NAD+ Precursor Supplements May Undermine Pancreatic Cancer Chemotherapy, Study Warns
核心洞察
Researchers at Case Western Reserve University found that vitamin B3 derivatives NMN, NR, and NAM may help pancreatic cancer (搜索) cells survive and resist chemotherapy.
In laboratory and animal models, the supplements shielded cancer cells against oxaliplatin, 5-fluorouracil, and gemcitabine, allowing tumors to survive otherwise fatal doses.
The study, published in Cancer Letters, found NMN had the greatest impact on chemotherapy resistance, while NR had a smaller effect.
Over-the-counter anti-aging supplements taken by millions of Americans to boost energy and lessen the side effects of chemotherapy may actually impair cancer treatments, according to new research from the Case Western Reserve University School of Medicine. The study, published in the journal Cancer Letters, found that popular vitamin B3 derivatives — including nicotinamide mononucleotide (NMN), nicotinamide riboside (NR) and nicotinamide (NAM) — could help cancer cells survive chemotherapy.
These compounds, known as NAD+ precursors, are used by the body to produce NAD+, a molecule that helps cells generate energy and repair damage. Celebrity figures from Kim Kardashian to Joe Rogan to Jennifer Aniston have discussed supplements that increase NAD+, which is needed for almost everything the body does and declines naturally with age.
How NAD+ Precursors May Fuel Cancer Cells
While boosting NAD+ levels through dietary supplements can offer health benefits to non-cancerous cells, pancreatic cancer (搜索) cells may exploit the extra resources to repair damage caused by chemotherapy and avoid cell death, the researchers found. In both laboratory settings and animal models, the supplements shielded cancer cells against three common chemotherapy drugs: oxaliplatin, 5-fluorouracil and gemcitabine. As a result, tumors survived chemotherapy doses that typically would prove fatal to them.
The supplements did not all have the same effect. NMN had the biggest impact on chemotherapy resistance, while NR had a smaller one. In animal tests, NMN and NAM also appeared to help tumors grow and resist chemotherapy. The supplements lowered oxidative stress in cancer cells and suppressed DNA damage and cell death, blocking the mechanisms by which chemotherapy kills cancer.
Researchers believe this occurs because cancer cells hijack some of the same processes NAD+ precursors support in healthy cells, using them to survive and resist treatment.
A Deadly Disease with Limited Options
Pancreatic cancer (搜索) is one of the deadliest cancers because it often progresses without symptoms and is diagnosed late. According to the American Cancer Society, the disease has a 13% five-year survival rate; other reporting cites a figure of only 12% of all people with the cancer surviving five years after diagnosis.
Age is the single most important risk factor for cancer — 88% of cases occur in people 50 and older. Researchers note that companies selling NAD+ precursor supplements primarily target older individuals who are at higher risk of age-related illness, including cancer. Some people with active cancer undergoing chemotherapy also turn to NAD+ precursors to help manage toxicity from treatment, despite some previous research suggesting these compounds might fight or weaken cancer. The new findings suggest some NAD+ precursors could, in certain circumstances, do the exact opposite.
A Call to Action for the Medical Community
"Our findings highlight a potentially concerning role for NAD+-boosting supplements in the context of active cancer, especially when used in conjunction with chemotherapy," said study lead Jordan Winter, a professor at Case Western Reserve School of Medicine and co-leader of the developmental therapeutics program at the Case Comprehensive Cancer Center. "Our discovery is a call to action for the medical community."
"This research is a critical reminder that 'natural' doesn't always mean safe, especially in the complex biology of cancer treatment," Winter added.
The study notes that these B3 derivatives are not considered dangerous for healthy individuals using them for general wellness. However, the risk becomes significant for patients currently undergoing active cancer therapy. For cancer patients, researchers say the potential risks of taking NAD+ precursors "are serious and demand immediate attention."
In light of the findings, the research team recommends that oncology teams begin routinely screening patients for supplement use, "as vitamin B3 derivatives may inadvertently promote tumor cell survival and compromise treatment efficacy." They also called for more studies into how NAD+ precursors interact with cancer therapies. Winter urged patients currently in treatment to consult their oncologists before taking any over-the-counter supplements.
Study Limitations
Because the study relied on laboratory cell cultures and animal models, the findings may not directly translate to how human patients process these supplements during treatment, the team noted. Additionally, the research focused exclusively on pancreatic cancer (搜索), meaning the supplements may not have the same effect on chemotherapy for other cancer types or with different drug combinations. The study also only evaluated short-term cellular responses under controlled laboratory conditions and not human clinical trials, so it remains unclear how these supplements could affect cancer patients over time.