The m⁶A epitranscriptome: A regulatory nexus linking cellular senescence and oncogenesis.

N⁶-methyladenosine (m⁶A) orchestrates RNA fate decisions through a dynamic interplay of writers, erasers, and readers, modulating splicing, stability, and translation. This review unveils how m⁶A fine-tunes senescence-associated pathways (p53/p21, p16-RB) with cancer-context-dependent duality-either as a tumor suppressor or promoter of progression/resistance. Leveraging single-cell and spatial omics, we dissect m⁶A's spatiotemporal heterogeneity in tumor-immune ecosystems. We consolidate diagnostic/prognostic biomarker advances and critically evaluate emerging therapeutics (small-molecule inhibitors, allosteric modulators, nanodelivery systems), addressing clinical barriers like selectivity and safety. Finally, we propose precision strategies targeting m⁶A-senescence networks for combined anti-cancer/anti-aging interventions.