Retinoids in the management of head and neck cancer. An update

Abstract

Despite smoking cessation programs and recent advances in cancer treatment, it is anticipated that head and neck cancer along with lung and esophageal cancers will still be a serious health hazard worldwide.

Cancer chemoprevention represents a promising new area of intensive clinical research.

Chemoprevention agents which have been considered in clinical trials with the intention of reversing the carcinogenic process include natural agents as well as synthetic retinoids.

At the molecular level these agents seem to modify gene expression through the mediation of intracellular-binding proteins and nuclear receptors.

In vitro, retinoids induce tumor cell differentiation, inhibit proliferation and also affect other important cell functions, such as adhesion and invasion.

Clinical studies conducted in individuals with premalignant lesions, such as oral leukoplakia or laryngeal papillomatosis, have shown that retinoids have the capability to reverse the malignant process in the majority of cases. Furthermore, in patients with head and neck tumors, who became disease-free, after primary treatment, 13-cis retinoic acid (isotretinoin) significantly reduced the incidence of second primaries as compared to placebo.

These exciting results urged investigators in Europe and the USA to organize confirmatory trials as well as other chemoprevention trials in order to evaluate the role of new agents.

It is hoped that these trials will clarify several important aspects of chemoprevention, such as the safety and activity of new compounds, the significance of integration of retinoids with chemotherapy and/or biotherapy and the establishment of biological markers as intermediate endpoints of carcinogenesis.

 

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See also:

- All-Trans-Retinoic Acid (ATRA - analogues and/or derivatives);

- The Di Bella Method (A Fixed Part - All-Trans Retinoic Acid, Analogues and/or Derivatives);

- Solution of retinoids in vitamin E in the Di Bella Method biological multitherapy;

- The Di Bella Method (A Fixed Part - Alpha tocopheryl acetate/Vitamin E);

- The Di Bella Method DBM improved survival objective response and performance status in a retrospective observational clinical study on 23 tumours of the head and neck;

- Oesophageal squamocellular carcinoma: a complete and objective response;

- Cyclophosphamide plus Somatostatin, Bromocriptin, Retinoids, Melatonin and ACTH in the Treatment of Low-grade Non-Hodgkin’s Lymphomas at Advanced Stage: Results of a Phase II Trial;

- Relapse of High-Grade Non-Hodgkin’s Lymphoma After Autologous Stem Cell Transplantation: A Case Successfully Treated With Cyclophosphamide Plus Somatostatin, Bromocriptine, Melatonin, Retinoids, and ACTH;

- Low-grade Non-Hodgkin Lymphoma at Advanced Stage: A Case Successfully Treated With Cyclophosphamide Plus Somatostatin, Bromocriptine, Retinoids, and Melatonin;

- The Di Bella Method (DBM) improved survival, objective response and performance status in a retrospective observational clinical study on 55 cases of Lymphomas;

- Large B-cells Non-Hodgkin's Lymphoma, Stage IV-AE: a Case Report;

- Non-Hodgkin's Lymphoma, Stage III-B-E: a Case Report;

- Somatostatin, retinoids, melatonin, vitamin D, bromocriptine, and cyclophosphamide in advanced non-small-cell lung cancer patients with low performance status;

- Somatostatin, retinoids, melatonin, vitamin D, bromocriptine, and cyclophosphamide in chemotherapy-pretreated patients with advanced lung adenocarcinoma and low performance status;

- Observations on the Report of a case of pulmonary adenocarcinoma with lymph node, hepatic and osseus metastasis;

- Chronic Lymphocytic Leukemia: Long-Lasting Remission with Combination of Cyclophosphamide, Somatostatin, Bromocriptine, Retinoids, Melatonin, and ACTH;

- Complete objective response, stable for 5 years, with the Di Bella Method, of multiple-metastatic carcinoma of the breast;

- Evaluation of the safety and efficacy of the first-line treatment with somatostatin combined with melatonin, retinoids, vitamin D3, and low doses of cyclophosphamide in 20 cases of breast cancer: a preliminary report;

- The Di Bella Method (DBM) improved survival, objective response and performance status in a retrospective observational clinical study on 122 cases of breast cancer;

- Complete objective response to biological therapy of plurifocal breast carcinoma.