Tretinoin (all-trans retinoic acid, ATRA)
The vitamin-A derivative that made acute promyelocytic leukaemia the first cancer cured by differentiation therapy rather than by killing cells.
Shanghai (Huang, 1988) reported complete remissions with ATRA alone; combined with chemotherapy and later arsenic trioxide, APL became the most curable adult leukaemia. Differentiation syndrome (capillary leak, fever, pulmonary infiltrates) is treated with dexamethasone. Approved US 1995.
- Medicare
- Part D (self-administered)
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic tretinoin capsules.
- Commercial insurance
- covered on label
Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Notes
- Standard for APL with arsenic trioxide (TA526) or chemotherapy; funded routinely without its own TA.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE search: tretinoin (ATRA). Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 1995 | Induction of remission in APL (t(15;17)/PML-RARA) |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Latest papers
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