High-dose vitamin D supplementation and prostate cancer progression: a phase II randomised trial in localised prostate cancer cases with intermediate risk of progression (ProsD).
- 2025-12-21
- British journal of cancer 134(5)
- Visalini Nair-Shalliker
- David P Smith
- Val Gebski
- Manish I Patel
- Mark Frydenberg
- John Yaxley
- Robert 'Frank' Gardiner
- David Espinoza
- Michael G Kimlin
- Varinderpal Dhillon
- Wayne Leifert
- David Gillatt
- Henry Woo
- Krishan Rasiah
- Nader Awad
- James Symons
- Jadon K Wells
- Hilda A Pickett
- Michael Fenech
- Paul H Anderson
- Bruce K Armstrong
- Howard Gurney
- PubMed: 41423505
- DOI: 10.1038/s41416-025-03278-w
Study Design
- Type
- Randomized Controlled Trial (RCT)
- Population
- 123 randomised participants (81 vitamin D and 42 placebo) newly diagnosed, low-intermediate risk PC cases, aged between 50 and 80 years and on active surveillance
- Methods
- Phase-II double-blinded randomized trial, monthly oral dose of cholecalciferol (50,000IU; Vitamin D) or placebo, blood samples analysed for vitamin D metabolites and cytokinesis-block micronucleus cytome (CBMN) markers
- Blinding
- Double-blind
- Duration
- 24 months
- Funding
- Unclear
Background
The ProsD trial aimed to determine if oral vitamin D supplementation could prevent prostate cancer (PC) progression in men on active surveillance (AS).Methods
ProsD is a phase-II double-blinded randomized trial of newly diagnosed, low-intermediate risk PC cases, aged between 50 and 80 years and on AS. The intervention was a monthly oral dose of cholecalciferol (50,000IU; Vitamin D) or placebo. Primary and secondary endpoints were active therapy-free (ATFS) and progression-free (PFS) survival, respectively. Blood samples were analysed for vitamin D metabolites and cytokinesis-block micronucleus cytome (CBMN) markers for lymphocytic genome damage.Results
There were 123 randomised participants (81 vitamin D and 42 placebo) included in this analysis. Mean (SD) for age was 66.5 (6.6) years and for 25(OH)D levels were 72.0 (19.9) and 66.4 (18.4) nmol/L at baseline (p = 0.1), and 91.9 (19.9) and 60.4 (24.4) nmol/L at 24 months, in the vitamin D and placebo arms respectively. There were no appreciable differences in ATFS (plog-rank = 0.44), PFS (p plog-rank = 0.60) and occurrence of adverse events, in each trial arm. There were declines in some of the lymphocytic CBMN markers in the vitamin D arm.Conclusion
Vitamin D supplementation did not prevent PC progression, although reduced prevalence of CBMN markers may indicate a benefit of vitamin D supplementation.Trial registration
Australia New Zealand Clinical Trials Registry (ACTRN12616001707459).Research Insights
There were no appreciable differences in ATFS (plog-rank=0.44)
- Effect
- Neutral
- Effect size
- Small
- Dose
- 50,000 IU/month orally
PFS (plog-rank=0.60)
- Effect
- Neutral
- Effect size
- Small
- Dose
- 50,000 IU/month orally
occurrence of adverse events, in each trial arm
- Effect
- Neutral
- Effect size
- Small
- Dose
- 50,000 IU/month orally
There were declines in some of the lymphocytic CBMN markers in the vitamin D arm
- Effect
- Neutral
- Effect size
- Small
- Dose
- 50,000 IU/month orally