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Article ; Online: Reply to R. Pham et al.

van 't Erve, Iris / Punt, Cornelis J A / Meijer, Gerrit A / Fijneman, Remond J A

JCO precision oncology

2022 Volume 6, Page(s) e2200053

Language	English
Publishing date	2022-03-28
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't ; Comment
ISSN	2473-4284
ISSN (online)	2473-4284
DOI	10.1200/PO.22.00053
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Article ; Online: A scenario-drafting study to explore potential future implementation pathways of circulating tumor DNA testing in oncology.

Kramer, Astrid / Rubio-Alarcón, Carmen / van den Broek, Daan / Vessies, Daan C L / Van't Erve, Iris / Meijer, Gerrit A / Vink, Geraldine R / Schuuring, Ed / Fijneman, Remond J A / Coupé, Veerle M H / Retèl, Valesca P

Molecular oncology

2023

Abstract: Circulating tumor DNA (ctDNA) detection has multiple promising applications in oncology, but the road toward implementation in clinical practice is unclear. We aimed to support the implementation process by exploring potential future pathways of ctDNA ... ...

Abstract	Circulating tumor DNA (ctDNA) detection has multiple promising applications in oncology, but the road toward implementation in clinical practice is unclear. We aimed to support the implementation process by exploring potential future pathways of ctDNA testing. To do so, we studied four ctDNA-testing applications in two cancer types and elicited opinions from 30 ctDNA experts in the Netherlands. Our results showed that the current available evidence differed per application and cancer type. Tumor profiling and monitoring treatment response were found most likely to be implemented in non-small cell lung cancer (NSCLC) within 5 years. For colorectal cancer, applications of ctDNA testing were found to be at an early stage in the implementation process. Demonstrating clinical utility was found a key aspect for successful implementation, but there was no consensus regarding the evidence requirements. The next step toward implementation is to define how clinical utility of biomarkers should be evaluated. Finally, these data indicate that specific challenges for each clinical application and tumor type should be appropriately addressed in a deliberative process involving all stakeholders to ensure implementation of ctDNA testing and timely access for patients.
Language	English
Publishing date	2023-12-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2415106-3
ISSN	1878-0261 ; 1574-7891
ISSN (online)	1878-0261
ISSN	1574-7891
DOI	10.1002/1878-0261.13562
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Zs.A 6637: Show issues

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Article ; Online: KRAS

van 't Erve, Iris / Wesdorp, Nina J / Medina, Jamie E / Ferreira, Leonardo / Leal, Alessandro / Huiskens, Joost / Bolhuis, Karen / van Waesberghe, Jan-Hein T M / Swijnenburg, Rutger-Jan / van den Broek, Daan / Velculescu, Victor E / Kazemier, Geert / Punt, Cornelis J A / Meijer, Gerrit A / Fijneman, Remond J A

JCO precision oncology

2021 Volume 5

Abstract: Somatic : Methods: A total of 419 patients with colorectal cancer with initially unresectable liver-limited metastases, who participated in a multicenter prospective trial, were evaluated for tumor tissue : Results: Most patients carried a : ... ...

Abstract	Somatic Methods: A total of 419 patients with colorectal cancer with initially unresectable liver-limited metastases, who participated in a multicenter prospective trial, were evaluated for tumor tissue Results: Most patients carried a Conclusion: Patients with mCRC with a
MeSH term(s)	Aged ; Analysis of Variance ; Colorectal Neoplasms/complications ; Colorectal Neoplasms/genetics ; Female ; Humans ; Liver Neoplasms/etiology ; Liver Neoplasms/genetics ; Male ; Middle Aged ; Mutation/genetics ; Neoplasm Metastasis/genetics ; Neoplasm Metastasis/physiopathology ; Prognosis ; Proto-Oncogene Proteins p21(ras)/genetics
Chemical Substances	KRAS protein, human ; Proto-Oncogene Proteins p21(ras) (EC 3.6.5.2)
Language	English
Publishing date	2021-11-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2473-4284
ISSN (online)	2473-4284
DOI	10.1200/PO.21.00223
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Article ; Online: Postoperative circulating tumour DNA is associated with pathologic response and recurrence-free survival after resection of colorectal cancer liver metastases.

