维生素D3是一种前激素，具有多种效应，包括调节免疫系统功能，可能会影响癌症患者的抗PD-1治疗的有效性。根据文献资料，维生素D对治疗有效性的潜在机制很可能与浸润肿瘤淋巴细胞的数量和活性有关。有数据显示维生素D对调控CD8淋巴细胞活性的细胞具有作用。该研究纳入了200例晚期黑色素瘤患者。所有患者接受抗PD-1免疫疗法(nivolumab或pembrolizumab)作为一线治疗。在治疗前和治疗过程中的每12周测定患者的血清维生素D水平。其中一部分组群的维生素D水平是从保留的血清中回顾性测定的。另一部分进行了前瞻性的补充组。低维生素D水平组未补充时的反应率为36.2%，而血清维生素D水平处于正常基线或补充后达到正常水平的组反应率为56.0%(p= .01)。此外，这些组的无进展生存期分别为5.75个月和11.25个月(p= .03)。在总生存期方面，维生素D水平正常的组也有更好的生存期表现(分别为27和31.5个月；p= .39)。在我们看来，维生素D水平正常在晚期黑色素瘤患者接受抗PD-1免疫疗法治疗期间应该是一种标准程序，可以改善治疗效果。©2023美国癌症学会。

Vitamin D3 is a prohormone with pleiotropic effects, including modulating the functions of the immune system and may affect the effectiveness of anti-PD-1 treatment in patients with cancer. According to the literature, the potential mechanism of vitamin D's influence on the effectiveness of therapy is most likely related to the amount and activity of tumor-infiltrating lymphocytes. There are data showing the effect of vitamin D on cells regulating the activity of CD8 lymphocytes.A total of 200 patients with advanced melanoma were included in the study. All patients received anti-PD-1 immunotherapy (nivolumab or pembrolizumab) as first-line treatment. Serum vitamin D levels were measured in patients both before and every 12 weeks during treatment. Part of the group had vitamin D measured retrospectively from the preserved serum. The other part of the supplementation group was tested prospectively.The response rate in the group with low vitamin D levels and not supplemented was 36.2%, whereas in the group with normal baseline levels or a normal level obtained with supplementation was 56.0% (p = .01). Moreover, progression-free survival in these groups was 5.75 and 11.25 months, respectively (p = .03). In terms of overall survival, there was also a difference in favor of the group with normal vitamin D levels (27 vs. 31.5 months, respectively; p = .39).In our opinion, maintaining the vitamin D level within the normal range during anti-PD-1 immunotherapy in advanced melanoma patients should be a standard procedure allowing the improvement of treatment outcomes.© 2023 American Cancer Society.