Should Nicotinamide Be Used for Melanoma Prevention?

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Nicotinamide, a form of vitamin B3 (niacin), may be an effective chemopreventive agent for patients at high risk for developing skin cancer
Nicotinamide, a form of vitamin B3 (niacin), may be an effective chemopreventive agent for patients at high risk for developing skin cancer

The risk of an invasive or in situ melanoma diagnosis is continuing to increase, with one recent study estimating the lifetime risk of developing either condition as 1 in 28.1 With this growing risk, the development of chemoprevention strategies against melanoma and other skin cancers is important, especially for those at high risk.

Nicotinamide, a form of vitamin B3 (niacin), is a “promising and well-tolerated” chemopreventive agent for patients at high risk for developing skin cancer, according to the results of a recent review of the agent.2

“Preclinical studies of nicotinamide have demonstrated important anticancer properties including DNA repair and the modulation of inflammation and immune suppression induced by damaging ultraviolet radiation,” Ahmad Tarhini, MD, PhD, director of the Melanoma and Skin Cancer Program at the Cleveland Clinic Taussig Cancer Institute in Ohio, told Cancer Therapy Advisor.

ONTRAC was a phase 3 study that compared nicotinamide with placebo in 386 patients with at least 2 non-melanoma skin cancers in the previous 5 years.3 By 1 year, nicotinamide reduced the rate of new non-melanoma skin cancers by a little less than 25% compared with placebo. This reduction in incidence was consistent for both new basal cell (20%) and squamous cell carcinomas (30%) and for actinic keratosis (AK; 13%).

“Nicotinamide can reduce the rate of non-melanoma skin cancer in high-risk patients who have already had numerous basal cell and squamous cell carcinomas,” said review author Diona L. Damian, PhD, professor of dermatology at the University of Sydney in Australia.

To date, there have not been any adverse effects associated with the use of nicotinamide that cause concern, according to Dr Damian. In the ONTRAC study, for example, there were no significant differences in adverse events between the 2 study arms after the 1-year intervention.

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