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Primary tumor microbiomes predict distant metastasis of colorectal cancer

  • Bishal Parajuli
  • , Vishal Midya
  • , Ryan Kiddle
  • , Nicola De Jager
  • , Shoshannah Eggers
  • , Daniel Spakowicz
  • , Rebecca Hoyd
  • , Bodour Salhia
  • , Carlos H.F. Chan
  • , Michelle L. Churchman
  • , Robert J. Rounbehler
  • , Song Yao
  • , Melanie R. Rutkowski
  • , Ahmad A. Tarhini
  • , Dinesh Pal Mudaranthakam
  • , Ashiq Masood
  • , Therese J. Bocklage
  • , Robert W. Lentz
  • , Hassan Hatoum
  • , Mmadili N. Ilozumba
  • Sheetal Hardikar, Cornelia M. Ulrich, June L. Round, Gregory Riedlinger, Craig D. Shriver, Dustin E. Bosch

Research output: Contribution to journalArticlepeer-review

3 Citations (SciVal)

Abstract

Metastasis causes most cancer-related deaths in colorectal carcinoma (CRC), and microbiome markers may have prognostic value. We hypothesized that primary tumor microbiomes predict distant metastases. We analyzed 5-year metastasis-free survival (MFS) in a retrospective cohort of 900 ORIEN CRC tumor microbiomes (RNAseq). ORIEN findings were validated on an independent cohort using 16S rDNA sequencing and pathobiont-specific qPCR. Microbiome alpha diversity was higher in primary tumors than metastases and positively correlated with metastasis risk. Microbiome beta diversity distinguished primary vs. metastasis and predicted 5-year MFS. High primary tumor abundance of B. fragilis and low F. nucleatum were associated with short MFS. Enterobacteriaceae, including E. coli, were enriched in metastases. qPCR identified increased enterotoxigenic B. fragilis and pks + E. coli detection in CRC metastasizers. Microbial co-occurrence analysis identified a 3-species clique that predicts metastasis (OR 1.9 [1.4–2.6]). Results suggest that primary tumor microbiomes and specific pathobionts are precision markers for metastasis risk.

Original languageEnglish
Article number405
Journalnpj Precision Oncology
Volume9
Issue number1
DOIs
StatePublished - Dec 2025

Bibliographical note

Publisher Copyright:
© The Author(s) 2025.

Funding

We gratefully acknowledge the University of Iowa Holden Comprehensive Cancer Center’s Microbiome Core for their essential support in providing microbiome sequencing services. The Histology Research Laboratory at Iowa provided histology services. This work was supported by the Holden Comprehensive Cancer Center ACS-IRG from the American Cancer Society (DEB). DEB was supported by the NIH, K08AI159619. RK was supported by the American Cancer Society (IRG-21-141-46-IRG) and the National Cancer Institute (R25CA273964). DS is supported by the National Institute on Aging (K01AG070310), the American Lung Association (1046611), and the American Cancer Society (RSG-23-1023205).

FundersFunder number
American Cancer Society-Michigan Cancer Research Fund
Division of Environmental Biology
Iowa Environmental Mesonet at Iowa State University
National Childhood Cancer Registry – National Cancer InstituteR25CA273964
National Institutes of Health (NIH)K08AI159619, IRG-21-141-46-IRG
National Institute on AgingK01AG070310
American Lung Association1046611, RSG-23-1023205

    UN SDGs

    This output contributes to the following UN Sustainable Development Goals (SDGs)

    1. SDG 3 - Good Health and Well-being
      SDG 3 Good Health and Well-being

    ASJC Scopus subject areas

    • Oncology
    • Cancer Research

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