Quiescent cells: A natural way to resist chemotherapy

Most chemotherapeutic treatments use drugs that target proliferating cancer cells. Therefore, they do not affect quiescent cells which are naturally resistant. Surviving cancer cells can reactivate their cell cycles in the intervals between doses, becoming proliferative again and thus restarting tumor growth. In this work, we present a mathematical model to study the impact of quiescent cells on chemotherapy effectiveness. Our simulations show that, although tumor growth is delayed after the beginning of each dose, the resistance of quiescent cells is enough to reactivate it due to accelerated repopulation, eventually causing therapy failure even in the absence of acquired resistance.