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Figure 2. Cell Death and resistance to treatment in cancer. Distinct cell populations and states underline the dynamic and plasticity of emergence of resistant cancer cells. Black dots surrounding dead/senescent cells are death-inducing factors that could support the survival in surrounding cells. Treatments could trigger cell death (or senescence) in tumor cells, subsequently called “sensitive” while the same treatment could be ineffective, not only in the resistant population, be present at a low level but also in persisters (left). In the first stage of treatment when the wave of cell death is over, persisters would be predominant (middle). Resistant clones would arise from the viable pool and with time acquire high proliferation rates (right). Whether or not, some resistant cells will derive from persisters, as a secondary resistant population, is not known. At the end of this process, resistant cells might encompass multiple mechanisms of resistance, which will prevail along with persisters or persister-derived “sensitive” cells (right)