4.6 Review

Vitamin D: Promises on the Horizon and Challenges Ahead for Fighting Pancreatic Cancer

Journal

CANCERS
Volume 13, Issue 11, Pages -

Publisher

MDPI
DOI: 10.3390/cancers13112716

Keywords

vitamin D; pancreatic cancer; cancer risk; cancer survival; immunotherapy

Categories

Funding

  1. Elsa U. Pardee Foundation
  2. University of Texas MD Anderson Cancer Center Duncan Family Institute for Cancer Prevention and Risk Assessment
  3. MD Anderson Cancer Center Institutional Research program
  4. Texas Medical Center Digestive Disease Center Pilot Research Program
  5. National Cancer Institute [R01 CA198090]

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Pancreatic cancer has a poor prognosis and increasing incidence, necessitating novel intervention strategies. Vitamin D shows promise in reducing the risk and improving survival of pancreatic cancer, as well as regulating stromal reprogramming and immune response, providing opportunities for intervention.
Pancreatic cancer has a dismal prognosis, while its incidence is increasing. This is attributed, in part, to a profound desmoplastic and immunosuppressive tumor microenvironment associated with this cancer and resistance to current available therapies. Novel and effective intervention strategies are urgently needed to improve the outcomes of patients with pancreatic cancer. Vitamin D has pleiotropic functions beyond calcium-phosphate homeostasis and has been extensively studied both in the laboratory and clinic as a potential preventive agent or adjunct to standard therapies. Accumulating evidence from ecological, observational, and randomized controlled trials suggests that vitamin D has beneficial effects on risk, survival, and mortality in pancreatic cancer, although controversies still exist. Recent advances in demonstrating the important functions of vitamin D/vitamin D receptor (VDR) signaling in the regulation of stromal reprogramming, the microbiome, and immune response and the emergence of checkpoint immunotherapy provide opportunities for using vitamin D or its analogues as an adjunct for pancreatic cancer intervention. Many challenges lie ahead before the benefits of vitamin D can be fully realized in pancreatic cancer. These challenges include the need for randomized controlled trials of vitamin D to assess its impact on the risk and survival of pancreatic cancer, optimizing the timing and dosage of vitamin D or its analogues as an adjunct for pancreatic cancer intervention and elucidating the specific role of vitamin D/VDR signaling in the different stages of pancreatic cancer. Nevertheless, vitamin D holds great promise for reducing risk and improving outcomes of this disease.

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