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All-trans-retinoic acid and cutaneous cancers
Journal of the American Academy of Dermatology
|October 1, 1986
Summary
All-trans-retinoic acid (tretinoin), a vitamin A derivative, shows antineoplastic effects against various tumors. Clinical trials demonstrate its efficacy in removing premalignant skin lesions, with no evidence of carcinogenicity in humans.
Area of Science:
- Dermatology
- Oncology
- Molecular Biology
Background:
- All-trans-retinoic acid (tretinoin) is a metabolite of vitamin A.
- Topical tretinoin exhibits antineoplastic activity against experimentally induced and naturally occurring tumors.
- Tretinoin's mechanisms may involve influences on DNA synthesis, polyamine enzymes, sister-chromatid exchanges, oncogene expression, and lysosome lability.
Purpose of the Study:
- To evaluate the antineoplastic and therapeutic effects of topical tretinoin.
- To investigate tretinoin's role in ultraviolet-induced tumorigenesis.
- To assess the safety and carcinogenic potential of topical tretinoin in humans.
Main Methods:
- Review of animal studies on ultraviolet-induced and chemically induced tumors.
- Analysis of clinical trials involving topical tretinoin for premalignant lesions.
- Examination of tretinoin's effects on various cellular and molecular pathways.
Main Results:
- Tretinoin inhibited some ultraviolet-induced carcinomas in animals but accelerated others.
- The drug eradicated chemically induced papillomas and carcinomas in animal models.
- Clinical trials showed tretinoin effectively removed actinic keratoses, especially when combined with 5-fluorouracil for forearm and hand lesions.
Conclusions:
- Topical tretinoin possesses antineoplastic properties and is effective in treating premalignant skin lesions.
- Tretinoin's complex effects on tumorigenesis warrant further investigation.
- Extensive topical use in humans has not indicated carcinogenic potential for tretinoin.
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