# BH3 profiling (functional apoptosis testing)

Source: https://onco.cc/technologies/bh3-profiling/  
OnCo record `bh3-profiling` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A lab test that measures how close a leukaemia cell is to self-destructing, and which survival protein is holding it back, to predict response to venetoclax-type drugs.

## Summary

Permeabilised cells are exposed to BH3 peptides; mitochondrial depolarisation reveals dependence on BCL-2, BCL-XL, or MCL-1. Predicted venetoclax response in AML and CLL in research cohorts and explains MCL-1-mediated resistance. Being commercialised as a companion tool for BH3-mimetic selection and combination design.

## Fields

- Kind: Technology
- Status: emerging
- Last checked: 2026-09-07
- Principle: Dynamic BH3 profiling quantifies 'priming' for apoptosis after brief drug exposure.
- Strengths: Functional readout of the pathway venetoclax targets; Fast (hours)
- Limitations: Fresh cells required; Not yet a validated companion diagnostic

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Bcl-2_family
- Wikipedia: https://en.wikipedia.org/wiki/Bcl-2_family

## Connected records

- technologies: [BCL-2 inhibitors](https://onco.cc/technologies/bcl2-inhibitors/), [Ex vivo drug sensitivity screening in blood cancers (EXALT)](https://onco.cc/technologies/functional-precision-medicine-haematology/), [Functional (ex vivo) drug testing](https://onco.cc/technologies/functional-drug-testing/)
- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [Chronic lymphocytic leukaemia](https://onco.cc/cancers/cll/)
- fronts: [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/), [Drug Discovery Platforms](https://onco.cc/fronts/drug-discovery/)
- targets: [BCL-2](https://onco.cc/targets/bcl2/)
- drugs: [Sonrotoclax](https://onco.cc/drugs/sonrotoclax/), [Venetoclax](https://onco.cc/drugs/venetoclax/)
- pathways: [Extrinsic apoptosis (death receptors)](https://onco.cc/pathways/extrinsic-apoptosis-death-receptors/), [Intrinsic apoptosis (BCL-2 family)](https://onco.cc/pathways/apoptosis-bcl2/)
- trials: [Metabolomic and BH3 Profiling of Esophageal Cancers: Identification of Novel Assessment Methods of Treatment Response for Precision Therapy](https://onco.cc/trials/nct03223662/)
- people: [Anthony Letai](https://onco.cc/people/anthony-letai/)
- bottlenecks: [Lab models that fail to predict what happens in patients](https://onco.cc/bottlenecks/b-preclinical-models/), [Too many combinations to test](https://onco.cc/bottlenecks/b-combination-space/)
- ideas: [A functional test for homologous recombination deficiency validated across laboratories](https://onco.cc/ideas/idea-tr2-hrd-functional-standard/), [Test drugs on the patient's own cancer cells when there is no trial to join](https://onco.cc/ideas/idea-bio2-functional-precision-rare/)
- roadmaps: [Drug discovery roadmap: screening in mice → maps of dependency → designing in silico](https://onco.cc/roadmaps/drug-discovery-roadmap/)

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