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Cited by 266Cervical Cancer and HPV ResearchEndometrial and Cervical Cancer TreatmentsRetinoids in leukemia and cellular processes

The DOI matches its Crossref record; 10 of the 20 references it cites were found in a registry or an index.

Enhancement of Regression of Cervical Intraepithelial Neoplasia II (Moderate Dysplasia) With Topically Applied All- trans -Retinoic Acid: a Randomized Trial

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Meyskens, Frank L., Surwit, Earl, Moon, Thomas E., Childers, Joel M., Davis, John R., Dorr, Robert T., Johnson, Cynthia S., Alberts, David S.·1994·JNCI: Journal of the National Cancer Institute
DOI 10.1093/jnci/86.7.539
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Abstract

BACKGROUND: Retinoids enhance differentiation of most epithelial tissues. Epidemiologic studies have shown an inverse relationship between dietary intake or serum levels of vitamin A and the development of cervical dysplasia and/or cervical cancer. Pilot and phase I investigations demonstrated the feasibility of the local delivery of all-trans-retinoic acid (RA) to the cervix using a collagen sponge insert and cervical cap. A phase II trial produced a clinical complete response rate of 50%. PURPOSE: This randomized phase III trial was designed to determine whether topically applied RA reversed moderate cervical intraepithelial neoplasia (CIN) II or severe CIN. METHODS: Analyses were based on 301 women with CIN (moderate dysplasia, 151 women; severe dysplasia, 150 women), evaluated by serial colposcopy, Papanicolaou cytology, and cervical biopsy. Cervical caps with sponges containing either 1.0 mL of 0.372% beta-trans-RA or a placebo were inserted daily for 4 days when women entered the trial, and for 2 days at months 3 and 6. Patients receiving treatment and those receiving placebo were similar with respect to age, ethnicity, birth-control methods, histologic features of the endocervical biopsy specimen and koilocytotic atypia, and percentage of involvement of the cervix at study. Treatment effects were compared using Fisher's exact test and logistic regression methods. Side effects were recorded, and differences were compared using Fisher's exact test. RESULTS: RA increased the complete histologic regression rate of CIN II from 27% in the placebo group to 43% in the retinoic acid treatment group (P = .041). No treatment difference between the two arms was evident in the severe dysplasia group. More vaginal and vulvar side effects were seen in the patients receiving RA, but these effects were mild and reversible. CONCLUSIONS: A short course of locally applied RA can reverse CIN II, but not more advanced dysplasia, with acceptable local side effects. IMPLICATIONS: A derivative of vitamin A can reverse or suppress an epithelial preneoplasia, lending further support to the notion that chemoprevention of human cancer is feasible.

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Crossref · 10.1093/jnci/86.7.539

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Metadata

Authors
Meyskens, F. L., Surwit, E., Moon, T. E., Childers, J. M., Davis, J. R., Dorr, R. T., Johnson, C. S., & Alberts, D. S.
Affiliations
University of Arizona (US)
ORCID
Venue
JNCI: Journal of the National Cancer Institute
Publisher
Oxford University Press (OUP)
Published
1994-04-06
Volume
86
Issue
7
Pages
539-543
ISSN
  • 0027-8874 (ISSN-L)
  • 1460-2105
DOI
10.1093/jnci/86.7.539
OpenAlex
W2012603529
Cited by
263
References
20
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 8 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 5 · 2016: 3 · 2015: 5 · 2014: 7 · 2013: 5 · 2012: 5
FWCI
15.77
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JNCI Journal of the National Cancer Institute (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders
National Cancer Institute (CA40889, CA 27502, P01CA027502)
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinoids in leukemia and cellular processes
Keywords
cervical intraepithelial neoplasia, moderate dysplasia, severe dysplasia, all-trans retinoic acid, topical retinoids, chemoprevention, histological regression, vitamin A, cervical cancer prevention, local adverse reactions
MeSH terms
Administration, Intravaginal, Adult, Antineoplastic Agents, Biopsy, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, Female, Humans, Remission Induction, Tretinoin, Logistic Models

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