N-alkyl-nitrosoureas and alkyl-triazenes are alkylating antineoplastic drugs, the efficacy of which is strongly affected by the level of expression of the DNA-repair enzyme O 6 -methylguanine-DNA methyltransferase (MGMT). In tumors, MGMT activity reduces the chemotherapeutic potential of alkylating drugs; therefore, efforts have been made to down-regulate the protein. A partial sensitization of Mex ϩ cells to alkylating drugs has been obtained using either free alkylated bases or oligonucleotides targeted against MGMT mRNA. In the present work, O 6 -methylguanine and a chemically modified ribozyme, without a cationic liposome as a carrier, were coadministered to CHO47 cells, which express a high level of human MGMT protein. The reduction of MGMT mRNA and protein enhanced the genotoxicity of the alkylating drug mitozolomide. Furthermore, the sensitivity of CHO47 cells is the same as that of CHO5 cells, which lack MGMT protein. These data indicate that a strategy in which both mRNA and protein are degradation targets can be successfully applied to down-regulate the MGMT gene. Cancer Gene Therapy (2000) T he Mex ϩ phenotype defines a cell that expresses the O 6 -methylguanine (MeG)-DNA methyltransferase (MGMT) repair enzyme. The protein is able to repair DNA alkylation damage by transferring the alkyl group from the O 6 position of guanine to a catalytic cysteine residue in a stoichiometric reaction. 1 Because a high level of expression of the MGMT gene was observed in human tumors resistant to alkylating antineoplastic drugs such as N-alkyl-nitrosoureas and alkyl-triazenes, 2,3 down-regulation of the MGMT gene represents a possible strategy to bypass the resistance. A peculiarity of the repair protein is that each molecule that has reacted with either a free O 6 alkylated guanine or an alkylated base in DNA is inactivated and degraded. 4 -6 Therefore, pretreatment with an alkylated base such as benzylguanine or methylguanine provides a means to deplete MGMT protein and thus renders the tumor cells sensitive to lower doses of chemotherapeutic alkylating drugs. 7,8 We found, however, that the alkylating drug mitozolomide (MTZ) was less cytotoxic to Mex ϩ cells depleted of MGMT than to Mex Ϫ cells, which do not have MGMT activity. 9 This indicates that despite MGMT depletion, the cells retained the Mex ϩ phenotype. An alternative approach uses oligonucleotides such as antisense oligodeoxynucleotides 10 and hammerhead ribozymes 11 to cleave MGMT mRNA and potentiates the genotoxicity of MTZ while cells are still Mex ϩ . It seems that neither alkylated base nor oligonucleotides are independently adequate to sensitize Mex ϩ cells fully to alkylating drugs. Most likely, the very long half-life of MGMT mRNA 12 as well as the incomplete inactivation of the MGMT protein pool 9 influence the maintenance of the Mex ϩ phenotype. To test this hypothesis, we coadministered ribozyme and MeG to CHO47-transfected cell lines in which the expression of human MGMT and correlations with sister chromatid exchanges (SCEs) and other genet...