Vitamin D3 / cholecalciferol (cancer chemoprevention research context)
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| ID | DRUG-VITAMIN-D3-CHEMOPREVENTION |
|---|---|
| Тип | Препарат |
| Синоніми | 25-OH-D3 precursorCholecalciferolD3 AquadetrimDrisdol (D2)Vit D3Vitamin D3 / cholecalciferol (cancer chemoprevention)many OTC supplementsВітамін D3 / холекальциферол (хіміопрофілактика раку — дослідницький контекст) |
| Статус | переглянуто 2026-05-18 | очікує клінічного підпису |
| Хвороби | Не вказано |
| Джерела | SRC-USPSTF-BREAST-2024 SRC-WCRF-AICR-CUP-2018 |
Дані про препарат
| Клас | Fat-soluble vitamin — secosteroid hormone precursor |
|---|---|
| Механізм дії | Cholecalciferol (D3) is hepatically hydroxylated to 25-hydroxyvitamin D (calcidiol), the storage form measured clinically, then renally hydroxylated to 1,25-dihydroxyvitamin D (calcitriol), the active hormone. Calcitriol binds the nuclear vitamin D receptor (VDR), modulating ~1000+ genes including those involved in cell-cycle arrest (p21, p27), apoptosis, differentiation, and innate immunity. Cancer-prevention rationale: observational ecological gradients (latitude, sunlight) and large cohort 25-OH-D associations suggest reduced incidence of colorectal, breast, and possibly other cancers at higher serum levels. VITAL RCT (Manson NEJM 2019, NCT01169259): 2000 IU/day for ~5 years did NOT reduce total invasive cancer incidence (primary endpoint), with a non-significant 17% reduction in cancer mortality. |
| Типове дозування | Cancer-prevention research context (VITAL, AMATERASU): 1000-4000 IU PO daily. Most cancer-prevention trials used 1000-2000 IU/day (VITAL: 2000 IU/day) or 2000 IU/day with calcium 1000 mg. Repletion of deficiency (25-OH-D <20 ng/mL): 50,000 IU weekly for 6-8 weeks then maintenance. Maintenance / general supplementation: 800-2000 IU/day. Goal serum 25-OH-D: 30-50 ng/mL (75-125 nmol/L); avoid >100 ng/mL (hypervitaminosis risk). |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | False |
| Остання перевірка для України | 2026-05-18 |
Нотатки
STUB — v0.2 chemoprevention-workstream authoring; pending two-Clinical- Co-Lead signoff per CHARTER §6.1 dev-mode. CANCER-CHEMOPREVENTION CONTEXT — distinct from generic supplementation for bone health / deficiency repletion. EVIDENCE LIMITED. VITAL RCT (Manson NEJM 2019, ~25,000 US adults, 2000 IU/day vs. placebo over ~5.3 years): no reduction in total invasive cancer (primary endpoint, HR 0.96); secondary signal of 17% reduction in cancer mortality (HR 0.83, NS at primary analysis, significant after excluding first 1-2 years). AMATERASU (Akiba JAMA 2019, Japan, adjuvant 2000 IU/day in digestive-tract cancer): no DFS improvement; subgroup p53-mutant benefit. Subgroup signals (lower BMI, Black participants, baseline D-deficient) suggest patient-selection may matter. USPSTF 2024: no recommendation for vitamin D supplementation for cancer prevention (insufficient evidence). Engine should NOT auto-recommend vitamin D for cancer prevention alone; appropriate for deficiency repletion and bone health.
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