Evolutionary hallmark-inspired identification of prognostic biomarkers and drug targets for cancers

Abstract

Identifying prognostic biomarkers and drug targets is important for cancer treatment. Accumulating evidence indicates that cancer progression reflects the reactivation of ancestral cellular programs, with evolutionarily ancient genes exerting a pivotal influence on tumor development. These ancient genes are markedly enriched among clinically validated biomarkers and therapeutic targets, highlighting their essential contribution to cancer pathogenesis and therapeutic development. The transcriptome age index (TAI) provides a quantitative framework to characterize transcriptome evolutionary dynamics, with demonstrated prognostic relevance across multiple cancer types. This review underscores the value of the TAI in shaping an evolutionary perspective for biomarker discovery and drug target identification, and considers its potential to advance precision oncology and future therapeutic development.