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A combination therapy regimen evaluated by the Eastern Cooperative Oncology Group (ECOG) in the phase II trial E6501 for the treatment of recurrent small cell lung cancer (SCLC). The regimen consists of the biologic immunomodulator interferon alpha, the retinoid 13-cis-retinoic acid (isotretinoin), and the taxane chemotherapy agent paclitaxel. The therapeutic rationale was based on the ability of interferon alpha and isotretinoin to downregulate the anti-apoptotic protein Bcl-2, which is often overexpressed in SCLC and contributes to chemotherapy resistance. By reducing Bcl-2 levels, the combination was intended to sensitize tumor cells to the microtubule-stabilizing and cytotoxic effects of paclitaxel. Despite the sound preclinical rationale, the clinical trial demonstrated that this specific combination did not significantly improve outcomes in patients with recurrent SCLC.
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