Key words: lung cancer; fenretinide; retinoids; proliferation; apoptosis; cancer therapyLung cancer rates have declined over the past decade, due to less consumption of tobacco. Lung cancer will also fall behind prostate and breast cancer as being the most frequent cancer incidences in the United States. 1,2 Despite this, the prognosis of lung cancer is still very poor, due to the fact that advances in therapy have not been made during the last years. The development of new treatment strategies is urgently needed to improve prognosis in the future. 1 Retinoids are natural and synthetic derivatives of vitamin A, which effect several physiologic functions, including control of proliferation and differentiation in epithelial tissue. Since alterations in the retinoid signalling pathways have been implicated in the pathogenesis of lung cancer, 3,4 retinoids have been investigated as possible agents for chemoprevention and therapy of lung cancer. 5,6 Several studies showed that all-trans-retinoic acid (ATRA), being the most active natural retinoid, failed to inhibit growth in many small cell lung cancer (SCLC) as well as nonsmall cell lung cancer (NSCLC) cell lines. Even growth stimulation has been observed in 2 cell lines. 4 Furthermore, ATRA showed only little activity against metastatic NSCLC in phase II of a clinical trial. 7 Therefore, other retinoids were investigated with the emphasis on synthetic retinoids, which imitate the growth inhibitory effects of ATRA and have lower toxicity than the natural retinoids. N-(4-hydroxyphenyl)retinamide) (4-HPR), a synthetic amide of ATRA, seems to be a promising retinoid that combines both features. 4-HPR has been shown to be a more potent growth inhibitor than ATRA in a variety of cancer cell lines, including lung cancer cell lines. 8 Whereas ATRA inhibits growth of cancer cell lines by induction of differentiation, 4-HPR has the ability to induce apoptosis selectively in these cell lines. 9 In the first clinical trials, 4-HPR exhibited low toxicity in humans and is currently under investigation in several other clinical trials. 8 Despite these encouraging results, some features of 4-HPR may limit clinical use, either as a chemopreventive agent or in the therapy of patients with solid tumours. On the one hand, the effect of 4-HPR on the growth of cancer cells has been shown to be reversible upon its removal in some cell lines, which requires long-term administration in patients to achieve the desired effect. 10,11 On the other hand, a recent study showed an acquired 4-HPR-induced resistant ovarian tumour cell line, after exposure to increasing concentrations of 4-HPR. 12 The aim of our study was to have a close look at the effect of 4-HPR on the growth of lung cancer cell lines, especially with regard to the clinical use in lung cancer patients. Therefore, we investigated the effect of 4-HPR on the growth of a broad panel of SCLC cell lines and NSCLC cell lines in order to see whether its inhibitory effect is a common phenomenon in lung cancer cell lines. We further compar...