Stratified Medicine Graduate Training Programme in Systems Medicine and Spectroscopic Profiling

Colorectal cancer (CRC) is the third most common type of cancer with more than 1 million cases recorded in 2018 worldwide. The high mortality rates associated with CRC are mainly the result of poor disease prognosis and diagnosis. Although robust diagnostic tools including histopathological analysis of biopsies and coloscopies, have contributed to the improvement of disease prognosis, information regarding tumour stage and disease progression cannot be provided using these methods. Hence, there is a great need to develop a more sensitive and non-invasive tool that can detect markers of diagnostic and prognostic importance during the early onset of the disease. The need of such markers is also crucial in determining the efficiency of chemotherapeutic drugs that are currently implemented in clinic. Studies conducted in recent years aimed to delineate the role of gut microbiome in health and disease. Strong evidence suggests that bacteria dysbiosis can lead to the development of numerous metabolic disorders as well as cancer. Therefore, metabolites released specifically at the disease state can be used as potential markers of CRC. Currently implemented screening tools use mucosal and faecal samples. Limitations associated with sample collection include invasiveness and patients' hygiene respectively. Therefore, this project aims to address whether the development of a non-invasive blood test, screening the gut microbiome function, can act as a prognostic and diagnostic tool for CRC development as well as for drug efficiency. To this end, analytical techniques including GC-MS and LC-MS, will be employed to detect circulating markers in blood samples derived from CRC patients. Such fundamental research will not only aid in the development of a new prognostic and diagnostic tool for CRC but will also provide insights on the mechanisms associating gut microbiome with CRC. This could be exploited therapeutically to modify gut microbiota composition to both improve chemotherapy efficiency and/or reduce cytotoxicity.