Meanwhile, SIRT3 and SIRT4 act as metabolic gatekeepers, repressing oncogenic signaling, preventing epithelial mesenchymal transition (EMT) and disrupting cancer cell metabolism, while SIRT2 and SIRT6 shape the tumor landscape by influencing AR sensitivity and tumor aggressiveness, with SIRT6 enhancing cell survival and metastatic potential in advanced disease [91,92,93,94]. The gene discussed is SIRT4; the disease is cancer.