Determinants of metastatic competency in colorectal cancer

Mol Oncol. 2017 Jan;11(1):97-119. doi: 10.1002/1878-0261.12018. Epub 2017 Jan 3.


Colorectal cancer (CRC) is one of the most common cancer types and represents a major therapeutic challenge. Although initial events in colorectal carcinogenesis are relatively well characterized and treatment for early-stage disease has significantly improved over the last decades, the mechanisms underlying metastasis - the main cause of death - remain poorly understood. Correspondingly, no effective therapy is currently available for advanced or metastatic disease. There is increasing evidence that colorectal cancer is hierarchically organized and sustained by cancer stem cells, in concert with various stromal cell types. Here, we review the interplay between cancer stem cells and their microenvironment in promoting metastasis and discuss recent insights relating to both patient prognosis and novel targeted treatment strategies. A better understanding of these topics may aid the prevention or reduction of metastatic burden.

Keywords: Heterogeneity; TGF-beta; cancer immunology; cancer stem cells; clonal diversity; combination therapy; dormancy; immunotherapy; stroma; tumour microenvironment.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Carcinogenesis / immunology
  • Carcinogenesis / pathology
  • Colon / immunology
  • Colon / pathology
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / immunology
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / therapy
  • Humans
  • Immunotherapy / methods
  • Molecular Targeted Therapy / methods
  • Neoplasm Metastasis / immunology
  • Neoplasm Metastasis / pathology*
  • Neoplastic Stem Cells / immunology
  • Neoplastic Stem Cells / pathology*
  • Prognosis
  • Rectum / immunology
  • Rectum / pathology
  • Tumor Microenvironment*