This 2015 review explores the diverse roles of sirtuins (SIRT1–SIRT7), a family of NAD⁺-dependent enzymes, in cancer biology. Sirtuins influence key processes such as metabolism, DNA repair, chromatin remodeling, and the tumor microenvironment. For instance, SIRT6 acts as a co-repressor for HIF1α, MYC, and NF-κB, thereby regulating cancer metabolism and