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 jgcyjycfuy kyfuyfuy, 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