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.”
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.
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.
- Glazer AM, Winkelmann RR, Farberg AS, Rigel DS. Analysis of trends in US melanoma incidence and mortality. JAMA Dermatol. 2017;153(2):225-6.
- 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]
- 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.