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We show that the effect of stress on the reproductive fitness of noisy cellpopulations can be modelled as first-passage time problem, and demonstrate thateven relatively short-lived fluctuations in gene expression can ensurelong-term survival of a drug-resistant population. We examine how this effectcontributes to the development of drug-resistant cancer cells, and demonstratethat permanent immunity can arise independently of mutations.

Gene Expression Noise Facilitates Adaptation and Drug Resistance Independently of Mutation