Prostate cancer is a major cause of mortality in men in developed countries. It has been reported that the naturally occurring antioxidant ␣-tocopherol (vitamin E) attenuates prostate cancer cell proliferation in cultured cells and mouse models. We hypothesized that overexpression of the tocopherol transfer protein (TTP), a vitamin E-binding protein that regulates tocopherol status, will sensitize prostate cancer cells to the antiproliferative actions of the vitamin. To test this notion, we manipulated the expression levels of TTP in cultured prostate cells (LNCaP, PC3, DU145, and RWPE-1) using overexpression and knockdown approaches. Treatment of cells with tocopherol caused a time-and dose-dependent inhibition of cell proliferation. Overexpression of TTP dramatically sensitized the cells to the apoptotic effects of ␣-tocopherol, whereas reduction ("knockdown") of TTP expression resulted in resistance to the vitamin. TTP levels also augmented the inhibitory effects of vitamin E on proliferation in semi-solid medium. The sensitizing effects of TTP were paralleled by changes in the intracellular accumulation of a fluorescent analog of vitamin E and by a reduction in intracellular levels of reactive oxygen species and were not observed when a naturally occurring, ligand bindingdefective mutant of TTP was used. We conclude that TTP sensitizes prostate cancer cells to the anti-proliferative effects of vitamin E and that this activity stems from the ability of protein to increase the intracellular accumulation of the antioxidant. These observations support the notion that individual changes in the expression level or activity of TTP may determine the responsiveness of prostate cancer patients to intervention strategies that utilize vitamin E.Prostate cancer is a major public health problem in developed countries, and it constitutes the second leading cause of cancer deaths among males in the United States. Like all malignant diseases, prostate cancer is a culmination of multiple genetic and epigenetic insults, which affect key regulatory features of cell proliferation. Although family history and ethnicity are key risk factors in the susceptibility to prostate cancer, no single gene has been identified as a high penetrance heritable prostate cancer trait to date. Current treatments of prostate cancer rely primarily on surgical and hormonal intervention strategies, coupled with sensitive diagnostic tools aimed at early detection. The incidence, prevalence, and mortality associated with prostate cancer, together with its slow progression from intraepithelial neoplasia (found in men Ͻ30 years of age) to clinical disease (found mostly in men Ͼ50 years of age), make chemoprevention an attractive therapeutic approach for this disease.Accumulation of reactive oxygen species (ROS) 3 and oxidative damage are thought to play important roles during oncogene-induced transformation (1-3) and specifically in the initiation and progression of prostate cancer (4 -6). For example, androgens are shown to increase intracellular ROS lev...