Unfolding ecDNA as a pan-cancer therapeutic target

Extrachromosomal DNA (ecDNA) drives the evolution of cancer cells. Its widespread presence in tumors and strong association with poor clinical outcomes make ecDNA a promising and broadly applicable therapeutic target. Recent studies have begun to unravel the mechanisms by which ecDNA promotes tumorigenesis and maintains its presence in cancer cells. These discoveries have paved the way for developing ecDNA-targeted therapies. In this Perspective, we summarize the latest advances in our understanding of the mechanism underlying both the ecDNA-induced cancer phenotype and ecDNA maintenance. We also explore potential strategies for targeting ecDNA in cancer treatment.