Oral paricalcitol (19-nor-1,25- Dihydroxyvitamin D2) in women receiving chemotherapy for metastatic breast cancer:A feasibility trial

Julia A. Lawrence, Steven A. Akman, Susan A. Melin, L. Douglas Case, Gary G. Schwartz

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

The vitamin d hormone, [1,25(OH)2d, calcitriol], inhibits proliferation and angiogenesis in breast cancer but its therapeutic use is limited by hypercalcemia. Synthetic analogs of 1,25(OH)2d that are less calcemic, such as paricalcitol (19-nor-1,25- dihydroxyvitamin d2), are used to treat hyperparathyroidism associated with chronic kidney disease. We sought to determine the safety and feasibility of taking oral paricalcitol with taxane-based chemotherapy in women with metastatic breast cancer (MBC). Oral paricalcitol was considered safe if it did not result in excessive toxicity, deined as grade 3 or higher serum calcium levels. it was considered feasible if the majority of women could take eight weeks of continuous therapy in the irst three months. Serum calcium was monitored weekly and the paricalcitol dose was adjusted based on its calcemic efect. intact parathyroid hormone (iPTH) was monitored as a marker of paricalcitol activity. Twenty-four women with MBC were enrolled. Twenty women (83%) received eight weeks of continuous therapy. Paricalcitol was welltolerated with no instances of hypercalcemia grade 2 or greater. Fourteen women (54%) were able to escalate the dose. The dose range of paricalcitol in the irst 3 mo was 2-7 μg/day. Serum iPTH levels at baseline were signiicantly higher in women with serum 25-Hydroxyvitamin d (25-OHd) levels less than 30 ng/ml (96.4 ± 40.9 pg/ml) vs. 46.2 ± 20.3 pg/ml (p = 0 0.001) (iPTH reference 12-72 pg/ml). We conclude that paricalcitol is safe and feasible in women with MBC who are receiving chemotherapy.

Original languageEnglish (US)
Pages (from-to)476-480
Number of pages5
JournalCancer Biology and Therapy
Volume14
Issue number6
DOIs
StatePublished - Jun 1 2013

Fingerprint

Breast Neoplasms
Drug Therapy
Parathyroid Hormone
Hypercalcemia
Serum
Calcium
paricalcitol
1,25-dihydroxyergocalciferol
Hyperparathyroidism
Calcitriol
Therapeutic Uses
Chronic Renal Insufficiency
Vitamins
Hormones
Safety
Therapeutics

Keywords

  • Cancer treatment
  • Metastatic breast cancer
  • Paricalcitol
  • Vitamin D

ASJC Scopus subject areas

  • Molecular Medicine
  • Oncology
  • Pharmacology
  • Cancer Research

Cite this

Oral paricalcitol (19-nor-1,25- Dihydroxyvitamin D2) in women receiving chemotherapy for metastatic breast cancer:A feasibility trial. / Lawrence, Julia A.; Akman, Steven A.; Melin, Susan A.; Case, L. Douglas; Schwartz, Gary G.

In: Cancer Biology and Therapy, Vol. 14, No. 6, 01.06.2013, p. 476-480.

Research output: Contribution to journalArticle

Lawrence, Julia A. ; Akman, Steven A. ; Melin, Susan A. ; Case, L. Douglas ; Schwartz, Gary G. / Oral paricalcitol (19-nor-1,25- Dihydroxyvitamin D2) in women receiving chemotherapy for metastatic breast cancer:A feasibility trial. In: Cancer Biology and Therapy. 2013 ; Vol. 14, No. 6. pp. 476-480.
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abstract = "The vitamin d hormone, [1,25(OH)2d, calcitriol], inhibits proliferation and angiogenesis in breast cancer but its therapeutic use is limited by hypercalcemia. Synthetic analogs of 1,25(OH)2d that are less calcemic, such as paricalcitol (19-nor-1,25- dihydroxyvitamin d2), are used to treat hyperparathyroidism associated with chronic kidney disease. We sought to determine the safety and feasibility of taking oral paricalcitol with taxane-based chemotherapy in women with metastatic breast cancer (MBC). Oral paricalcitol was considered safe if it did not result in excessive toxicity, deined as grade 3 or higher serum calcium levels. it was considered feasible if the majority of women could take eight weeks of continuous therapy in the irst three months. Serum calcium was monitored weekly and the paricalcitol dose was adjusted based on its calcemic efect. intact parathyroid hormone (iPTH) was monitored as a marker of paricalcitol activity. Twenty-four women with MBC were enrolled. Twenty women (83{\%}) received eight weeks of continuous therapy. Paricalcitol was welltolerated with no instances of hypercalcemia grade 2 or greater. Fourteen women (54{\%}) were able to escalate the dose. The dose range of paricalcitol in the irst 3 mo was 2-7 μg/day. Serum iPTH levels at baseline were signiicantly higher in women with serum 25-Hydroxyvitamin d (25-OHd) levels less than 30 ng/ml (96.4 ± 40.9 pg/ml) vs. 46.2 ± 20.3 pg/ml (p = 0 0.001) (iPTH reference 12-72 pg/ml). We conclude that paricalcitol is safe and feasible in women with MBC who are receiving chemotherapy.",
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