O⁶-Benzylguanine and its role in chemotherapy

The presence of the DNA repair protein, O⁶-alkylguanine-DNA alkyltransferase (AGT) in tumor cells is a significant source of resistance to chemotherapeutic alkylnitrosoureas and alkyltriazenes. O⁶-Benzylguanine provides a means to effectively inactivate the AGT protein and increase the chemotherapeutic effectiveness of chloroethylating and methylating agents in vitro and in human tumor xenograft models. Phase I clinical trials of the combination of O⁶-benzylguanine and 1,3-bis(2-chloroethyl)-1-nitrosourea are ongoing. Efforts directed at overcoming potential enhanced hematopoietic toxicity and mutagenicity have included the use of gene therapy to express an alkyltransferase gene in the relevant marrow stem cells. Altered AGT proteins resistant to O⁶-benzylguanine generated from point mutations in the mammalian alkyltransferase gene have been expressed in animal models using retroviral transduction techniques, It is anticipated that the successful application of this approach in humans may provide a means to increase the therapeutic index of O⁶-benzylguanine and 1,3-bis(2-chloroethyl)-1-nitrosourea.