A recipe for chaos: Extrachromosomal DNA and the hallmarks of cancer
Summary
Some aggressive cancers exhibit a level of rapid genome change and therapy resistance that is difficult to explain. Research over the past decade has shown that extrachromosomal DNA (ecDNA) can be the cause. When oncogenic genetic elements untether from chromosomes and no longer follow Mendelian inheritance, genomic chaos and accelerated evolution ensue, generating unique ecDNA biology and non-traditional therapeutic vulnerabilities distinct from traditional mutation-targeting approaches.
Content
# A recipe for chaos: Extrachromosomal DNA and the hallmarks of cancer
*Published: 2026 Apr 16*
Some aggressive cancers exhibit a level of rapid genome change and therapy
resistance that is difficult to explain. Research over the past decade has shown
that extrachromosomal DNA (ecDNA) can be the cause. When oncogenic genetic
elements untether from chromosomes and no longer follow Mendelian inheritance,
genomic chaos and accelerated evolution ensue, generating unique ecDNA biology
and non-traditional therapeutic vulnerabilities distinct from traditional
mutation-targeting approaches. Here, we put forward a holistic view where ecDNA
is integrated into the broader Hallmarks of Cancer framework to better
understand the problem and chart a path forward.
DOI: 10.1016/j.cell.2026.03.011