This common vitamin could help fight one of the deadliest brain cancers

Edward (Ed) Waldner knew something was wrong, even though he could not explain exactly what was happening. At age 55, he was constantly exhausted, regardless of how demanding his day had been. At first, he wondered whether sleep apnea might be responsible.

Then he began noticing changes in the way he walked. His heels would sometimes drag, and his movement no longer felt normal. When his symptoms became especially concerning one day, he went to the Emergency Department.

"The doctor said I had a mass on my brain and needed to see an oncologist," says Waldner.

The mass turned out to be glioblastoma, an aggressive form of brain cancer that is notoriously difficult to treat. Standard care typically combines surgery, radiation, and chemotherapy. Surgeons try to remove as much of the tumor as possible, but glioblastoma cells can spread into surrounding brain tissue, making complete removal extremely difficult. Even after treatment, the cancer commonly returns.

Researchers at the University of Calgary are now investigating whether an unexpected addition to standard treatment could help: high doses of vitamin B3, also known as niacin.

"I have no problem trying to help anybody. I agreed. I want to help myself too," says Waldner. "I can tell you being part of this research helps me mentally because we're trying. When I left the hospital after surgery I was told, that's it, that's all we can do."

The study is being led by two researchers who are members of both the Hotchkiss Brain Institute and Arnie Charbonneau Cancer Institute. Gloria Roldan Urgoiti, MD, is an oncologist who specializes in brain cancers, while Wee Yong, PhD, is a neuroscientist who studies how the immune system affects the brain.

Their research centers on a key problem with glioblastoma: the tumor can interfere with the immune system, weakening the very cells that might otherwise help attack the cancer.

The team designed the study to determine whether niacin could restore some of those impaired immune cells and help them destroy tumor cells.

The idea first emerged from experiments in Yong's laboratory using mice. Those studies found that niacin treatment extended survival, encouraging the researchers to move the approach into a combined Phase I and Phase II clinical trial in people.

Phase I trials generally focus heavily on safety and determining an appropriate dose, while Phase II studies begin looking more closely for signs that a treatment may provide a clinical benefit.

"Normally the immune system will try to counter and prevent tumor growth, however, this brain cancer supresses the immune system," says Yong, a professor at the Cumming School of Medicine (CSM). "Niacin treatment rejuvenates immune cells so they can do what they are supposed to do, attack and kill the cancer cells. I see it as an ongoing 'battle for the brain'."