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Although targeted therapy is yielding promising results in the treatment of
specific cancers, drug resistance poses a problem. We develop a mathematical
framework that can be used to study the principles underlying the emergence and
prevention of resistance in cancers treated with targeted small-molecule drugs.
We consider a stochastic dynamical system based on measurable parameters, such
as the turnover rate of tumor cells and the rate at which resistant mutants are
generated. We find that resistance arises mainly before the start of treatment
and, for cancers with high turnover rates, combination therapy is less likely to
yield an advantage over single-drug therapy.
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