Vitamin A and retinoid derivatives for lung cancer: a systematic review and meta analysis | CCNM

Vitamin A and retinoid derivatives for lung cancer: a systematic review and meta analysis

You are here

BACKGROUND: Despite reported antiproliferative activity of vitamin A and its common use for cancer, there is no comprehensive synthesis of its safety and efficacy in lung cancers. To address this issue we conducted a systematic review of the safety and efficacy of vitamin A for the treatment and prevention of lung cancers. METHODS AND FINDINGS: Two independent reviewers searched six electronic databases from inception to July 2009 for clinical, observational, and preclinical evidence pertaining to the safety and efficacy of vitamin A and related retinoids for lung cancers. 248 studies were included for full review and analysis. Five RCTs assessed treatment of lung cancers, three assessed primary prevention, and three looked at secondary prevention of lung cancers. Five surrogate studies, 26 phase I/II, 32 observational, and 67 preclinical studies were also included. 107 studies were included for interactions between vitamin A and chemo- or radiation- therapy. Although some studies demonstrated benefits, there was insufficient evidence overall to support the use of vitamin A or related retinoids for the treatment or prevention of lung cancers. Retinyl palmitate combined with beta carotene increased risk of lung cancer in smokers in the large CARET trial. Pooling of three studies pertaining to treatment and three studies on secondary prevention revealed no significant effects on response rate, second primary tumor, recurrence, 5-year survival, and mortality. There was a small improvement in event free survival associated with vitamin A compared to controls, RR 1.24 (95% CI 1.13–1.35). The synthetic rexinoid bexarotene increased survival significantly among a subset of patients in two RCTs (p,0.014, ,0.087). CONCLUSIONS: There is a lack of evidence to support the use of naturally occuring retinoids for the treatment and prevention of lung cancers. The rexinoid bexarotene may hold promise for use among a subset of patients, and deserves further study.
Title of abstract: 
Vitamin A and Retinoid Derivatives for Lung Cancer: A Systematic Review and Meta Analysis
Heidi Fritz 1, Deborah Kennedy 1,2, Dean Fergusson 4, Rochelle Fernandes 1,3, Steve Doucette 4, Kieran Cooley 1,2, Andrew Seely 5, Stephen Sagar 6, Raimond Wong 6, Dugald Seely 1,4
1 Department of Research and Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada, 2 Leslie Dan Faculty of Pharmacy, The University of Toronto, Toronto, Ontario, Canada, 3 Laboratory Medicine and Pathobiology (LMP), The Un
Friday, December 31, 2010
PLoS One 2011; 6(6): e21107

CCNM logo


Talk to a student services advisor today by emailing

Canadian College of Naturopathic Medicine

Educating naturopathic doctors in North America for over 40 years

1255 Sheppard Avenue East, Toronto, Ontario M2K 1E2

College: (416) 498-1255 I 1 (866) 241-2266 (toll-free)

Clinic: (416) 498-9763

Member of the Association of
Accredited Naturopathic Medical Colleges