Tumor evolution shapes metastatic competence in colorectal cancer

A large-scale genomic analysis of over 7,000 colorectal cancers reveals that distinct evolutionary trajectories of primary tumors determine their metastatic competence and organ-specific tropism. By integrating primary tumor location, genomic alterations, and clinical variables, Manca et al. identify patterns linking tumor evolution to the likelihood and destination of metastatic spread. The resulting framework offers a basis for refining post-treatment surveillance strategies tailored to individual tumor biology.