Decoding Colorectal Cancer: Innovations in Biomarkers, Microbiota, and Therapeutic Resistance

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cancer Biology and Oncology".

Deadline for manuscript submissions: 30 November 2025 | Viewed by 160

Special Issue Editor


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Guest Editor
1.Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
2. Department of Diagnostic Radiology, Surgery, Chemical and Biomolecular Engineering, and Biomedical Engineering, Yong Loo Lin School of Medicine, College of Design and Engineering, National University of Singapore, Singapore 119074, Singapore
3. Clinical Imaging Research Centre, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117599, Singapore
Interests: colorectal cancer; biomarkers; microbiota; nanomaterials

Special Issue Information

Dear Colleagues,

Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide, necessitating continuous advancements in its prevention, diagnosis, and treatment. In recent years, a deeper understanding of CRC pathogenesis has revealed complex molecular signatures, tumor microenvironmental interactions, and host–microbiota dynamics that contribute to disease progression and therapeutic resistance. Notably, innovations in biomarker discovery—from circulating tumor DNA and exosomal RNAs to metabolic and microbial signatures—are reshaping early detection and paving the way for personalized therapeutic strategies.

This Special Issue, “Decoding Colorectal Cancer: Innovations in Biomarkers, Microbiota, and Therapeutic Resistance”, aims to showcase cutting-edge research that deciphers the biological complexity of CRC. We welcome studies investigating the interplay between tumor genomics, gut microbiota, and resistance to chemotherapy, targeted therapy, and immunotherapy. Contributions utilizing emerging technologies such as multi-omics integration, organoid models, AI-driven radiomics, and spatial transcriptomics are particularly encouraged.

Biomarkers play a critical role in the tumorigenesis, progression, recurrence, and metastasis of colorectal cancer. Their clinical detection facilitates individualized treatment planning, offering the potential to improve therapeutic outcomes and survival rates. With the continued advancement of genomics and molecular biology, numerous biomarkers have been translated into clinical practice, underscoring the need for further clinical studies to validate their utility and expand their application.

Moreover, nanomaterials have demonstrated tremendous promise in oncology by enhancing drug delivery efficiency, minimizing systemic toxicity, and overcoming treatment resistance. As novel nanomaterials and scalable production technologies evolve, CRC therapies are expected to become increasingly precise and effective. Research into the application of nanomedicine in colorectal cancer is therefore poised to become a major driver of innovation in this field.

We invite original research articles, comprehensive reviews, pre-clinical research, and methodologically rigorous perspectives that expand our understanding of colorectal cancer and contribute to the advancement of precision oncology.

Dr. Yinghao Cao
Guest Editor

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Keywords

  • colorectal cancer
  • tumor biomarkers
  • nanomaterials
  • drug delivery
  • microbiome–tumor interaction
  • therapeutic resistance
  • exosomes
  • tumor microenvironment
  • prognostic model
  • neoadjuvant therapy
  • conversion therapy

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Published Papers (1 paper)

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Research

29 pages, 6725 KB  
Article
Analysis of Immune Cell Infiltration Distribution and Prognostic Value in Obstructive Colorectal Cancer
by Yifan Xue, Zhenxing Jiang, Junnan Gu, Shenghe Deng, Kailin Cai and Ke Wu
Biomedicines 2025, 13(11), 2596; https://doi.org/10.3390/biomedicines13112596 (registering DOI) - 23 Oct 2025
Abstract
Objective: This study aims to determine how intestinal obstruction influences the tumor immune microenvironment (TIME) and its impact on prognosis in colorectal cancer (CRC). Methods: Immune cell densities (CD4+, CD8+, CD20+, CD68+) within central tumor [...] Read more.
Objective: This study aims to determine how intestinal obstruction influences the tumor immune microenvironment (TIME) and its impact on prognosis in colorectal cancer (CRC). Methods: Immune cell densities (CD4+, CD8+, CD20+, CD68+) within central tumor (CT) and invasive margin (IM) compartments were quantitatively analyzed using immunohistochemistry (IHC) and QuPath digital pathology in surgical resection samples from 328 patients (164 obstructed colon cancer [OCRC] vs. 164 non-obstructed [NOCRC], cohorts matched by propensity scoring). Findings on tumor-infiltrating immune cell spatial distribution were integrated with peripheral blood immune cell counts and clinicopathological characteristics to characterize the obstructed colon cancer immune microenvironment. Associations with disease-free survival (DFS) and overall survival (OS) were evaluated. Results: OCRC exhibited higher lymphocytic infiltration, particularly in the CT compartment, compared to NOCRC, with significantly elevated CT-CD8⁺ T cell density in T4-stage OCRC (p < 0.005). Obstruction enhanced immune cell correlations across compartments, especially in T4 tumors, and the CD68⁺/CD8⁺ ratio effectively discriminated obstruction status (CT area under the curve (AUC): T4 = 0.879). Peripheral lymphocytopenia was pronounced in obstructive cases (p = 0.003). Critically, T4 OCRC showed a complete loss of all correlations between tumor-infiltrating immune cells and peripheral parameters. Despite increased infiltration, high CD8⁺ density in OCRC correlated with worse prognosis, indicating a paradoxical role influenced by obstruction context. CD68⁺ macrophages in the invasive margin consistently predicted improved survival (Disease-free survival [DFS]: Hazard ratio [HR] = 0.59, p = 0.008). Conclusions: Intestinal obstruction in CRC, particularly in T4-stage tumors, may represent an immunologically active state that alters local immune infiltration and systemic–local immune crosstalk. These findings suggest that obstruction status could refine prognostic stratification and inform therapeutic strategies, although validation in larger cohorts is warranted. Full article
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