Emerging hallmarks and the rise of complexities and heterogeneity of tumor

Cancer is known for its complexities and heterogeneity due to genetic, epigenetic, known, and unknown environmental components. From time to time, incremental viewpoints on the expanding landscape of tumor hallmarks, including sustained proliferation, evasion of cell death, immune evasion, metabolic reprogramming, and the metabolic-epigenomic-immune axis, are presented. Unifying old and new tumor hallmarks may offer progressive platforms for new diagnostic, therapeutic, and monitoring approaches to therapy responses. Here, we strive to present an updated framework at intracellular, cellular, intercellular, and extracellular levels, assisted by emerging technologies such as OMICS and super-resolution imaging technologies. This review emphasizes that understanding emerging tumor hallmarks may help reveal the dynamics and heterogeneity of tumors. This could lead to sustainable diagnosis, prognosis, and therapeutic management, including precision and personalized approaches for cancer patients. This review presents a unified hierarchical model that connects classical and emerging tumor hallmarks through AI-powered multi-omics integration, emphasizing its conceptual innovation and translational potential in advancing precision oncology.