While promoting the destruction of the majority of tumour cells, chemotherapy treatment in cancer patients also permits chemo-resistant, senescent tumour cells to survive. Such senescent cells can live off dead tumour cells during and after chemotherapy. They can then form new tumours, resulting in disease progression. We have recently observed that chemotherapy treatment also induces strong degradation of an important macromolecule in tumour cells called ribosomal RNA. High ribosomal RNA degradation [as measured by the RNA disruption assay (RDA)] predicts for complete tumour destruction and improved outcome in cancer patients. Low ribosomal RNA degradation predicts for chemo-resistant disease and disease progression. We hypothesize that the level of tumour senescence in tumours during treatment may improve the utility and efficacy of the RDA at identifying early in treatment patients at high risk of treatment failure and disease progression. Such patients might best be served by being quickly moved to alternative treatments.
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