Retinoic acid (Tretinoin) binds to and activates retinoic acid receptors (RARs), thereby inducing changes in gene expression that lead to cell differentiation, decreased cell proliferation, and inhibition of tumorigenesis. This agent also inhibits telomerase, resulting in telomere shortening and eventual apoptosis of some tumor cell types. Tretinoin is a naturally-occurring acid of retinol. The oral form of tretinoin has teratogenic and embryotoxic properties.