Cancer remains one of the hardest diseases to treat because cancer cells come from the body’s own cells and can find ways to escape treatment.
Chemotherapy, radiation, targeted drugs and newer immune-based treatments have saved many lives, but some cancers return or stop responding to available therapies.
This is a major problem for people with blood cancers such as lymphoma and leukemia. Researchers are therefore studying ways to help the immune system recognize and destroy cancer cells more effectively, especially when standard treatments have failed.
A team led by scientists at the University of Minnesota has explored an unusual way to strengthen natural killer cells, a type of immune cell that can attack infected or abnormal cells. Their approach uses nicotinamide, a form of vitamin B3, to improve these cells before they are given to patients.
Natural killer cells are part of the body’s early defense system. Unlike some other immune cells, they can attack suspicious cells without first being trained to recognize one specific target, which has made them an attractive option for cancer treatment.
However, natural killer cell therapy has faced an important problem. After the cells are given to a patient, they may not survive for long enough or remain active enough to produce a strong and lasting effect.
The researchers found that growing donated natural killer cells in the laboratory with nicotinamide and a substance that supports immune-cell growth helped the cells work better. The treated cells were better able to kill cancer cells, cope with cellular stress and travel to places where cancer was present.
Importantly, this does not mean that simply taking vitamin B3 supplements can treat cancer. Nicotinamide was used as part of a laboratory process to prepare the immune cells before they were infused into patients, and the patients also received other treatments as part of the clinical trial.
The team tested the approach in a first-in-human phase 1 trial involving people with difficult-to-treat blood cancers. Among 19 patients with advanced non-Hodgkin lymphoma, 14 responded to treatment, giving an overall response rate of 74 percent.
Thirteen of those patients had a complete response, meaning doctors could no longer detect signs of their cancer using the study’s response measures. One additional patient had a partial response, meaning the cancer became smaller but did not disappear completely.
The researchers also found that the prepared natural killer cells could be detected in blood, bone marrow and tumor tissue for up to 14 days. This suggested that the nicotinamide-based preparation may help the cells survive and remain useful after they enter the body.
Nicotinamide is a water-soluble form of vitamin B3 found naturally in foods and also sold as a supplement. Vitamin B3 is important for basic processes that help cells produce and use energy, but the new work shows that nicotinamide may also be useful as a tool for preparing immune cells for cancer therapy.
The findings are promising, but the study was small and was designed mainly to examine an experimental treatment in its early stages. Larger clinical trials are needed to learn how well the approach works in different patients, how long responses last and how it compares with other cancer treatments.
The research was published in the peer-reviewed journal Science Translational Medicine in July 2023. The study, led by Frank Cichocki, Veronika Bachanova and colleagues, was titled “Nicotinamide enhances natural killer cell function and yields remissions in patients with non-Hodgkin lymphoma.”
If larger studies confirm the results, the method could add another option for people whose lymphoma has returned or resisted other therapies. More broadly, the research shows how a familiar nutrient can be used in a carefully controlled laboratory setting to help immune cells become stronger cancer fighters.
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