Evidence map›Paper›PMID 41976285›Full record

ReviewCancers2026

Metastatic Odyssey: Decoding the Genomic Journey from Primary Colorectal Cancer to Disseminated Disease.

Taxiarchis Konstantinos Nikolouzakis, John Souglakos, Epameinondas Evangelos Kantidakis, Katerina Achilleos, Troye van Staden, Emmanuel Chrysos

Abstract readReview
In one paragraph

Review in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Taxiarchis Konstantinos NikolouzakisDepartment of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Greece.ORCID 0000-0002-9884-1232
John SouglakosLaboratory of Translational Oncology, Medical School, University of Crete, 70013 Heraklion, Greece.ORCID 0000-0002-1642-1147
Epameinondas Evangelos KantidakisGeneral Practice and Family Medicine, Venizeleion General Hospital, 71409 Heraklion, Greece.ORCID 0009-0009-6272-6089
Katerina AchilleosDepartment of General Surgery, Wits School of Clinical Medicine, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
Troye van StadenDepartment of General Surgery, Wits School of Clinical Medicine, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa.
Emmanuel ChrysosDepartment of General Surgery, University General Hospital of Heraklion, 71110 Heraklion, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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 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.

Indexed as

circulating tumor DNAcolorectal cancergenomicsmetastasisorganotropismtumor microenvironment

Identifiers

PMID41976285
PMCPMC13072234

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.