1. Introduction
colorectal cancer, death, cancers, CRC, ulcerative colitis, cancer, digestive tract cancer, thrombi
COLORECTAL CANCER, CANCERS, ULCERATIVE COLITIS, CANCER, THROMBI, ATHEROSCLEROSIS, CORONARY ARTERY DISEASE
Although elevated serum levels of soluble CD40 ligand (sCD40L) were reported in patients with cancer, the importance of high sCD40L levels in clinical oncology remains unknown. We conducted a post hoc analysis of the AMATERASU randomized clinical trial of vitamin D3 supplementation (2000 IU/day) in patients with digestive tract cancer to assess its significance. Serum sCD40L levels were measured by ELISA in 294 residual samples, and were divided into tertiles. In patients with colorectal cancer (CRC), 5-year relapse-free survival (RFS) rates in the middle and highest tertiles were 61.6% and 61.2%, respectively, which was significantly lower than 83.8% in the lowest tertile. A Cox proportional hazard analysis showed that the lowest tertile had a significantly lower risk of relapse or death than the highest tertile even with multivariate adjustment (hazard ratio (HR), 0.30; 95% confidence interval (CI), 0.11–0.80; In 2020, the global community witnessed an estimated 19.3 million new cancer cases and nearly 10.0 million cancer-related fatalities [Immunotherapy for cancer, with a particular focus on immune checkpoint inhibitors targeting PD-1 or PD-L1, has emerged as a prominent area of research and clinical interest [In the 1990s, the field of immunology witnessed the initial revelations surrounding CD40-CD40L interactions. The CD40 receptor was originally identified on B cells as well as B cell malignancies [Since 1998, there has been a mounting interest in the role of sCD40L in the context of platelets, atherosclerosis, and coronary artery disease. Studies showed that activated platelets prominently express CD40L, a factor that actively contributes to the formation of thrombi [CRC is the third most frequently diagnosed cancer on a global scale, and carries the second-highest mortality rate among cancers [Fast-forwarding to approximately 2010, researchers began delving into the relationship between sCD40L and solid cancers. Moreover, compared to healthy individuals, patients with different types of cancer, including CRC [A recent RCT showed that vitamin D supplementation had the capacity to reduce expression of the CD40L gene in patients with ulcerative colitis [