Retinoids, natural or synthetic substances which have vitamin A activity, h
ave a well-known reputation for their antitumour and differention-inducing
activity in vitro and in vivo. More than 1500 retinoids have been tested so
far but very few of them have been entered into clinical trials because of
their side-effects. All-trans-N-(4-hydroxyphenyl)retinamide (4HPR or fenre
tinide) is a synthetic retinoid that is reported to have fewer side-effects
compared to naturally occurring retinoids such as all-trans retinoic acid
(ATRA) and 9-cis retinoic acid. In addition, fenretinide has been shown to
induce cell death (apoptosis) even in ATRA-resistant cell lines. Although t
he mechanism by which fenretinide acts is not entirely known it is consider
ed to be a promising drug and seems to induce apoptosis via different pathw
ay(s) from classical retinoids. In this reveiw, we discuss possible mechani
sms of fenretinide action and summarize results of clinical trials.