Impact of vitamin D levels on objective response rate and progression-free survival with anti-PD-1 therapy for advanced melanoma

Vitamin D3 is a prohormone with pleiotrophic effects, including modulation of the functions of the immune system, and may affect the effectiveness of immune checkpoint inhibition in patients with cancer. A study at Poznan University of Medical Sciences (Poland) evaluated the impact of vitamin D levels on activity of first-line pembrolizumab or nivolumab for advanced melanoma. The ORR was 36.2% in the group of patients with low baseline serum vitamin D levels, versus 56.0% in the group of patients with normal baseline vitamin D levels or normal levels obtained with vitamin D supplementation (p=0.01). The PFS in the two groups was 5.75 months versus 11.25 months (p=0.03). There was also a numerical difference in overall survival (27 versus 31.5 months; p=0.39). The authors conclude that maintaining the vitamin D level within the normal range during anti-PD-1 immunotherapy for advanced melanoma should be a standard procedure.