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Abstract

In this work, we investigate the population dynamics of tumor cells under therapeutic pressure. Although drug treatment initially induces a reduction in tumor burden, treatment failure frequently occurs over time due to the emergence of drug resistance, ultimately leading to cancer recurrence. To model this process, we employ a two-type branching process with state-dependent growth rates. The model assumes an initial tumor population composed predominantly of drug-sensitive cells, with a small subpopulation of resistant cells. Sensitive cells may acquire resistance through mutation, which is coupled to a change in cellular fitness. Furthermore, the growth rates of resistant cells are modulated by the overall tumor burden. Using stochastic differential equation techniques, we establish a functional law of large numbers for the scaled populations of sensitive cells, resistant cells, and the initial resistant clone. We then define the stochastic recurrence time as the first time the total tumor population regrows to its initial size following treatment. For this recurrence time, as well as for measures of clonal diversity and the size of the largest resistant clone at recurrence, we derive corresponding law of large number limits. These asymptotic results provide a theoretical foundation for constructing statistically consistent estimators for key biological parameters, including the cellular growth rates, the mutation rate, and the initial fraction of resistant cells.