Drug resistance is a major impediment in cancer. Although it is generally thought that acquired drug resistance is due to genetic mutations, emerging evidence indicates that nongenetic mechanisms also play an important role. Resistance emerges through a complex interplay of clonal groups within a heterogeneous tumor and the surrounding microenvironment. Traits such as phenotypic plasticity, intercellular communication, and adaptive stress response, act in concert to ensure survival of intermediate reversible phenotypes, until permanent, resistant clones can emerge. Understanding the role of group behavior, and the underlying nongenetic mechanisms, can lead to more efficacious treatment designs and minimize or delay emergence of resistance.

耐药性是癌症的主要障碍。尽管通常认为获得性耐药性是由基因突变引起的，但新出现的证据表明非遗传机制也起着重要作用。耐药性是通过异质肿瘤和周围微环境中克隆群的复杂相互作用而出现的。诸如表型可塑性、细胞间通讯和适应性应激反应等特征协同作用以确保中间可逆表型的存活，直到出现永久性抗性克隆。了解群体行为的作用以及潜在的非遗传机制，可以导致更有效的治疗设计，并最大限度地减少或延迟耐药性的出现。