Edward Waldner, a 55-year-old man, found himself grappling with persistent exhaustion and subtle neurological symptoms that gradually worsened over time. Unaware of the underlying cause, his declining physical state culminated in a visit to the Emergency Department, where he received the devastating diagnosis: glioblastoma. This aggressive and fatal brain tumor presents a formidable challenge to modern oncology, demonstrating a notorious resistance to conventional treatment methods. Despite intensive surgery, radiation, and chemotherapy, glioblastoma frequently recurs, underscoring an urgent need for innovative therapeutic strategies.
Researchers at the University of Calgary have embarked on a pioneering clinical trial investigating the adjunctive use of high-dose niacin, also known as vitamin B3, in treating glioblastoma patients. This approach is grounded in compelling preclinical research demonstrating that niacin can rejuvenate immune cells compromised by the tumor microenvironment. Glioblastomas have a profound capacity to suppress the immune system, thereby facilitating tumor progression. By restoring immune function, niacin holds the potential to empower the body’s natural defenses in the fight against cancer.
The scientific rationale for this trial hinges on niacin’s ability to enhance the activity of critical immune cells, such as macrophages and microglia, within the brain. These cells play a pivotal role in surveilling and eliminating aberrant cells but become functionally impaired in glioblastoma. Experimental studies in animal models revealed that niacin supplementation prolonged survival by reversing immune suppression and promoting an antitumor immune response. These promising findings laid the groundwork for translational research, culminating in a Phase I and II clinical trial designed to establish safety, dosing parameters, and preliminary efficacy in human subjects.
This meticulously designed trial enrolled 24 patients with newly diagnosed glioblastoma, combining high-dose controlled-release niacin with standard-of-care chemotherapy and radiotherapy. The primary endpoint was progression-free survival at six months, with the study engineered to discontinue if improvements did not exceed a 20% threshold compared to historical data. Remarkably, 82% of participants remained progression-free at six months, marking a 28% improvement over previous studies. Such results are unprecedented in this notoriously difficult-to-treat malignancy, sparking cautious optimism among the scientific community.
The trial is spearheaded by oncologist Dr. Gloria Roldan Urgoiti and neuroscientist Dr. Wee Yong, both affiliated with the Hotchkiss Brain Institute and the Arnie Charbonneau Cancer Institute. These investigators emphasize the importance of rigorous safety monitoring given the known toxicities associated with megadoses of vitamins such as niacin. Excessive intake can lead to adverse effects including hepatotoxicity and gastrointestinal distress, necessitating a carefully controlled clinical environment.
From a mechanistic perspective, niacin’s role appears multifaceted. It serves as a precursor for nicotinamide adenine dinucleotide (NAD+), a critical coenzyme in metabolic and DNA repair processes. By augmenting NAD+ levels, niacin enhances cellular resilience and the capacity of immune effector cells to attack cancer cells. Moreover, niacin modulates inflammatory signaling pathways, which may further contribute to restoring a tumoricidal microenvironment. This dual biochemical and immunological impact positions niacin as a uniquely promising adjunct therapy.
Ongoing research will continue to assess long-term outcomes and the potential for niacin to be integrated into standard treatment regimens. The study aims to complete a full cohort of 48 patients by early 2027, providing more robust data to support its preliminary positive findings. If successful, this therapy could represent a paradigm shift in managing glioblastoma, transforming a fatal diagnosis into a manageable chronic disease.
The psychological benefits for patients participating in such trials cannot be overstated. Edward Waldner expresses a renewed sense of hope and mental resilience as a direct result of being involved in this groundbreaking research. The feeling of actively contributing to medical advancement provides a critical boost to patient morale, which is often compromised during the rigorous treatment process for brain cancer.
Researchers caution that although niacin shows promise, it should not be self-administered outside of clinical trials due to the risk of toxicity. The precise dosing and controlled-release formulation used in the study are essential to achieving therapeutic effects without undue harm. Medical supervision remains paramount to ensure patient safety.
This study is supported by the Canadian Institutes of Health Research and the Alberta Cancer Foundation, underscoring significant institutional investment in translating bench research into clinical practice. The collaboration between clinicians and basic scientists exemplifies the interdisciplinary effort required to tackle complex diseases like glioblastoma.
The findings have recently been published in the peer-reviewed journal Neuro-Oncology, providing an important academic platform for dissemination and further scrutiny. As with all emergent therapies, ongoing peer review, replication, and larger Phase III trials will be critical steps to validate and expand upon these early results.
In the realm of immuno-oncology and neuro-oncology, the niacin trial stands as a beacon of innovation, blending nutrient science and cancer biology to combat one of the most intractable malignancies known to medicine. The story of Edward Waldner and this research initiative exemplifies the hope that can emerge from scientific perseverance and patient participation.
Subject of Research: People
Article Title: A phase I-II study of niacin in patients with newly diagnosed glioblastoma: safety and interim phase II analysis
News Publication Date: 25-Nov-2025
Web References:
https://link.springer.com/article/10.1007/s11060-025-05351-z
References:
Roldan Urgoiti, G., Yong, W. et al. (2025). A phase I-II study of niacin in patients with newly diagnosed glioblastoma: safety and interim phase II analysis. Neuro-Oncology.
Image Credits: Riley Brandt, University of Calgary
Keywords:
Glioblastomas, Brain cancer, Cancer, Vitamin B, Nicotinamides, Cells, Immunology
