The ONTRAC study did not, however, assess nicotinamide in melanoma and excluded anyone with a history of melanoma in the previous 5 years.

“At this point in time we do not have clinical evidence from well-conducted studies that nicotinamide may affect the incidence or evolution of melanoma,” Dr Tarhini said. “Therefore, at best we can say that it is considered promising.”


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Dr Damian agreed, adding that “clinical trials would be needed to determine safety and effectiveness of nicotinamide in reducing melanoma risk in patients at high risk of [the disease].”

These trials would have to recruit patients at an increased risk for developing melanoma, not just skin cancer. These would be people with previous melanoma or those with genetic susceptibility.

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Dr Damian recommended the use of high-dose nicotinamide as a medical treatment only in those people at “extreme skin cancer risk,” like those with a history of multiple skin cancers.

According to Dr Damian, anyone considering taking high-dose nicotinamide should discuss it first with their dermatologists to check that none of their other medications may interact. Some epileptic drugs, for example, may have a drug-drug interaction with nicotinamide.

References

  1. Glazer AM, Winkelmann RR, Farberg AS, Rigel DS. Analysis of trends in US melanoma incidence and mortality. JAMA Dermatol. 2017;153(2):225-6.
  2. Minocha R, Damian DL, Halliday GM. Melanoma and nonmelanoma skin cancer chemoprevention: a role for nicotinamide? Photodermatol Photoimmunol Photomed. 2017 Jul 5. doi: 10.1111/phpp.12328 [Epub ahead of print]
  3. Chen AC, Martin AJ, Choy B, et al. A phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention. N Engl J Med. 2015;373:1618-26.