Tumor formation is a multi-step process that can be divided into the stages of
tumor initiation, promotion and progression. Previously, we showed that overexpression in skin of mice of the DNA repair
protein O(6)-methylguanine-DNA methyltransferase (MGMT) protects against
N-methyl-N-nitrosourea (MNU)-induced
tumor initiation without affecting
tumor promotion. This indicated that
O(6)-methylguanine, which is specifically repaired by MGMT, is a major
tumor-initiating lesion. Here we extended this transgenic approach to the study of
tumor progression. Benign
papillomas that arose on the skin of CkMGMT transgenic mice upon initiation with 7,12-dimethylbenz[a]
anthracene (DMBA) and promotion by 12-O-tetradecanoylphorbol-13-acetate (TPA) expressed higher levels of MGMT than
papillomas that appeared on DMBA/TPA treated non-transgenic NMRI mice. Treatment of
papillomas with MNU resulted in the formation of malignant
carcinomas to a significantly lower frequency in CkMGMT mice as compared with the non-transgenic control. The data provide evidence that increased DNA repair protects against the conversion of benign into malignant
tumors. They show at the same time that a particular type of damage induced in
DNA, namely
O(6)-methylguanine, is decisively involved in triggering
tumor progression. This supports the concept that the major cause of both
tumor initiation and
tumor progression is mutation. Data also indicate that alkylating anti-neoplastic drugs may provoke
tumor progression in case of failure of
tumor therapy, which is attenuated by DNA repair.