Metallothionein (MT) is a high-affinity metal binding protein thought to mitigate the toxicity of various metals. Cisplatin is a widely used cancer chemotherapeutic that is a rodent carcinogen and may have carcinogenic potential in humans. MT seems to reduce cisplatin toxicity by binding the metal compound but how MT deficiency might impact the carcinogenic effects of cisplatin is unknown. Thus, groups (n 5 25) of male MT-I/II double knockout (MT-null) or MT wild-type (WT) mice were exposed to a single treatment of cisplatin (5 or 10 mg/kg, i.p.), or left untreated (control) and observed over the next 104 weeks. The doses of cisplatin used equate to only a fraction of the total dose used typically in clinical settings. In cisplatin-treated MT-null mice, a dose-related increase in hepatocellular carcinoma (HCC) occurred (control, 0%; 5 mg/kg, 17%; 10 mg/kg, 36%) that was not seen in WT mice. Similarly, liver carcinoma multiplicity (HCC/liver) was increased markedly by cisplatin but only in MT-null mice, indicating the formation of multiple primaries in MT deficient mice. Harderian gland carcinoma incidence was also increased by cisplatin treatment in MT-null mice but not WT mice. Our results indicate that MT-null mice are hypersusceptible to the hepatocarcinogenic effects of cisplatin, and poor MT expression may be a predisposing factor for cisplatin-induced secondary tumors after chemotherapy. ' 2006 Wiley-Liss, Inc.Key words: cisplatin; carcinogenesis; mice; metallothionein To kill cancer cells, chemotherapeutic agents are often used at toxic levels. One long-term manifestation of these toxic effects could be secondary tumor formation. 1 As cancer survival improves because of more effective treatments, secondary, iatrogenic tumors arising from the initial therapeutic intervention will become an increasing issue 1 and knowledge of factors that predispose patients to such tumors could have important clinical applications. For instance, although cis-diamminedichloroplatinum(II) (cisplatin) is a widely used and very effective cancer chemotherapeutic, it can have limiting side effects and is considered probably carcinogenic in humans. 2,3 There are many case reports of secondary tumors developing in cancer patients that had received cisplatin for an initial malignancy, although this metallochemotherapeutic is used typically in combination with other chemical or physical treatments making etiologic linkage to any one component of the combination difficult. 2,3 Cisplatin is a complete carcinogen in rats or mice, however, inducing malignant tumors of the hematopoietic system and benign tumors of the liver. [4][5][6][7] Similarly, cisplatin will enhance the incidence or increase the multiplicity of benign lung tumors in strain A mice. [8][9][10] The platinum drug is also an effective initiator of renal and dermal cancers in rodents. 4,5,10,11 Metallothionein (MT) is a multi-functional, ubiquitously expressed, low-molecular-weight, metal-binding protein. [12][13][14][15] MT is distinctive in having numerous cysteines th...