For example, can a drug that targets a given protein induce overexpression of that protein or increase the copy number of the gene coding that protein?

I strongly suspect that antineoplastic resistance happens due to natural selection alone but I was wondering if there are examples that suggest otherwise.



There is a lot of literature on cancer evolution and now several countries have genome sequencing programs for "pharmacogenomics", for example Genomics England, specifically to see which cancers are likely to evolve resistance to which drugs.

One small detail is that mutation exists before treatment in a subset of the cancer population —as happens with evolution normally. That mutation is neutral for the fitness of the cancer before, but is advantageous during treatment.

  • $\begingroup$ Thanks, the last phrase is especially useful $\endgroup$ – Click Dec 16 '19 at 11:08

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