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What doesn’t kill cancer can make it stronger

Memphis, Tenn. - September 1, 2022

Two immunologists in their laboratory at St. Jude Children’s Research Hospital

Halime Kalkavan, M.D., and Doug Green, Ph.D., of St. Jude Immunology.

Cancer treatments are better today than they have ever been. However, sometimes cancer cells survive. These are called “persister” cells. These cells sometimes cause the cancer to return. The recurrent cancer is often worse than the initial cancer.

Scientists at St. Jude found how persister cells form. Chemotherapy kills most cancer cells by activating a cell death pathway called apoptosis. The same pathway can sometimes create persister cells.

The researchers showed that persister cells form when the same molecule that starts apoptosis also activates a stress response. The stress response overrides apoptosis. These cancer cells then express genes that promote their survival, becoming persister cells.

In a way, the ‘near-death experience’ creates the persister cells.

The researchers stopped the formation of persister cells by blocking proteins in the stress response pathway. This finding could lead to new drugs that prevent cancer recurrence.

“When it comes to cancer cells, what doesn’t kill them makes them stronger,” said Doug Green, PhD, Department of Immunology chair.

The work was published today in Cell.

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