# Clear the zombie cells left behind by chemotherapy and radiotherapy

Source: https://onco.cc/ideas/idea-bio1-senolytics-after-therapy/  
OnCo record `idea-bio1-senolytics-after-therapy` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Treatment leaves behind damaged cells that stop dividing but do not die, and they release signals that help surviving cancer cells regrow. Removing them could reduce relapse.

## Summary

Therapy-induced senescence produces a secretory phenotype that promotes proliferation, angiogenesis and immune suppression, and senescent tumour cells can re-enter the cell cycle. Senolytics such as navitoclax-class BCL-2 family inhibitors and dasatinib-quercetin combinations clear these cells in models, and a one-two sequence of pro-senescence therapy followed by a senolytic has shown benefit preclinically.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: A senolytic given after therapy-induced senescence reduces relapse rates in models and lowers markers of senescence and inflammation in patients after chemotherapy or radiotherapy.
- Rationale: The sequence is mechanistically rational and both halves already exist clinically; senolytics are being tested in ageing and fibrosis, providing safety data.
- Proposed test: A window study measuring senescence markers in tumour and normal tissue before and after a short senolytic course following neoadjuvant chemotherapy, with residual disease as an exploratory endpoint.
- Maturity: preclinical-evidence
- Actor: research

## Sources

- Bottleneck evidence (Acquired resistance to every therapy): Soria et al., Osimertinib in untreated EGFR-mutated NSCLC (FLAURA, NEJM 2018): https://doi.org/10.1056/NEJMoa1713137

## Connected records

- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Senolytics after cancer treatment](https://onco.cc/technologies/rejuv-frontier-senolytics/)
- targets: [BCL-2](https://onco.cc/targets/bcl2/)
- pathways: [Intrinsic apoptosis (BCL-2 family)](https://onco.cc/pathways/apoptosis-bcl2/)
- bottlenecks: [Acquired resistance to every therapy](https://onco.cc/bottlenecks/b-resistance/), [Survivorship and late effects are neglected](https://onco.cc/bottlenecks/b-survivorship/)

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