested as a potential predictor of pCR. Methods We retrospectively evaluated breast cancer patients who received NACT between December 2022 and December 2024. Baseline serum vitamin D and inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CAR), prognostic nutritional index (PNI), and atherogenic index of plasma (AIP), were assessed. Pathological response was defined as pCR or Miller-Payne grades 4-5. ROC analysis identified optimal cut-offs, and logistic regression was applied to explore factors associated with pathological response. Results Among 223 patients, pCR occurred in 39.0%. ROC analysis identified 14.5 ng/mL as the optimal vitamin D threshold (AUC 0.705, p < 0.001). Vitamin D >= 14.5 ng/mL was independently associated with higher response, particularly in HR + /HER2 - and HER2 + subtypes; multivariable analyses also supported significance in TNBC. Recent vitamin D supplementation before NACT was significantly correlated with improved outcomes. Elevated CAR and AIP were inversely associated with response. Conclusions Vitamin D levels above 14.5 ng/mL independently predicted superior pathological response to NACT, with subtype-specific effects. Both baseline status and supplementation may enhance chemosensitivity, supporting vitamin D as a clinically relevant predictive biomarker.