Hazard identification and risk assessment paradigms depend on the presumption of the similarity of rodents to humans, yet species specific responses, and the extrapolation of high-dose effects to low-dose exposures can affect the estimation of human risk from rodent data. As a consequence, a human relevance framework concept was developed by the International Programme on Chemical Safety (IPCS) and International Life Sciences Institute (ILSI) Risk Science Institute (RSI) with the central tenet being the identification of a mode of action (MOA). To perform a MOA analysis, the key biochemical, cellular, and molecular events need to first be established, and the temporal and dose-dependent concordance of each of the key events in the MOA can then be determined. The key events can be used to bridge species and dose for a given MOA. The next step in the MOA analysis is the assessment of biological plausibility for determining the relevance of the specified MOA in an animal model for human cancer risk based on kinetic and dynamic parameters. Using the framework approach, a MOA in animals could not be defined for metal overload. The MOA for phenobarbital (PB)-like P450 inducers was determined to be unlikely in humans after kinetic and dynamic factors were considered. In contrast, after these factors were considered with reference to estrogen, the conclusion was drawn that estrogen-induced tumors were plausible in humans. Finally, it was concluded that the induction of rodent liver tumors by porphyrogenic compounds followed a cytotoxic MOA, and that liver tumors formed as a result of sustained cytotoxicity and regenerative proliferation are considered relevant for evaluating human cancer risk if appropriate metabolism occurs in the animal models and in humans.

Carcinogenesis is a multistage process consisting of the three distinct stages: initiation, promotion, and progression. The initiation-promotion-progression (IPP) protocol models these stages and establishes a method whereby agents that possess a carcinogenic risk can be classified as acting primarily at any one or combination of these stages. In one hepatocarcinogenesis IPP protocol, rats were initiated with 10 mg of diethylnitrosamine/kg body wt at 5 days of age, started on the promoting agent phenobarbital at weaning, subjected to a 70% partial hepatectomy at 6 months, and, at the peak of proliferation, given a putative progressor agent, ethylnitrosourea ([ENU] 100 mg/kg, ip) or hydroxy-urea ([HU] 3 x 150 mg/kg, ip). Administration of the promoting agent was discontinued after the progressor agent was given, and the rats were sacrificed 6 months later. The number and volume fraction of promoter-independent (growth in the absence of the promoting agent) altered hepatic foci (AHF) were then determined by quantitative stereology. The number of such AHF increased with either ENU or HU treatment compared with animals not given a progressor agent. In addition, hepatocytes isolated from animals subjected to an IPP regimen with ENU as the progressor agent exhibited a greater degree of chromosomal breakage and aneuploidy than animals not given a second initiator. A variation of this model, in which the promoting agent was maintained after administration of the progressor agent, was examined. In this IPP model, the number of heterogeneous AHF (foci-in-foci) increased after application of the progressor agent (ENU or HU). An increased incidence of hepatocellular carcinoma was also observed in animals subjected to the IPP protocol when promotion was maintained until sacrifice. Thus, the characteristics of progression--increased chromosomal damage, aneuploidy, growth of AHF in the absence of continued tumor promotion, the presence of foci-in-foci, and an increased incidence of malignant neoplasia--have been used as end points for the demonstration of progressor activity by ENU. In addition, the potential progressor activity of HU and benzene has been demonstrated with the IPP model of rat hepatocarcinogenesis.

Cell proliferation is pivotal to all stages of the carcinogenesis process and is one of the primary characteristics of the promotion stage of cancer development. Both a two-stage model of initiation and promotion for analysis of early preneoplasia and a three-stage initiation-promotion-progression model of hepatocarcinogenesis were used to address the effect of the liver tumor-promoting agent phenobarbital (PB) on hepatic cellular proliferation. Male rats were subjected to a 70% partial hepatectomy and 10 mg diethylnitrosamine (DEN)/kg or the solvent alone and were administered PB for 4-8 months. Analysis of bromodeoxyuridine (BrdU) incorporation (1 h pulse) in liver within (focal) and not within (non-focal) altered hepatic foci (AHF) demonstrated a labeling index in AHF of 2% in DEN-initiated rats; the non-focal labeling index of placental glutathione S-transferase expressing hepatocytes was 0.3-0.6%. The focal labeling index was constant over the 8 month period of promotion. Inasmuch as one characteristic of promotion is the reversibility of the induced effects on clonal expansion of initiated cells, groups of rats initially promoted with PB were maintained in the absence of continued promotion for 4 or 8 months prior to being killed. Assessment of the focal labeling index after cessation of PB treatment indicated a drop in the index from 2.3% to 0.7%. When a progressor agent, ethylnitrosourea, was given at the time PB was discontinued for 4 or 8 months, a significant change in focal labeling index was not observed relative to the index in AHF when the animals were killed immediately after 8 months of PB promotion. Thus, cell proliferation plays an integral role in both the promotion and progression stages of multistage rat hepatocarcinogenesis and is influenced by administration of promoting and progressor agents.