Nicotinamide may put a stop to melanoma

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09 Aug 2017 --- Nicotinamide, a form of vitamin B3, has the potential to prevent melanoma in high-risk individuals, according to a review published in the Photodermatology, Photoimmunology & Photomedicine review. Strategies for skin cancer that prevent the need for chemotherapy are extremely important, especially during a time of aging populations and increasing rates of melanoma and non-melanoma skin cancers worldwide, notes the study. The use of nicotinamide, therefore, presents an interesting option for preventing the most dangerous form of skin cancer in the future. The cost of nicotinamide is approximately US$10 per month if taken at 1g per day as recommended. 

Nicotinamide is an amide form of vitamin B3 (niacin), a water-soluble vitamin. According to the study, it can help to reduce or reverse DNA damage, inflammation and immunosuppression caused by ultraviolet radiation.

The first study considered in the review is the ONTRAC (Oral Nicotinamide to Reduce Actinic Cancer) study, a multicenter, phase III, double-blinded placebo-controlled trial in which 386 participants were recruited. At each three-monthly visit, the number of new non-melanoma skin cancers in the nicotinamide group was lower than that in the placebo group, showing between an 18 percent and a 29 percent relative rate reduction. However, the study did not assess the effect on the rate of melanomas.

In comparison, there have been relatively few studies investigating nicotinamide’s impact on melanomas. In one of the few relevant studies, melanoma cell migratory investigations conducted by Kunimoto et al., nicotinamide significantly reduced the invasion of subcutaneously transplanted melanoma cells in immunocompetent mice.

High-dose oral nicotinamide is increasingly being used in clinical practice for the prevention of non-melanoma skin cancers in high-risk, immune competent patients who have already had multiple skin cancers, reports the review. Its protective effects against some of the biological mechanisms important in causing melanoma, such as the aforementioned DNA damage and UV-caused immunosuppression, suggest to researchers that it could also be effective in melanoma prevention.

Based on current clinical evidence of the use of nicotinamide in non-melanoma skin cancers and early in vitro studies conducted with melanocytes and melanoma cells, the study concludes that randomized placebo controlled trials are now warranted to determine its efficacy and safety for melanoma prevention.

“Nicotinamide has been shown in a clinical trial […] to reduce the incidence of non-melanoma skin cancer in high-risk individuals and it would be worthwhile to determine whether it would also be useful for high-risk melanoma patients,” says Dr. Gary Halliday, senior author of the Photodermatology, Photoimmunology & Photomedicine review.

The review, “Melanoma and nonmelanoma skin cancer chemoprevention: A role for nicotinamide?” can be found here.

The use of nicotinamide is the latest possible strategy for fighting skin cancer without the need for chemotherapy. A study has recently found that eating a tomato-rich diet cut the risk of skin cancer in half in some cases, while it may also be useful to avoid white wine, which has been associated with higher rates of invasive melanoma among white men and women. Patients with malignant melanoma that has spread have also been advised that diverse gut bacteria could help with immunotherapy treatment. 

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