isotretinoin and Carcinoma-in-Situ

Topics: Animals; Antineoplastic Agents; beta Carotene; Butylhydroxybutylnitrosamine; Carcinoma in Situ; Carcinoma, Papillary; Carotenoids; Cell Differentiation; Dose-Response Relationship, Drug; Epithelium; Fenretinide; Humans; Isotretinoin; Neoplasms; Neoplasms, Experimental; Tretinoin; Urinary Bladder Neoplasms; Vitamin A

To determine the utility of isotretinoin oral rinses as a method of chemoprevention for recurrent oral cavity squamous cell carcinoma (SCC), carcinoma in situ, and dysplasia.. Retrospective cohort study.. One hundred forty-three patients were initially enrolled in the study; however, 18 were excluded due to inability to tolerate therapy. The included patients were classified into four groups. Group 1 included patients with multiple early stage oral cavity lesions following initial resection. Group 2 included patients with SCC in situ after excision. Group 3 included patients with multifocal dysplasia following initial CO. Using a Bonferroni correction, the significance threshold was 0.0125. By that cutoff, isotretinoin rinses were found to be associated with lower recurrence in groups 1 and 3 (P = .00014, P = .00002, respectively) but not in groups 2 and 4 (P = .4, P = .3846, respectively).. Oral isotretinoin as chemoprophylaxis for patients treated for oral cavity squamous cell carcinoma, in situ disease, or dysplasia may be beneficial in decreasing recurrence rate.. 4. Laryngoscope, 127:1595-1599, 2017.

Topics: Carcinoma in Situ; Carcinoma, Squamous Cell; Cohort Studies; Combined Modality Therapy; Female; Humans; Isotretinoin; Laser Therapy; Leukoplakia, Oral; Male; Middle Aged; Mouth Neoplasms; Mouthwashes; Neoplasm Recurrence, Local; Neoplasm Staging; Precancerous Conditions; Retrospective Studies; Secondary Prevention

The collaborative group chemotherapy studies of the National Bladder Cancer Project are summarized with regard to intravesical and systemic agents. The necessity for longitudinal observations and data collection in all cases of bladder cancer, and not just those receiving chemotherapy, is also stressed.

Topics: Adult; Aminoacridines; Amsacrine; Antineoplastic Agents; Carcinoma in Situ; Carcinoma, Papillary; Cisplatin; Clinical Trials as Topic; Drug Evaluation; Humans; Isotretinoin; Mitomycin; Mitomycins; Multi-Institutional Systems; Neoplasm Recurrence, Local; Thiotepa; Tretinoin; Urinary Bladder Neoplasms

Vulvar intraepithelial neoplasias are difficult to eradicate completely without extensive surgical intervention. Cidofovir, a deoxycytidine monophosphate analog, may have a therapeutic role in this disease. A 43-year-old woman with a 20-year history of genital warts presented with extensive vulvar intraepithelial neoplasia III, and refused surgical resection. Topical cidofovir 1% in Beeler base completely eradicated the lesion. Successive treatment applications, however, were necessary. Cidofovir is a promising topical antiviral compound for HPV induced vulvar intraepithelial neoplasia.

Topics: Administration, Oral; Administration, Topical; Adult; Antineoplastic Agents; Carcinoma in Situ; Cidofovir; Cytosine; Drug Resistance, Multiple; Female; Humans; Injections, Subcutaneous; Interferons; Isotretinoin; Neoplasm Recurrence, Local; Organophosphonates; Organophosphorus Compounds; Uterine Cervical Dysplasia; Vulvar Neoplasms

A panel of retinoids (all-trans-, 13-cis-, 19-cis retinoic acid and acitretin), and interferon-alpha-2a was tested for the capacity to modulate the proliferation of UT-DEC-1 (HPV-33-positive) and UT-DEC-2 (HPV-16-positive) cell lines derived from vaginal intra-epithelial neoplasias (VAIN). At concentrations 10(-6) to 10(-8) M, all retinoids inhibited the growth of early-passage UT-DEC cell lines, but also of normal vaginal keratinocytes and fibroblasts. The inhibition was significantly reduced in late-passage UT-DEC cells. The effect on proliferation was essentially equal for all retinoids in high (1.8 mM)-Ca2+ medium, but decreased markedly in low (0.09 mM)-Ca2+ medium. Interferon-alpha-2a at 1000 IU/ml had an additive growth-inhibitory effect in the low- and in the high-Ca2+ medium. No consistent decrease in HPV E6-E7 mRNA levels could be associated either with retinoid or with interferon effect in either cell line. The expression of TGFbeta1 and TGFbeta2 mRNA increased 2- to 3-fold by 10(-6) M 13-cis-RA treatment in early- and in late-passage cells of both cell lines. TGFbeta1 at 0.1 to 1.0 ng/ml also inhibited the proliferation of both cell lines, and was more effective at early passage, but the inhibition was not dependent on calcium concentration. Neutralizing anti-TGFbeta antibodies partially relieved the proliferation inhibition by 13-cis-RA. The results show that the calcium-associated regulation of growth by the tested retinoids was seen in normal vaginal cells and in early pre-neoplastic cells, but was significantly reduced in cells with higher-grade phenotype, while also suggesting that the loss of responsiveness to retinoids and TGFbeta may play a role in the progression of squamous intra-epithelial neoplasia.

Topics: Acitretin; Carcinoma in Situ; Cell Division; Cell Line; Dose-Response Relationship, Drug; Female; Fibroblasts; Humans; Interferon alpha-2; Interferon-alpha; Isotretinoin; Keratinocytes; Recombinant Proteins; Retinoids; Tretinoin; Tumor Cells, Cultured; Vagina; Vaginal Neoplasms

We report the result of the follow-up molecular analysis of a bronchial carcinoma in situ treated by 13-cis-retinoic acid, which relapsed 9 months after cessation of drug therapy. Loss of heterozygosity at 3p21 and 9p22 genomic sequences were assessed by polymerase chain reaction (PCR) after microdissection of the dysplastic epithelia. Despite a transient regression of the lesion to a lower grade with treatment, molecular analysis showed the persistence of a 3p and 9p deletion in all the bronchial biopsies taken in the same area during a 1 year follow-up, preceding by 9 months the recurrence of the carcinoma in situ. Our findings suggest that molecular follow-up analysis can help to assess the persistence of a malignant clone within a bronchial epithelium that displays a more benign phenotype under retinoid treatment on follow-up. Molecular analysis may be of great importance to evaluate the effects of chemoprevention and to determine the duration of such intervention in responder patients.

Topics: Bronchial Neoplasms; Carcinoma in Situ; DNA, Neoplasm; Follow-Up Studies; Humans; Isotretinoin; Male; Middle Aged; Neoplasm Invasiveness