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Because of the dispersion of initial cell states within a clonal tumor cell population, a perturbation imparted by a cytocidal drug only kills a fraction of cells. Due to dynamic instability of cellular states the cells not killed are pushed by the treatment into a variety of functional states, including a \u201cstem-like state\u201d that confers resistance to treatment and regenerative capacity. This immanent stress-induced stemness competes against cell death in response to the same perturbation and may explain the near-inevitable recurrence after any treatment. This double-edged-sword mechanism of treatment complements the selection of preexisting resistant cells in explaining post-treatment progression. Unlike selection, the induction of a resistant state has not been systematically analyzed as an immanent cause of relapse. Here, we present a generic elementary model and analytical examination of this intrinsic limitation to therapy. We show how the relative proclivity towards cell death versus transition into a stem-like state, as a function of drug dose, establishes either a window of opportunity for containing tumors or the inevitability of progression following therapy. The model considers measurable cell behaviors independent of specific molecular pathways and provides a new theoretical framework for optimizing therapy dosing and scheduling as cancer treatment paradigms move from \u201cmaximal tolerated dose,\u201d which may promote therapy induced-stemness, to repeated \u201cminimally effective doses\u201d (as in adaptive therapies), which contain the tumor and avoid therapy-induced progression.<\/jats:p>","DOI":"10.1371\/journal.pcbi.1010319","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T13:36:59Z","timestamp":1658756219000},"page":"e1010319","update-policy":"https:\/\/doi.org\/10.1371\/journal.pcbi.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["A model for the intrinsic limit of cancer therapy: Duality of treatment-induced cell death and treatment-induced 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