Little research has been performed to understand the specific rules and mechanisms of minimal residual
disease, including clonal evolution at the metastatic site, epigenetic programs, interaction with organ defense and immune systems, mechanisms of
dormancy and re-awakening, and last but not least, mechanisms of therapy resistance in specific niches.
As they come out of
dormancy, their bodies are low on important nutrients that help ward off
disease, so they are more likely to become vulnerable to illness.