Spatial multi-omics landscape of colorectal cancer macro- and micrometastases.

Spatial multi-omics reveals that liver micrometastases in colorectal cancer originate early and exhibit dormancy, with a six-gene signature linked to disease recurrence and therapy resistance.

• Why it matters: Understanding the spatial and evolutionary dynamics of metastases is crucial for improving detection and treatment of residual disease that causes recurrence. Identifying biomarkers associated with minimal residual disease can guide better surveillance and targeted therapies.
• What they did: The study employed spatial transcriptomics, whole-genome sequencing, and high-plex protein imaging on 49 tumors from 19 patients, analyzing primary tumors and matched liver and lung metastases to map their cellular and molecular landscapes.
• The result: Findings demonstrate distinct stromal barriers and immune environments in metastases, with a specific gene signature in liver micrometastases correlating with minimal residual disease, prognosis, and chemotherapy resistance, enabling improved clinical management.