Membrane Curvature and Cancer: Mechanisms, Implications, and Therapeutic Perspectives.

Membrane curvature is a fundamental biophysical property of cellular membranes that underlies essential processes such as vesicle formation, organelle shaping, intracellular trafficking, and membrane scission. While traditionally studied in the context of cell biology and membrane dynamics, membrane curvature is now emerging as a critical, albeit underrecognized, regulator of oncogenic transformation and tumor progression. Curvature not only governs the mechanical properties of the membrane but also influences the spatial localization and activation of key signaling proteins, including Ras family GTPases, whose oncogenic functions are closely dependent on membrane topology. Cancer is frequently associated with disruptions in the regulation of membrane curvature as a result of aberrant lipid metabolism, overexpression of curvature-modulating proteins, and cytoskeletal remodeling. These changes facilitate the hallmarks of malignancy such as uncontrolled proliferation, enhanced motility, immune evasion, metabolic rewiring, and therapy resistance. Notably, recent evidence reveals that curvature acts as a spatial cue for Ras activation, particularly during epithelial-to-mesenchymal transition (EMT), where curvature-driven Ras relocalization amplifies growth factor signaling and promotes metastasis. This review provides a comprehensive overview of the molecular determinants that generate and sense membrane curvature from lipid shape and membrane asymmetry, BAR domain proteins, and actin dynamics, and explores how these mechanisms are hijacked in cancer. We describe the feedback between membrane architecture and oncogenic pathways such as Ras/MAPK and PI3K/AKT, emphasizing the role of curvature in shaping signal transduction platforms. It should be noted that "curvature-driven signaling" is defined as signaling regulation that arises from membrane-geometry-dependent localization, clustering, or activation of signaling proteins, while "curvature-sensitive platforms" refer to membrane subdomains whose specific curvature selectively recruits and stabilizes signaling complexes. Furthermore, we examine how these biophysical alterations impact vesicular trafficking, organelle morphology, and secretion, all of which are co-opted to support tumor development. From a translational standpoint, we assess emerging therapeutic strategies designed to target curvature-regulating factors and leverage membrane topology for precision drug delivery. Innovations in nanomedicine, super-resolution imaging, and curvature-sensing biosensors are also discussed as tools for both diagnostics and therapeutic monitoring. By integrating advances in membrane biophysics, cancer signaling, and bioengineering, this review highlights membrane curvature as a central and actionable dimension of cancer biology.