Esmo Open

Professor Marco Merlano, Oncology Department Santa Croce e Carle, General Hospital, Italy, is the leading author of the ESMO Open article ‘Heterogeneity of colon cancer: from bench to bedside’, summarised in this podcast. Abstract The large bowel shows biomolecular, anatomical and bacterial changes that proceed from the proximal to the distal tract. These changes account for the different behaviour of colon cancers arising from the diverse sides of the colon–rectum as well as for the sensitivity to the therapy, including immunotherapy. The gut microbiota plays an important role in the modulation of the immune response and differs between the right colon cancer and the left colorectal cancer. The qualitative and quantitative difference of the commensal bacteria between the right side and the left side induces epigenetic changes in the intestinal epithelial cells as well as in the resident immune population. The second player in the pathological homeostasis of colorectal cancer is the differences of the genet