Defining the clinical importance of epithelial-stroma-immune signalling in colorectal cancer using a molecular pathology approach

Molecular and histological subtyping of CC has identified a poor-prognostic group of patients characterised by high levels of epithelial-to-mesenchymal transition (EMT) signalling and an abundance of stroma (particularly fibroblasts) in their tumour microenvironment.

To date, there has been inconsistent data regarding the benefit of standard chemotherapy in these patients with high-fibroblast (HiFi) tumours. Additionally, there is limited understanding of the specific biological signalling driving relapse in HiFi tumours. This study provides evidence to support the hypothesis that the EMT signalling seen in the poor-prognostic CC patients is due to increased levels of stromal cells present in their tumour samples, rather than increased epithelial cells undergoing EMT.