Keep them asleep: dormancy maintenance as adjuvant therapy

This idea proposes dormancy maintenance as adjuvant therapy: keep hidden cancer cells dormant for life with low-toxicity drugs rather than trying to kill them all, as extended hormone therapy already does in breast cancer. Extended Endocrine therapy (SERMs, AIs, SERDs) and adjuvant CDK4/6 inhibitors may work partly by enforcing dormancy, and 5-azacytidine plus ATRA induced NR2F1 in a prostate pilot (Tumour dormancy pathway). The hypothesis is that a dormancy-enforcing regimen given for 3-5 years to patients positive for Minimal / molecular residual disease (MRD) delays or prevents relapse with less toxicity than cytotoxic escalation. The test is a randomised phase 2 in MRD-positive early Prostate cancer or HR-positive / HER2-negative breast cancer.