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Next-Generation Biomarkers and AI-Enhanced Digital Pathology Alliance: Revolutionizing Therapeutic Strategies and Prognostic Assessment in Colorectal Cancer

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: 20 August 2026 | Viewed by 1200

Special Issue Editor


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Guest Editor
Department of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Greece
Interests: colorectal cancer; biomarkers; minimal invasive therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The management of colorectal cancer is undergoing a paradigm shift, propelled by the emergence of next-generation biomarkers. Moving beyond static, single-analyte tests, this new era is defined by dynamic, multi-modal, and technology-driven tools—from liquid biopsies and multi-omic signatures to AI-enhanced digital pathology. These innovations are fundamentally revolutionizing clinical practice, enabling ultra-sensitive detection of minimal residual disease, real-time monitoring of therapeutic response, and the precise tailoring of treatment strategies to an individual’s unique tumor biology. This Special Issue, titled “Next-Generation Biomarkers and AI-Enhanced Digital Pathology Alliance: Revolutionizing Therapeutic Strategies and Prognostic Assessment in Colorectal Cancer”, seeks to capture this transformative momentum. We aim to compile cutting-edge research and reviews that illuminate the discovery, validation, and integration of these advanced biomarkers. Our goal is to provide a comprehensive overview of how these tools are refining prognostication, personalizing therapeutic interventions, and ultimately paving the way toward more adaptive and effective patient care.

Dr. Τaxiarchis Κonstantinos Νikolouzakis
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • liquid biopsy
  • precision oncology
  • predictive prognostication

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Published Papers (1 paper)

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Review

39 pages, 1820 KB  
Review
Metastatic Odyssey: Decoding the Genomic Journey from Primary Colorectal Cancer to Disseminated Disease
by Taxiarchis Konstantinos Nikolouzakis, John Souglakos, Epameinondas Evangelos Kantidakis, Katerina Achilleos, Troye van Staden and Emmanuel Chrysos
Cancers 2026, 18(7), 1062; https://doi.org/10.3390/cancers18071062 - 25 Mar 2026
Viewed by 980
Abstract
Metastatic colorectal cancer (mCRC) accounts for 90% of CRC-related mortality. This review synthesizes insights from comparative genomics tracing evolutionary trajectories from primary tumor to disseminated disease. Multi-region sequencing reveals metastatic seeding often occurs early—before clinical detection—challenging linear progression models. The metastatic bottleneck reduces [...] Read more.
Metastatic colorectal cancer (mCRC) accounts for 90% of CRC-related mortality. This review synthesizes insights from comparative genomics tracing evolutionary trajectories from primary tumor to disseminated disease. Multi-region sequencing reveals metastatic seeding often occurs early—before clinical detection—challenging linear progression models. The metastatic bottleneck reduces clonal diversity while enriching for dissemination-competent traits including SMAD4 loss, PTEN inactivation and metabolic reprogramming. Organ-specific adaptation yields distinct molecular signatures: liver metastases exhibit Wnt hyperactivation and TGF-β-driven immune suppression; peritoneal tumors display mucinous features; brain metastases show HER2 enrichment. The immune microenvironment evolves toward immunosuppressive configurations, with Microsatellite instability high (MSI-H) tumors acquiring B2M or JAK1/2 mutations. Circulating tumor DNA (ctDNA) enables real-time tracking of clonal dynamics, detecting molecular residual disease months before radiographic progression. Therapeutic resistance follows predictable evolutionary trajectories—from RAS/BRAF mutations to EGFR ectodomain alterations, HER2/MET amplifications and lineage plasticity—with metastasis-specific mechanisms including microenvironmental protection and cellular dormancy. The clinical future lies in interception: leveraging liquid biopsies for early detection, targeting both tumor-intrinsic vulnerabilities and permissive metastatic niches and adapting therapy dynamically to anticipate resistance. Understanding this genomic odyssey is essential for transforming mCRC into a controllable chronic condition. Full article
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