Bolhuis, Karen / van 't Erve, Iris / Mijnals, Clinton / Delis-Van Diemen, Pien M / Huiskens, Joost / Komurcu, Aysun / Lopez-Yurda, Marta / van den Broek, Daan / Swijnenburg, Rutger-Jan / Meijer, Gerrit A / Punt, Cornelis J A / Fijneman, Remond J A

EBioMedicine

2021 Volume 70, Page(s) 103498

Abstract: Background: Recurrence rates after resection of colorectal cancer liver metastases (CRLM) are high and correlate with worse survival. Postoperative circulating tumour DNA (ctDNA) is a promising prognostic biomarker. Focusing on patients with resected ... ...

Abstract	Background: Recurrence rates after resection of colorectal cancer liver metastases (CRLM) are high and correlate with worse survival. Postoperative circulating tumour DNA (ctDNA) is a promising prognostic biomarker. Focusing on patients with resected CRLM, this study aimed to evaluate the association between the detection of postoperative ctDNA, pathologic response and recurrence-free survival (RFS). Methods: Twenty-three patients were selected from an ongoing phase-3 trial who underwent resection of RAS-mutant CRLM after induction systemic treatment. CtDNA analysis was performed by droplet digital PCR using blood samples collected at baseline, before and after resection. Pathologic response of CRLM was determined via the Tumour Regression Grading system. Findings: With a median follow-up of 19.6 months, the median RFS for patients with detectable (N = 6, [26%]) and undetectable (N = 17, [74%]) postoperative ctDNA was 4.8 versus 12.1 months, respectively. Among 21 patients with available tumour tissue, pathologic response in patients with detectable compared to undetectable postoperative ctDNA was found in one of six (17%) and 15 of 15 (100%) patients, respectively (p < 0.001). In univariable Cox regression analyses both postoperative detectable ctDNA (HR = 3.3, 95%CI = 1.1-9.6, p = 0.03) and pathologic non-response (HR = 4.6, 95%CI = 1.4-15, p = 0.01) were associated with poorer RFS and were strongly correlated (r = 0.88, p < 0.001). After adjusting for clinical characteristics in pairwise multivariable analyses, postoperative ctDNA status remained associated with RFS. Interpretation: The detection of postoperative ctDNA after secondary resection of CRLM is a promising prognostic factor for RFS and appeared to be highly correlated with pathologic response. Funding: None.
MeSH term(s)	Aged ; Biomarkers, Tumor/blood ; Cell-Free Nucleic Acids/blood ; Colorectal Neoplasms/pathology ; Female ; Humans ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local/blood ; Neoplasm Recurrence, Local/epidemiology ; Postoperative Complications/blood ; Postoperative Complications/epidemiology ; Postoperative Period ; Survival Analysis
Chemical Substances	Biomarkers, Tumor ; Cell-Free Nucleic Acids
Language	English
Publishing date	2021-07-29
Publishing country	Netherlands
Document type	Clinical Trial, Phase III ; Journal Article ; Randomized Controlled Trial
ZDB-ID	2851331-9
ISSN	2352-3964
ISSN (online)	2352-3964
DOI	10.1016/j.ebiom.2021.103498
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Zs.A 7090: Show issues

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Article ; Online: Metastatic Colorectal Cancer Treatment Response Evaluation by Ultra-Deep Sequencing of Cell-Free DNA and Matched White Blood Cells.

van 't Erve, Iris / Medina, Jamie E / Leal, Alessandro / Papp, Eniko / Phallen, Jillian / Adleff, Vilmos / Chiao, Elaine Jiayuee / Arun, Adith S / Bolhuis, Karen / Simmons, John K / Karandikar, Aanavi / Valkenburg, Kenneth C / Sausen, Mark / Angiuoli, Samuel V / Scharpf, Robert B / Punt, Cornelis J A / Meijer, Gerrit A / Velculescu, Victor E / Fijneman, Remond J A

Clinical cancer research : an official journal of the American Association for Cancer Research

2022 Volume 29, Issue 5, Page(s) 899–909

Abstract: Purpose: Circulating tumor DNA (ctDNA) has the potential to guide therapy selection and monitor treatment response in patients with metastatic cancer. However, germline and clonal hematopoiesis-associated alterations can confound identification of tumor- ...

