Vitamin D3 Supplementation Modulates C-MYC/VEGF and Improves Chemotherapy Outcomes in Metastatic CRC Patients: Integrated Clinical–Mechanistic Evidence
5 affiliations
- 1Cancer Biology Department, (Pharmacology and Experimental Oncology), South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
- 2Clinical Pharmacy Practice Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo, Egypt.
- 3Oncological Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
- 4Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
- 5Medical Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
Abstract
Objective:: Systemic chemotherapy with fluoropyrimidine regimens is the cornerstone of management for unresectable metastatic colorectal cancer (CRC). This study aimed to evaluate the clinical outcomes and potential molecular mechanisms of adding vitamin D3 supplementation to fluoropyrimidine-based chemotherapy in metastatic CRC patients.
Methods:: This study evaluated the clinical effects of vitamin D3 addition to fluoropyrimidine therapy. Serum vitamin D3 levels and expression of vascular endothelial growth factor (VEGF) and cellular myelocytomatosis (C-Myc) were determined at baseline and after two months of therapy. Clinical endpoints such as overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were assessed.
Results:: Patients supplemented with vitamin D3 had a significant rise in the median vitamin D3 levels after two months (8 (6–14) to 13.5 (8–16.3) ng/mL; Δ +5.5 (3–8); Wilcoxon p<0.001), whereas those in the control group, who did not receive supplementation, experienced a decline in median vitamin D3 levels (11 (8–14.3) to 9 (8–16.3) ng/mL; Δ −2 (−4 to +1); Wilcoxon p=0.01). Supplementation was also associated with greater downregulation of VEGF and C-Myc expression (p<0.05). The overall response rate was higher in the vitamin D3 group of patients (63.3% vs. 25.8%; p<0.01), and median PFS was significantly prolonged (9.1 vs. 6.5 months; p=0.028).
Conclusion:: Our study suggests that vitamin D3 enhances fluoropyrimidine efficacy in metastatic CRC patients by modulating angiogenesis and proliferation pathways, supporting its potential as a safe, low-cost adjunct to chemotherapy.
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BibTeX
@article{rahman2026vitamin,
title = {{Vitamin D3 Supplementation Modulates C-MYC/VEGF and Improves Chemotherapy Outcomes in Metastatic CRC Patients: Integrated Clinical–Mechanistic Evidence}},
author = {Aya M.A. Rahman and Nivin A. Hassan and Marwa S. Hamza and Noha Gaber and Mervat M. Omran and Samia A. Shouman and Salah M. Khallaf},
journal = {Asian Pacific Journal of Cancer Prevention : APJCP},
year = {2026},
month = jun,
doi = {10.31557/apjcp.2026.27.6.2279},
url = {https://doi.org/10.31557/apjcp.2026.27.6.2279},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Vitamin D3 Supplementation Modulates C-MYC/VEGF and Improves Chemotherapy Outcomes in Metastatic CRC Patients: Integrated Clinical–Mechanistic Evidence
AU - Aya M.A. Rahman
AU - Nivin A. Hassan
AU - Marwa S. Hamza
AU - Noha Gaber
AU - Mervat M. Omran
AU - Samia A. Shouman
AU - Salah M. Khallaf
PY - 2026
DA - 2026/06/21
JO - Asian Pacific Journal of Cancer Prevention : APJCP
DO - 10.31557/apjcp.2026.27.6.2279
UR - https://doi.org/10.31557/apjcp.2026.27.6.2279
AB - Objective:: Systemic chemotherapy with fluoropyrimidine regimens is the cornerstone of management for unresectable metastatic colorectal cancer (CRC). This study aimed to evaluate the clinical outcomes and potential molecular mechanisms of adding vitamin D3 supplementation to fluoropyrimidine-based chemotherapy in metastatic CRC patients. Methods:: This study evaluated the clinical effects of vitamin D3 addition to fluoropyrimidine therapy. Serum vitamin D3 levels and expression of vascular endothelial growth factor (VEGF) and cellular myelocytomatosis (C-Myc) were determined at baseline and after two months of therapy. Clinical endpoints such as overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were assessed. Results:: Patients supplemented with vitamin D3 had a significant rise in the median vitamin D3 levels after two months (8 (6–14) to 13.5 (8–16.3) ng/mL; Δ +5.5 (3–8); Wilcoxon p<0.001), whereas those in the control group, who did not receive supplementation, experienced a decline in median vitamin D3 levels (11 (8–14.3) to 9 (8–16.3) ng/mL; Δ −2 (−4 to +1); Wilcoxon p=0.01). Supplementation was also associated with greater downregulation of VEGF and C-Myc expression (p<0.05). The overall response rate was higher in the vitamin D3 group of patients (63.3% vs. 25.8%; p<0.01), and median PFS was significantly prolonged (9.1 vs. 6.5 months; p=0.028). Conclusion:: Our study suggests that vitamin D3 enhances fluoropyrimidine efficacy in metastatic CRC patients by modulating angiogenesis and proliferation pathways, supporting its potential as a safe, low-cost adjunct to chemotherapy.
SN - 1513-7368
SN - 2476-762X
ER -