An experimental drug derived from vitamin A may be useful in fighting neuroblastoma when other chemotherapy drug fails.

Neuroblastomas are highly malignant tumors that arise in nervous system tissue and are usually diagnosed in infants or young children. The tumors usually spread rapidly to the lymph nodes, liver, lung and bone.

The drug, known as fenretinide or 4-HPR, induced laboratory-grown neuroblastoma cells to undergo apoptosis, a cell suicide program, according to a report in the Journal of the National Cancer Institute.

The drug was able to kill cancer cells even in low-oxygen conditions, which often reduce the effectiveness of chemotherapy drugs. Therefore the drug may be useful in treating neuroblastoma that has spread to bone marrow, an area with low oxygen levels, report Dr. Barry J. Maurer of Children’s Hospital Los Angeles, and colleagues. The study also suggests that the drug might be effective in treating cancer cells resistant to other anticancer drugs.

Past studies in laboratory-grown cells have suggested that fenretinide may be effective against cancers of the colon, rectum, head and neck, breast, prostate, lung and ovary. However, the level of the drug needed to kill cells has not yet been tested in humans.

If further study shows that high dose fenretinide is safe in humans, the drug may offer a new type of chemotherapy. The drug appears to kill cells by increasing levels of ceramide, a known tumor-killing molecule that is difficult to produce with relatively nontoxic doses of chemotherapy drugs.