Diverse mutant selection windows shape spatial heterogeneity in evolving populations.

Drug resistance in infectious disease and cancer is a major driver of mortality. While undergoing treatment, the population of cells in a tumor or infection may evolve the ability to grow despite the use of previously effective drugs. Researchers hypothesize that the spatial organization of these disease populations may contribute to drug resistance. In this work, we analyze how spatial gradients of drug concentration impact the evolution of drug resistance. We consider a decades-old model called the mutant selection window (MSW), which describes the drug concentration range that selects for drug-resistant cells. We show how extending this model with continuous dose-response data, which describes how different types of cells respond to drug, improves the ability of MSWs to predict evolution. This work helps us understand how the spatial organization of cells, such as the organization of blood vessels within a tumor, may promote drug resistance. In the future, we may use these methods to optimize drug dosing to prevent resistance or leverage known vulnerabilities of drug-resistant cells.