Cleveland Clinic unveils tumor bacteria in young CRC

Alok Khorana, M.D.

In a groundbreaking move, Cleveland Clinic’s latest research sheds light on the distinctive bacteria present in young-onset colorectal cancer (CRC) tumors. The study offers a glimmer of hope for individuals under 50, pointing toward the possibility of novel screening methods and treatments tailored to this demographic.

Colorectal cancer in younger adults has seen a worrying increase over the past decades. The number of cases has climbed from approximately 95,000 in 1990 to over 225,000 in 2019, a statistic from the Global Cancer Association that underscores an urgent need for answers and intervention.

Dr. Alok Khorana, a Cleveland Clinic oncologist and the study’s lead investigator, voiced his concern: “The unexplained rise of young-onset colorectal cancer is of great concern.”

He elaborated on the team’s findings, published in eBioMedicine, which highlight the greater abundance and distinct composition of bacteria in tumors from young patients. “These insights help us to better understand the disease causes and inform new prevention approaches, diagnostic markers, and therapeutic targets,” Dr. Khorana explained.

The retrospective study, supported by the Sondra and Stephen Hardis Family, utilized gene sequencing technology to analyze tissue samples from 136 young CRC patients. These samples were compared to those from 140 patients of average onset age. This comparison unveiled unique tumor-related bacteria within the younger cohort, who also presented more frequently with left-sided, rectal, and advanced-stage tumors. Notably, bacteria such as Akkermansia and Bacteroides were linked to young-onset cancers.

The research was brought to light by the efforts of Dr. Shimoli Barot of Cleveland Clinic Cancer Institute and Dr. Naseer Sangwan of Cleveland Clinic Lerner Research Institute, both serving as first authors of the publication. Dr. Khorana, who holds the Sondra and Stephen Hardis Chair for Oncology Research, also contributed significantly to the study.

Dr. Barot sees the findings as a pathway to innovation: “By detailing this microbial signature of young-onset disease, we can look toward new screening biomarkers and drugs targeting related bacteria.”

Echoing this sentiment, Dr. Sangwan emphasized the need for more research, specifically regarding how lifestyle factors—such as diet, medications, and obesity—affect gut bacteria and the incidence of young-onset colon cancers. This study marks a pivotal step in understanding and eventually stemming the tide of young-onset colorectal cancer.