A new study points to a protein that may decide whether colorectal cancer cells stay aggressive. The protein is BEX2. It seems to set the limit on how stem-like these cells can get.

The findings appear in Cancer Biology & Medicine. They open new avenues for therapies that may prevent tumours from coming back. This BEX2 colorectal cancer stem cell research could change the treatment playbook.

Why colorectal cancer stem cells matter

Colorectal cancer is the third most common cancer worldwide. It is also the second leading cause of cancer-related deaths.

Around 30% of patients experience a recurrence of the disease after surgery. The reason is a small group of cells inside the tumour. These cancer stem cells survive treatment. They rebuild the tumour, resist chemotherapy, and can spread.

Researchers think they live because of certain signalling pathways. Block the right one, and you may weaken the cells that drive recurrence. That is what makes the new BEX2 colorectal cancer stem cell research so striking.

What BEX2 actually does

The team studied BEX2 across patient datasets, lab experiments, and mouse models. BEX2 has a mixed reputation in cancer biology. It can help tumours grow or suppress them, depending on context.

In colorectal cancer, this BEX2 research suggests it acts as a brake on colorectal cancer stem cells. When BEX2 is high, cancer cells behave more normally. When BEX2 is low or missing, the cells turn stem-like — harder to kill, more invasive, more drug-resistant.

Ketan Thanki, MD, a board-certified colorectal surgeon at the MemorialCare Todd Cancer Institute at Long Beach Medical Centre, was not involved in the study.

"BEX2 taps the brakes on pathways that allow cancer cells to revert to more primitive, aggressive stem-like states. When BEX2 levels are high, cancer cell behaviours are more controlled. When BEX2 is low or absent, cancer cells become more like stem cells: harder to kill, more invasive, and more resistant to chemotherapy," Thanki told Medical News Today.

The MCL1 and Hedgehog link

At the molecular level, BEX2 attaches to MCL1. MCL1 is a survival protein, often overactive in colorectal tumours. BEX2 marks it for breakdown. With less MCL1 around, the Hedgehog signalling pathway quiets down. Hedgehog drives cancer stem cell activity in colorectal disease.

"BEX2 acts like a tag on MCL1, marking it for destruction so that it can no longer activate the Hedgehog (Hh) signalling pathway," Thanki explained to MNT. He described the Hh pathway as a growth accelerator behind drug resistance and recurrence in colorectal cancer.

When BEX2 was missing, MCL1 stayed stable. Hedgehog signalling switched on. Stem-like traits grew stronger. Stopping either MCL1 or Hedgehog activity reversed those changes in lab models.

What the patient data show

Tumour samples backed the lab work. BEX2 levels ran lower in colorectal cancer tissue than in healthy tissue. Lower BEX2 also tracked with worse disease-free survival.

Removing BEX2 in cell experiments increased stemness markers such as CD133 and CD44. The cells became more resistant to drugs like oxaliplatin. In animal studies, low BEX2 led to faster tumour growth.

What this could mean for future treatments

The findings point to a new strategy. Doctors may one day target the cells that fuel relapse instead of just shrinking tumours. That is the promise of BEX2 colorectal cancer stem cell research.

"The data from this study are promising," Thanki told MNT. He cautioned that BEX2 is years away from clinical use and would need large, standardised studies first.

If larger trials confirm it, BEX2 could play two roles. It could serve as a biomarker for high-risk tumours. It could also be a therapeutic target — by restoring BEX2 activity, destabilising MCL1, or blocking Hedgehog signalling.

Thanki added that low-BEX2 tumours could be flagged as high-risk for recurrence and chemotherapy resistance. Clinicians could then pursue more aggressive treatment or enrol patients in trials targeting the Hedgehog pathway.

The work is early. Still, it adds a new tool for thinking about why colorectal cancer returns. BEX2 colorectal cancer stem cell research needs larger trials before reaching the clinic. Coverage on Medigear.uk underscores why hospital teams, distributors, and clinic owners must track the progress of BEX2 colorectal cancer stem cell research toward real-world testing.

Source: Originating coverage based on the BEX2 colorectal cancer study published in Cancer Biology & Medicine, with expert commentary by Ketan Thanki, MD (MemorialCare Todd Cancer Institute, Long Beach Medical Center) reported by Medical News Today — https://www.medicalnewstoday.com/