The genomic and epigenomic evolution of colorectal cancer.

Colorectal cancer progression is mapped by evolving somatic genomic and epigenomic alterations across morphological stages, linking early transformation to metastasis and treatment resistance.

• Why it matters: Understanding how genetic, epigenetic, and immune changes accumulate during multistep carcinogenesis addresses a gap in explaining CRC evolution and how it shapes clinical outcomes.
• What they did: This Review synthesizes latest evidence on genetic, epigenetic, immune, and epigenome–cell plasticity changes, focusing on dynamics from initial transformation through metastatic dissemination and resistance.
• The result: The integrated evolutionary view is described as redefining clinical strategies and highlighting translational frontiers for evolution-informed therapy in colorectal cancer.

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