Abstract	Purpose: Circulating tumor DNA (ctDNA) has the potential to guide therapy selection and monitor treatment response in patients with metastatic cancer. However, germline and clonal hematopoiesis-associated alterations can confound identification of tumor-specific mutations in cell-free DNA (cfDNA), often requiring additional sequencing of tumor tissue. The current study assessed whether ctDNA-based treatment response monitoring could be performed in a tumor tissue-independent manner by combining ultra-deep targeted sequencing analyses of cfDNA with patient-matched white blood cell (WBC)-derived DNA. Experimental design: In total, 183 cfDNA and 49 WBC samples, along with 28 tissue samples, from 52 patients with metastatic colorectal cancer participating in the prospective phase III CAIRO5 clinical trial were analyzed using an ultra-deep targeted sequencing liquid biopsy assay. Results: The combined cfDNA and WBC analysis prevented false-positives due to germline or hematopoietic variants in 40% of patients. Patient-matched tumor tissue sequencing did not provide additional information. Longitudinal analyses of ctDNA were more predictive of overall survival than standard-of-care radiological response evaluation. ctDNA mutations related to primary or acquired resistance to panitumumab were identified in 42% of patients. Conclusions: Accurate calling of ctDNA mutations for treatment response monitoring is feasible in a tumor tissue-independent manner by combined cfDNA and patient-matched WBC genomic DNA analysis. This tissue biopsy-independent approach simplifies sample logistics and facilitates the application of liquid biopsy ctDNA testing for evaluation of emerging therapy resistance, opening new avenues for early adaptation of treatment regimens.
MeSH term(s)	Humans ; Biomarkers, Tumor/genetics ; Cell-Free Nucleic Acids/genetics ; Circulating Tumor DNA/genetics ; Colonic Neoplasms ; DNA, Neoplasm/genetics ; High-Throughput Nucleotide Sequencing ; Mutation ; Prospective Studies ; Rectal Neoplasms
Chemical Substances	Biomarkers, Tumor ; Cell-Free Nucleic Acids ; Circulating Tumor DNA ; DNA, Neoplasm
Language	English
Publishing date	2022-12-08
Publishing country	United States
Document type	Clinical Trial, Phase III ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1225457-5
ISSN	1557-3265 ; 1078-0432
ISSN (online)	1557-3265
ISSN	1078-0432
DOI	10.1158/1078-0432.CCR-22-2538
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Zs.A 4223: Show issues

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Article: Identifying Genetic Mutation Status in Patients with Colorectal Cancer Liver Metastases Using Radiomics-Based Machine-Learning Models.

Cancers

2023 Volume 15, Issue 23

Abstract: For patients with colorectal cancer liver metastases (CRLM), the genetic mutation status is important in treatment selection and prognostication for survival outcomes. This study aims to investigate the relationship between radiomics imaging features and ...

Abstract	For patients with colorectal cancer liver metastases (CRLM), the genetic mutation status is important in treatment selection and prognostication for survival outcomes. This study aims to investigate the relationship between radiomics imaging features and the genetic mutation status (KRAS mutation versus no mutation) in a large multicenter dataset of patients with CRLM and validate these findings in an external dataset. Patients with initially unresectable CRLM treated with systemic therapy of the randomized controlled CAIRO5 trial (NCT02162563) were included. All CRLM were semi-automatically segmented in pre-treatment CT scans and radiomics features were calculated from these segmentations. Additionally, data from the Netherlands Cancer Institute (NKI) were used for external validation. A total of 255 patients from the CAIRO5 trial were included. Random Forest, Gradient Boosting, Gradient Boosting + LightGBM, and Ensemble machine-learning classifiers showed AUC scores of 0.77 (95%CI 0.62-0.92), 0.77 (95%CI 0.64-0.90), 0.72 (95%CI 0.57-0.87), and 0.86 (95%CI 0.76-0.95) in the internal test set. Validation of the models on the external dataset with 129 patients resulted in AUC scores of 0.47-0.56. Machine-learning models incorporating CT imaging features could identify the genetic mutation status in patients with CRLM with a good accuracy in the internal test set. However, in the external validation set, the models performed poorly. External validation of machine-learning models is crucial for the assessment of clinical applicability and should be mandatory in all future studies in the field of radiomics.
Language	English
Publishing date	2023-11-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15235648
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Article ; Online: Diagnostic Strategies toward Clinical Implementation of Liquid Biopsy RAS/BRAF Circulating Tumor DNA Analyses in Patients with Metastatic Colorectal Cancer.

