Persisting cancer cells are different from bacterial persisters

Trends Cancer. 2024 May;10(5):393-406. doi: 10.1016/j.trecan.2024.02.002. Epub 2024 Mar 1.


The persistence of drug-sensitive tumors poses a significant challenge in cancer treatment. The concept of bacterial persisters, which are a subpopulation of bacteria that survive lethal antibiotic doses, is frequently used to compare to residual disease in cancer. Here, we explore drug tolerance of cancer cells and bacteria. We highlight the fact that bacteria, in contrast to cancer cells, have been selected for survival at the population level and may therefore possess contingency mechanisms that cancer cells lack. The precise mechanisms of drug-tolerant cancer cells and bacterial persisters are still being investigated. Undoubtedly, by understanding common features as well as differences, we, in the cancer field, can learn from microbiology to find strategies to eradicate persisting cancer cells.

Keywords: bacterial persisters; drug resistance; drug tolerance; epigenetics; quiescence; residual disease in cancer.

MeSH terms

  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Bacteria* / drug effects
  • Drug Resistance, Neoplasm / drug effects
  • Humans
  • Neoplasm, Residual
  • Neoplasms* / drug therapy
  • Neoplasms* / pathology


  • Anti-Bacterial Agents
  • Antineoplastic Agents