image: wiki cancer cells
New research from China shows that commonly used chemotherapy drugs can awaken dormant cancer cells and promote metastatic spread, revealing a biological mechanism that may explain cancer relapse years after treatment.
The study, published in Cancer Cell, was conducted by researchers at the Shanghai Institute of Nutrition and Health of the Chinese Academy of Sciences in collaboration with the Fudan University Shanghai Cancer Center.
The research team documented that chemotherapy induces cellular senescence in lung tissue, creating an environment favorable to metastatic growth. They state their findings “provide direct evidence of dormancy awakening and reveal a mechanism underlying detrimental effect of chemotherapy on metastasis.”
Earlier work from researchers in Israel had suggested that cancer treatments could awaken dormant tumor cells, but the underlying mechanism remained unclear until the current study directly linked chemotherapy to neutrophil extracellular trap formation in lung tissue.
Scientific Mechanism and Findings
Chemotherapy triggers accelerated aging in connective tissue cells called fibroblasts. These senescent fibroblasts release proteins that activate immune cells to form neutrophil extracellular traps. These biological structures remodel lung tissue environments, effectively awakening dormant cancer cells that had evaded initial treatment.
The study specifically tested doxorubicin and cisplatin, two widely used chemotherapy drugs. Both drugs demonstrated capacity to enhance proliferation and lung metastasis of dormant breast cancer cells in mouse models. The research conclusively showed that awakened dormant cells, not existing proliferative cells, drive chemotherapy-induced metastases.
Institutional Context and Financial Implications
The global chemotherapy market exceeds $200 billion annually, creating substantial economic inertia around treatment protocols. Cancer treatment centers generate significantly higher revenue from metastatic cancer care than early-stage treatment, establishing financial structures that may disincentivize metastasis prevention research.
image: metastasis
Regulatory frameworks like the FDA’s accelerated approval pathway allow chemotherapy drugs to reach market without long-term metastasis studies. Pharmaceutical companies fund substantial portions of oncology journal operations and medical education, creating potential conflicts of interest in research dissemination.
Unresolved Questions and Ongoing Research
A phase II clinical trial is currently investigating whether senolytic drugs can mitigate chemotherapy-induced metastasis when combined with traditional treatment. The trial combines dasatinib and quercetin with chemotherapy to target senescent fibroblasts specifically.
Critical investigative gaps remain regarding whether Western researchers previously identified this mechanism without publishing findings. Documented patterns of pharmaceutical influence on medical research raise questions about potential suppression of inconvenient data. The full extent of chemotherapy’s metastatic risks across cancer types requires further independent study.
Study details:
Conducted by the Shanghai Institute of Nutrition and Health (Chinese Academy of Sciences) and Fudan University Shanghai Cancer Center.
Corresponding author: Guohong Hu (sinh.ac.cn).
Published in Cancer Cell, Volume 43, Issue 9 (September 8, 2025)
“Chemotherapy awakens dormant cancer cells in lung by inducing neutrophil extracellular traps” — Cancer Cell
DOI (direct article identifier):
10.1016/j.ccell.2025.06.007
PubMed entry:
https://pubmed.ncbi.nlm.nih.gov/40614736/