van 't Erve, Iris / Greuter, Marjolein J E / Bolhuis, Karen / Vessies, Daan C L / Leal, Alessandro / Vink, Geraldine R / van den Broek, Daan / Velculescu, Victor E / Punt, Cornelis J A / Meijer, Gerrit A / Coupé, Veerle M H / Fijneman, Remond J A

The Journal of molecular diagnostics : JMD

2020 Volume 22, Issue 12, Page(s) 1430–1437

Abstract: Detection of KRAS, NRAS, and BRAF mutations in tumor tissue is currently used to predict resistance to treatment with anti-epidermal growth factor receptor (EGFR) antibodies in patients with metastatic colorectal cancer (mCRC). Liquid biopsies are ... ...

Abstract	Detection of KRAS, NRAS, and BRAF mutations in tumor tissue is currently used to predict resistance to treatment with anti-epidermal growth factor receptor (EGFR) antibodies in patients with metastatic colorectal cancer (mCRC). Liquid biopsies are minimally invasive, and cell-free circulating tumor DNA (ctDNA) mutation analyses may better represent tumor heterogeneity. This study examined the incorporation of liquid biopsy RAS/BRAF ctDNA analyses into diagnostic strategies to determine mCRC patient eligibility for anti-EGFR therapy. Tumor tissue and liquid biopsies were collected from 100 mCRC patients with liver-only metastases in a multicenter prospective clinical trial. Three diagnostic strategies incorporating droplet digital PCR ctDNA analyses were compared with routine tumor tissue RAS/BRAF mutation profiling using decision tree analyses. Tissue DNA mutations in KRAS, NRAS, and BRAF were present in 54%, 0%, and 3% of mCRC patients, respectively. A 93% concordance was observed between tissue DNA and liquid biopsy ctDNA mutations. The proportion of patients with RAS/BRAF alterations increased from 57% to 60% for diagnostic strategies that combined tissue and liquid biopsy mutation analyses. Consecutive RAS/BRAF ctDNA analysis followed by tissue DNA analysis in case of a liquid biopsy-negative result appeared to be the most optimal diagnostic strategy to comprehensively determine eligibility for anti-EGFR therapy in a cost-saving manner. These results highlight the potential clinical utility of liquid biopsies for detecting primary resistance to anti-EGFR-targeted therapies.
MeSH term(s)	Biomarkers, Tumor/genetics ; Circulating Tumor DNA/genetics ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/genetics ; Colorectal Neoplasms/pathology ; DNA Mutational Analysis/economics ; DNA Mutational Analysis/methods ; Data Accuracy ; Drug Resistance, Neoplasm/genetics ; ErbB Receptors/antagonists & inhibitors ; ErbB Receptors/genetics ; Female ; GTP Phosphohydrolases/genetics ; Humans ; Liquid Biopsy/economics ; Liver Neoplasms/secondary ; Male ; Membrane Proteins/genetics ; Mutation ; Polymerase Chain Reaction/economics ; Polymerase Chain Reaction/methods ; Prospective Studies ; Proto-Oncogene Proteins B-raf/genetics ; Proto-Oncogene Proteins p21(ras)/genetics ; Sensitivity and Specificity
Chemical Substances	Biomarkers, Tumor ; Circulating Tumor DNA ; KRAS protein, human ; Membrane Proteins ; EGFR protein, human (EC 2.7.10.1) ; ErbB Receptors (EC 2.7.10.1) ; BRAF protein, human (EC 2.7.11.1) ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1) ; GTP Phosphohydrolases (EC 3.6.1.-) ; NRAS protein, human (EC 3.6.1.-) ; Proto-Oncogene Proteins p21(ras) (EC 3.6.5.2)
Language	English
Publishing date	2020-09-19
Publishing country	United States
Document type	Evaluation Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2000060-1
ISSN	1943-7811 ; 1525-1578
ISSN (online)	1943-7811
ISSN	1525-1578
DOI	10.1016/j.jmoldx.2020.09.002
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Zs.A 5146: Show issues

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Article ; Online: Detection of tumor-derived cell-free DNA from colorectal cancer peritoneal metastases in plasma and peritoneal fluid.

