| Summary: | <p>Abstract</p> <p>Background</p> <p>It is known that sensitivity or resistance of tumor cells to a given chemotherapeutic agent is an acquired characteristic(s), depending on the heterogeneity of the tumor mass subjected to the treatment. The clinical success of a chemotherapeutic regimen depends on the ratio of sensitive to resistant cell populations.</p> <p>Results</p> <p>Based on findings from clinical and experimental studies, a unifying model is proposed to delineate the potential mechanism by which tumor cells progress towards multi drug resistance, resulting in failure of chemotherapy.</p> <p>Conclusion</p> <p>It is suggested that the evolution of multi drug resistance is a developmentally orchestrated event. Identifying stage-specific time windows during this process would help to identify valid therapeutic targets for the effective elimination of malignancy.</p>
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