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Tumor Discovery A comprehensive review of bexarotene

11 (41%) patients, with improved platelet counts, 4 (15%)
patients showed reduced bone marrow impacts to <5%,
and 7 (26%) patients demonstrated enhanced neutrophil
counts. Bexarotene induces cell death in tumor cells
stimulated by tumor necrosis factor-related apoptosis-
inducing ligand (TRAIL) . It triggers TRAIL-induced
[36]
apoptosis in tumorous cell lines ML-1 (apoptosis-
sensitive) and KG1a (apoptosis-resistant), resulting in
cell death of myelogenous cells [36,37] . Researchers reported
that bexarotene was all around endured and showed the
potential to strengthen the production of new lymphocytes
compared to standard cytotoxic medications. As a result,
it could be considered a specific single or combination
treatment, particularly for relapsed or refractory patients .
[17]
5.5. Thyroid cancer
Figure 3. Mechanism of action of bexarotene in combination with
chemotherapy. Thyroid cancer is the most commonly recognized risk
among endocrine organs. The overall prognosis for
[29]
of patients achieve complete remission . Bexarotene patients with thyroid malignancy is relatively high, with
can be used either individually or as salvage therapy in around 5 – 10% of patients advanced thyroid disease
[17]
combination with recognized anticancer medications such and showing resistance to standard therapy . In a
as tamoxifen. Studies have shown that co-administration study, bexarotene treatment reduced proliferation in an
of bexarotene with tamoxifen caused suppression of 72% anaplastic thyroid disease cell line, and in vivo experiments
of primary tumors, compared to tamoxifen alone, which using a nude mouse model confirmed diminished tumor
[37]
only resulted in a 33% response in an NMU model of size . Bexarotene may activate RXR/PPAR heterodimer,
mammary carcinogenesis [30,31] . Bexarotene also signifies which, in turn, stimulates the expression of the ANGPTL4
a good contender for paclitaxel-based combined therapy gene (the gene that encodes angiopoietin-like 4 protein).
for breast cancer, as this combination induced apoptosis This action can result in diminished tumor vascularity and
[17]
in rodent NMU-induced mammary tumors both in vitro improved necrosis of tumor cells . Bexarotene has been
and in vivo . In a separate study, the combination of observed to induce radioiodine take-up (RI) in patients
[32]
[17]
guggulsterone and bexarotene elevated ceramide levels with radioiodine-resistant thyroid malignant growth .
and thus induced the secretion of exosomes which lowered A clinical report revealed that 8 out of 11 patients with
the cellular levels of breast cancer resistance protein thyroid carcinoma experienced a significant restoration
(BCRP) to 20%. This reduction in BCRP level resulted in of I-131 take-up following a 6-week pre-treatment
elevated doxorubicin retention and a five-fold increase in with 300 mg/day of bexarotene . However, the basic
[38]
apoptosis of cancerous cells . Reportedly, bexarotene also mechanisms underlying bexarotene’s RI take-up effect
[33]
[17]
inhibited the expression of cyclooxygenase-2 (COX-2) in remain unclear . Given these promising findings, further
breast tumor cells through sequestration of CBP/p300 (a robust research is needed for better utilization of this drug
transcription factor) and thus prevented breast cancer . against thyroid cancer.
[34]
When combined with a multi-antigen and multi-
peptide vaccine, bexarotene synergistically inhibited the 5.6. Cushing’s disease
multiplication and development of mammary tumors . Cushing’s disease is a challenging endocrine condition
[35]
characterized by hypersecretion of the steroid hormone
5.4. Acute myeloid leukemia (AML) cortisol due to an overproduction of adrenocorticotropic
AML is a form of acute leukemia characterized by hormone. The first-line treatment for this condition
various hematopoietic malignancies. It is caused by the involves tumor removal, which has been successful in
hyperplasia of myelogenous cells, leading to arrested 70 – 90% of cases . However, effective medical therapy
[39]
growth and maturation. AML is usually manageable with options are limited. Studies with retinoic acid have
chemotherapy or stem cell transplantation. Studies have shown some promise in reducing corticotrophs release
shown that bexarotene, in combination with vorinostat, and tumor development . During the treatment of MF
[40]
inhibits cell viability in human cancerous cell lines . with bexarotene, a side effect of induced hypopituitarism
[17]
In clinical settings, positive outcomes were reported in was observed. These findings suggest that induced

Volume 2 Issue 2 (2023) 5 https://doi.org/10.36922/td.0436