Van't Erve, Iris / Rovers, Koen P / Constantinides, Alexander / Bolhuis, Karen / Wassenaar, Emma Ce / Lurvink, Robin J / Huysentruyt, Clément J / Snaebjornsson, Petur / Boerma, Djamila / van den Broek, Daan / Buffart, Tineke E / Lahaye, Max J / Aalbers, Arend Gj / Kok, Niels Fm / Meijer, Gerrit A / Punt, Cornelis Ja / Kranenburg, Onno / de Hingh, Ignace Hjt / Fijneman, Remond Ja

The journal of pathology. Clinical research

2021 Volume 7, Issue 3, Page(s) 203–208

Abstract: Tumor-derived cell-free DNA (cfDNA) is an emerging biomarker for guiding the personalized treatment of patients with metastatic colorectal cancer (CRC). While patients with CRC liver metastases (CRC-LM) have relatively high levels of plasma cfDNA, little ...

Abstract	Tumor-derived cell-free DNA (cfDNA) is an emerging biomarker for guiding the personalized treatment of patients with metastatic colorectal cancer (CRC). While patients with CRC liver metastases (CRC-LM) have relatively high levels of plasma cfDNA, little is known about patients with CRC peritoneal metastases (CRC-PM). This study evaluated the presence of tumor-derived cfDNA in plasma and peritoneal fluid (i.e. ascites or peritoneal washing) in 20 patients with isolated CRC-PM and in the plasma of 100 patients with isolated CRC-LM. Among tumor tissue KRAS/BRAF mutation carriers, tumor-derived cfDNA was detected by droplet digital polymerase chain reaction (ddPCR) in plasma of 93% of CRC-LM and 20% of CRC-PM patients and in peritoneal fluid in all CRC-PM patients. Mutant allele fraction (MAF) and mutant copies per ml (MTc/ml) were lower in CRC-PM plasma than in CRC-LM plasma (median MAF = 0.28 versus 18.9%, p < 0.0001; median MTc/ml = 21 versus 1,758, p < 0.0001). Within patients with CRC-PM, higher cfDNA levels were observed in peritoneal fluid than in plasma (median MAF = 16.4 versus 0.28%, p = 0.0019; median MTc/ml = 305 versus 21, p = 0.0034). These data imply that tumor-derived cfDNA in plasma is a poor biomarker to monitor CRC-PM. Instead, cfDNA detection in peritoneal fluid may offer an alternative to guide CRC-PM treatment decisions.
MeSH term(s)	Aged ; Ascitic Fluid/chemistry ; Biomarkers, Tumor/blood ; Biomarkers, Tumor/genetics ; Circulating Tumor DNA/blood ; Circulating Tumor DNA/genetics ; Clinical Decision-Making ; Colorectal Neoplasms/blood ; Colorectal Neoplasms/genetics ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/therapy ; DNA Mutational Analysis ; Female ; Humans ; Liquid Biopsy ; Male ; Middle Aged ; Mutation ; Netherlands ; Peritoneal Neoplasms/blood ; Peritoneal Neoplasms/genetics ; Peritoneal Neoplasms/secondary ; Peritoneal Neoplasms/therapy ; Polymerase Chain Reaction ; Predictive Value of Tests ; Prognosis ; Proto-Oncogene Proteins B-raf/blood ; Proto-Oncogene Proteins B-raf/genetics ; Proto-Oncogene Proteins p21(ras)/blood ; Proto-Oncogene Proteins p21(ras)/genetics
Chemical Substances	Biomarkers, Tumor ; Circulating Tumor DNA ; KRAS protein, human ; BRAF protein, human (EC 2.7.11.1) ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1) ; Proto-Oncogene Proteins p21(ras) (EC 3.6.5.2)
Language	English
Publishing date	2021-02-26
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2814357-7
ISSN	2056-4538 ; 2056-4538
ISSN (online)	2056-4538
ISSN	2056-4538
DOI	10.1002/cjp2.207
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Article ; Online: Changes in Circulating Levels of 25-hydroxyvitamin D3 in Breast Cancer Patients Receiving Chemotherapy.

