This review by Douglas Hanahan synthesizes twenty-five years of research into the
hallmarks of cancer, a conceptual framework used to organize the vast complexities of the disease. The author categorizes the mechanistic foundation of cancer into
four distinct dimensions: acquired functional capabilities, enabling phenotypic characteristics, specialized cells within the tumor microenvironment, and systemic interactions. The updated model identifies
nine hallmark capabilities, such as sustaining proliferative signaling and evading immune destruction, alongside
five enabling traits like genomic instability and chronic inflammation. A significant focus is placed on the
tumor microenvironment, where diverse cell types like fibroblasts, macrophages, and neurons are reprogrammed to support malignancy. Furthermore, the text explores how systemic factors like
aging and obesity modulate these hallmarks, influencing how tumors develop and evolve. Ultimately, Hanahan proposes that
therapeutic co-targeting—using drug combinations to disrupt multiple hallmarks simultaneously—could overcome adaptive resistance and significantly improve patient outcomes.
References:
- Hanahan D. Hallmarks of cancer—Then and now, and beyond[J]. Cell, 2026.