OnCo
ideasIdea

A drug screen that only rewards killing sleeping cancer cells

Nearly all cancer drugs are found by killing fast-growing cells. Sleeping cells survive them. A screen designed around dormant cells would find a different class of drug.

Dormant disseminated tumour cells are non-cycling, so proliferation-based screens are blind to them. Induced-dormancy models exist — serum-starved and matrix-confined cells, bone-marrow-niche co-cultures, three-dimensional dormancy assays — and small screens have already flagged cardiac glycosides, autophagy inhibitors and specific metabolic dependencies. Nobody has run a million-compound campaign with dormancy-selective killing as the primary readout.

Hypothesis
A dormancy-selective screen yields compounds that kill non-cycling disseminated tumour cells at least ten times more potently than cycling cells, a selectivity profile absent from current oncology libraries.
Rationale
Screening paradigm determines drug class: kinase inhibitors dominate because proliferation assays reward them. Anti-persister screening in bacteriology produced genuinely new antibiotic chemistry by the same logic.
What would test it
Build and openly publish a validated dormancy assay pair (dormant versus cycling isogenic cells), screen an approved-drug library plus 100,000 diverse compounds, and report all hit and miss data.
Maturity
preclinical evidence
Who has to act
research
Cost to try
Medium ($1M to $50M)
Years to first evidence
6
Bottlenecks it attacks

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