Kok, Dieuwertje E / van den Berg, Maaike M G A / Posthuma, Liesbeth / van 't Erve, Iris / van Duijnhoven, Fränzel J B / de Roos, Wilfred K / Grosfeld, Sissi / Los, Maartje / Sommeijer, Dirkje W / van Laarhoven, Hanneke W M / Winkels, Renate M / Kampman, Ellen

Nutrition and cancer

2019 Volume 71, Issue 5, Page(s) 756–766

Abstract: Cancer treatments, toxicities and their effects on lifestyle, may impact levels of vitamin D. The aim of this study was to determine serum 25-hydroxyvitamin D3 (25(OH) ... ...

Abstract	Cancer treatments, toxicities and their effects on lifestyle, may impact levels of vitamin D. The aim of this study was to determine serum 25-hydroxyvitamin D3 (25(OH)D
MeSH term(s)	Adult ; Aged ; Breast Neoplasms/blood ; Breast Neoplasms/drug therapy ; Calcifediol/blood ; Dietary Supplements ; Female ; Humans ; Middle Aged ; Vitamins/blood
Chemical Substances	Vitamins ; Calcifediol (P6YZ13C99Q)
Language	English
Publishing date	2019-01-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	424433-3
ISSN	1532-7914 ; 0163-5581
ISSN (online)	1532-7914
ISSN	0163-5581
DOI	10.1080/01635581.2018.1559938
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Zs.A 1496: Show issues

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Article: Changes in Circulating Levels of 25-hydroxyvitamin D3 in Breast Cancer Patients Receiving Chemotherapy

Kok, Dieuwertje E / van den Berg, Maaike M. G. A / Posthuma, Liesbeth / van ’t Erve, Iris / van Duijnhoven, Fränzel J. B / de Roos, Wilfred K / Grosfeld, Sissi / Los, Maartje / Sommeijer, Dirkje W / van Laarhoven, Hanneke W. M / Winkels, Renate M / Kampman, Ellen

Nutrition and cancer. 2019 July 4, v. 71, no. 5

2019

Abstract: Cancer treatments, toxicities and their effects on lifestyle, may impact levels of vitamin D. The aim of this study was to determine serum 25-hydroxyvitamin D3 (25(OH)D3) levels before, directly after and 6 months after chemotherapy in breast cancer ... ...

Abstract	Cancer treatments, toxicities and their effects on lifestyle, may impact levels of vitamin D. The aim of this study was to determine serum 25-hydroxyvitamin D3 (25(OH)D3) levels before, directly after and 6 months after chemotherapy in breast cancer patients (n = 95), and a comparison group of women (n = 52) not diagnosed with cancer. Changes in 25(OH)D3 levels over time were compared using linear mixed models adjusted for age and season of blood sampling. Before start of chemotherapy, 25(OH)D3 levels were lower in patients (estimated marginal mean 55.8 nmol/L, 95% confidence interval (95%CI) 51.2–60.4) compared to the comparison group (67.2 nmol/L, 95%CI 61.1–73.3, P = 0.003). Directly after chemotherapy, 25(OH)D3 levels were slightly decreased (–5.1 nmol/L, 95%CI –10.7–0.5, P = 0.082), but ended up higher 6 months after chemotherapy (10.9 nmol/L, 95%CI 5.5–16.4, P < 0.001) compared to pre-chemotherapy values. In women without cancer, 25(OH)D3 levels remained stable throughout the study. Use of dietary supplements did not explain recovery of 25(OH)D3 levels after chemotherapy. We reported lower 25(OH)D3 levels in breast cancer patients, which decreased during chemotherapy, but recovered to levels observed in women without cancer within 6 months after chemotherapy. Suboptimal 25(OH)D3 levels in the majority of the participants highlight the relevance of monitoring in this vulnerable population.
Keywords	25-hydroxycholecalciferol ; at-risk population ; blood sampling ; blood serum ; breast neoplasms ; confidence interval ; drug therapy ; lifestyle ; monitoring ; patients ; women
Language	English
Dates of publication	2019-0704
Size	p. 756-766.
Publishing place	Taylor & Francis
Document type	Article
ZDB-ID	2025822-7
ISSN	1532-7914 ; 0163-5581
ISSN (online)	1532-7914
ISSN	0163-5581
DOI	10.1080/01635581.2018.1559938
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