Suicide genes have recently emerged as an attractive alternative therapy for the treatment of various types of intractable cancers. The efficacy of suicide gene therapy relies on efficient gene delivery to target tissues and the localized concentration of final gene products. Here, we showed a potential ex vivo therapy that used mesenchymal stem cells (MSCs) as cellular vehicles to deliver a bacterial suicide gene, cytosine deaminase (CD) to brain tumors. MSCs were engineered to produce CD enzymes at various levels using different promoters. When co-cultured, CD-expressing MSCs had a bystander, anti-cancer effect on neighboring C6 glioma cells in proportion to the levels of CD enzymes that could convert a nontoxic prodrug, 5-fluorocytosine (5-FC) into cytotoxic 5-fluorouracil (5-FU) in vitro. Consistent with the in vitro results, for early stage brain tumors induced by intracranial inoculation of C6 cells, transplantation of CD-expressing MSCs reduced tumor mass in proportion to 5-FC dosages. However, for later stage, established tumors, a single treatment was insufficient, but only multiple transplantations were able to successfully repress tumor growth. Our findings indicate that the level of total CD enzyme activity is a critical parameter that is likely to affect the clinical efficacy for CD gene therapy. Our results also highlight the potential advantages of autograftable MSCs compared with other types of allogeneic stem cells for the treatment of recurrent glioblastomas through repetitive treatments.Gliomas are the most common primary tumors of the central nervous system and easily metastasize to other brain regions. Despite recent technical advances in surgery, radiotherapy and chemotherapy, only palliative therapy is available; there is no authentic cure for gliomas. 1,2 Suicide genes from non-human sources have emerged as an attractive alternative therapy for the treatment of brain tumors. Cytosine deaminase (CD) has attracted considerable attention by virtue of its stronger bystander effects than other suicide genes. 3 CD converts a nontoxic prodrug, 5-fluorocytosine (5-FC), into a potent anticancer drug, 5-fluorouracil (5-FU). 5-FU enters neighboring cells through simple diffusion, exerting a cytotoxic effect by interfering with DNA and RNA synthesis. By combining CD and 5-FC in a single therapeutic modality, it may be possible to bypass the systemic toxicity of 5-FU while efficiently increasing the 5-FU concentration in a localized area. 4,5 Neural stem cells (NSCs) and mesenchymal stem cells (MSCs) exhibit strong tropism toward brain tumors that are attributed to receptors for chemokines and growth factors including SDF-1, 6,7 MCP-1, 8 HGF, 9 IL-8, NT3, TGF-b 10 and VEGF. 11 The migratory properties make NSCs and MSCs efficient tools for delivering therapeutic genes to brain tumors. For example, when combined with 5-FC administration,