Cancer drug plus a plant compound eased liver scarring in a small trial

A pairing of two drugs that already exist, the leukemia medicine dasatinib and the plant compound quercetin, eased liver scarring in a small controlled trial of people with a severe form of fatty liver disease.¹ Scarring improved in 8 of the 17 patients who got the pair, against 1 of the 14 who got a placebo, a dummy pill.² The study was published in the journal Nature Metabolism on 1 October 2026.²

The drugs belong to a class called senolytics, medicines designed to clear out worn-out cells. Coverage of the paper described it as the first controlled study to test whether clearing these cells can change how much disease is visible in liver tissue in people with this condition.¹ It is a small, early study, and the authors want a larger trial.²

What happened

The trial ran at Amsterdam University Medical Center.¹ It enrolled people with MASH, short for metabolic dysfunction-associated steatohepatitis, the stage of fatty liver disease where fat in the liver tips into inflammation and cell damage. It was once called NASH.² Over years, the damage lays down scar tissue, called fibrosis, which can progress to cirrhosis, liver failure or liver cancer.²

The study was double-blind, meaning neither patients nor doctors knew who got the real drugs, and it was randomized, meaning a random draw decided who got what.¹ The 31 participants all had scarring confirmed by a liver biopsy (a small tissue sample), and all were at stage 2 or 3 on a scale where 0 means no scarring and 4 means cirrhosis.² Seventeen were assigned to the drug pair and 14 to placebo.²

The pills were not taken every day. Patients took them three days a week for three weeks, then had four weeks off, and this seven-week cycle was repeated three times, for 21 weeks in total.² The idea is that worn-out cells take weeks to build up again and do not divide, so short bursts of treatment may be enough to clear them while limiting how much drug people take.¹

The results in numbers

The main goal the trial set itself was at least a one-stage improvement in scarring on a second biopsy, without the disease getting worse.² The biopsies were read by three pathologists, doctors who examine tissue, who did not know which group each sample came from.¹

• Scarring improved: 47 percent on the drug pair versus 7 percent on placebo, a difference that met the usual statistical bar (P = 0.021).¹
• Disease cleared on biopsy: the hallmark liver-cell damage of MASH resolved in 53 percent of treated patients versus 7 percent of those on placebo.¹
• A disease activity score fell more in the treated group.¹
• A second scarring scale pointed the same way but narrowly missed statistical significance.¹

Twenty-seven of the 31 people finished the study. Everyone who was randomized was included in the analysis, and those who dropped out were counted as not improving.¹

The team also looked inside the liver samples. They measured gene activity in individual liver cells from 53 frozen biopsy samples, before and after treatment.¹ The paper reports that “single-nucleus RNA sequencing demonstrates decreased senescence and fibrotic gene signatures and reduced fibrogenic cell populations in the D + Q group,” meaning fewer signs of worn-out cells and of scar-making activity in the treated livers.³

Why clear worn-out cells?

Senescent cells are cells that have more or less permanently stopped dividing, often after stress such as DNA damage.¹ In the short term this helps wounds heal and keeps damaged cells from turning cancerous. When the cells linger, though, they resist dying, hide from the immune system and give off a mix of inflammatory and scar-promoting signals.¹ Cellular senescence is counted among the hallmarks of aging.² In the liver, these signals have been linked to the inflammation and scarring that define MASH.¹

Dasatinib is a prescription leukemia drug. Quercetin is a flavonoid, a plant compound found in onions and apples and sold as a supplement.² In lab and animal studies, the pair kills senescent cells while largely sparing healthy ones.² A team led from Mayo Clinic by James Kirkland proposed the senolytic class of drugs in 2015 and reported dasatinib and quercetin as two of them.²

What it does not show yet

The trial was small, and the random draw did not produce evenly matched groups. Type 2 diabetes was more common among treated patients, 13 of 17 versus 5 of 14. The treated group also started with more scarring: 11 of 17 had the more advanced stage 3, against 4 of 14 on placebo. The median age was 58 on the drugs and 51 on placebo.² In a trial this size, such imbalances can push results in either direction.²

Four people left early, three of them on the drug pair. Reasons included side effects, mainly stomach complaints and fatigue; heavy drinking that broke the trial’s rules; and tests linked to a cancer not disclosed at screening. The fourth, on placebo, declined the second biopsy.²

Twenty-one weeks is also short. The trial measured scarring on biopsies, not whether patients went on to avoid cirrhosis, liver failure or cancer. And it tested a liver disease, not aging itself.²

Small details differ between records. The trial registry lists the study as an early-to-mid-stage trial (phase 1/2) with an actual enrollment of 30, while the published paper, as reported, describes 31 participants; coverage also calls it a phase 2 trial.⁴²¹ As of the registry record, no results had been posted there.⁴

Who is behind it

The trial, called the TRUTH study, was sponsored by the Academic Medical Center of the University of Amsterdam. It started in July 2023, and its main data collection finished in February 2026.⁴ The lead author is Mijra Koning and the senior author is Abraham Meijnikman.²

Kirkland and Tamar Tchkonia, who co-authored the 2015 senolytics paper, are co-authors of the new trial. Both now work at Cedars-Sinai in Los Angeles, and both have a financial interest in patents on senolytic drugs held by Mayo Clinic, which the paper declares.²

How it fits the field

Fatty liver disease is the leading liver disease worldwide, with an estimated prevalence of almost 40 percent, according to the paper.² The trial’s registry description noted that no treatment had been proven to target liver scarring, leaving control of related conditions plus diet and lifestyle changes.⁵

Senolytics have had a mixed record in people. Earlier small studies in a lung-scarring disease and in diabetic kidney disease suggested on-and-off dosing could reduce the number of worn-out cells with acceptable safety, but did not test the liver.¹ Longevity Science Daily reported that two earlier randomized trials it checked, which tested a senolytic for benefit, missed their main goals, and that no drug is approved as a senolytic.² One such trial, in women after menopause, found that a marker of bone breakdown did not differ between groups at 20 weeks.³ Against that background, this trial met its main goal.²

A research tracker counts 305 papers on dasatinib plus quercetin since 2015, including 15 trials in people, with most of the work done in animals and cells.³

What to watch next

The authors want a larger trial.² Key questions for any follow-up: whether the result holds in bigger, better-matched groups; whether the improvement lasts after the pills stop; how often side effects lead people to quit; and whether easing scarring on a biopsy translates into fewer cases of cirrhosis, liver failure or cancer. Results may also be posted to the trial’s registry entry, which still showed none.⁴