W ith little regard for borders, age, wealth or ethnicity, cancer

has swept through human history and remains one of

our biggest killers. In curating this Milestone collection,
our aim was to pick up where our last Milestone project
(https://www.nature.com/milestones/milecancer/timeline.html) left off
and to showcase major advances in the understanding of cancer and
the development of novel therapies that are improving patient survival.
Although we have done our best to be comprehensive, we recognize that
our list is by no means exhaustive.
In recent decades, understanding of the disease has developed at an
astonishing pace. Our catalogues of the genetic (MILESTONES 7,11) and
epigenetic (MILESTONE 10) aberrations underpinning tumour development
are crystallizing. The adaptations used by tumour cells to breach
cell-intrinsic (MILESTONES 5,6) and tissue-specific proliferative barriers, and
establish malignant diaspora at secondary sites are better understood
than ever before. Cancer cells can be profiled at unprecedented scale
and resolution, increasingly in the context of their tissue and microbial
(MILESTONE 13) microenvironments.
These discoveries have propelled the development of new treatments, most
notably immunotherapies (MILESTONES 8,9), which are now a crucial part of
the treatment armoury, alongside surgery, chemotherapy, radiotherapy and
an expanding repertoire of targeted treatments (MILESTONES 4,12).
We hope that these Milestones will inspire optimism about the future
of cancer research. We look forward to new approaches to tackle cancer
types for which progress to date has been modest. We anticipate further
improvements in the understanding of treatment resistance (MILESTONE 1)
and metastasis, the process responsible for most cancer deaths. We also
hope that technological innovations will drive powerful new strategies to
detect and monitor cancer (MILESTONES 2,14).
As treatments become more sophisticated, so too must the strategies
to ensure that the benefits of research are available to everyone. The
socioeconomic disparities that disproportionately limit access to care must
be overcome. From prevention (MILESTONE 3) to diagnosis and treatment—
we must ensure that no patient is left behind.
This project was made possible by the support of our colleagues in the
Nature Editorial Cancer Community. We thank Javier Carmona and Ian Green
for preparing the original proposal. In addition to the many editors who wrote
these milestones, we extend our gratitude to Javier Carmona, Anna Dart,
Iain Dickson, Linda Gummlich, Ulrike Harjes, Barbara Marte and Sarah
Seton-Rogers for managing and editing individual milestones. We appreciate
the support we have received from Rebecca Jones, Simon Fenwick, Chris Ryan
and Maya Shani. Finally, we would like to thank our expert advisors and to
acknowledge support from our sponsors and grant funders (AstraZeneca,
Boehringer Ingelheim, Illumina, Johnson & Johnson and MSD). As always,
Springer Nature takes complete responsibility for the editorial content.
Safia Danovi, Senior Editor, Nature Genetics
Saheli Sadanand, Senior Editor, Nature Medicine