Cancer is increasingly recognised as a complex and heterogeneous disease, shaped not only by genetic mutations but also by the physical and biochemical context in which tumours develop. The spatial position of a cell, including its physical, cellular and molecular surroundings, shapes its fate, phenotypic plasticity and potential to transform and drive tumour progression and evolution. Tissue architecture provides a powerful framework for understanding the complex dynamics of cancer. It integrates the structural organisation of the tumour and its surrounding tissue, the distribution of physical forces, biochemical niches, cellular neighbourhoods, and the broader tissue and organ context in which the tumour develops. Together, these elements form a dynamic and evolving landscape that is continuously remodelled through the multiscale communication of cellular, biochemical and mechanical components. Understanding the principles that govern these interactions reveals that cancer is not merely a chaotic aggregation of cells, but a patterned system shaped by coordinated spatial relationships. Here, we discuss the recent literature to examine how physical, biochemical and cellular relationships orchestrate tumour initiation, progression and treatment resistance, and how their collaboration acts not as a passive scaffold, but as the architect of tumour behaviour.
Dörner et al. (2026) studied this question.