We will identify and validate novel combinatorial biomarkers that can be employed for the prognosis of colorectal cancer. Our unique approach is based on imaging the co-expression of multiple colon cancer markers and putative cancer stem cell markers simultaneously in tissue sections obtained via colonoscopy or surgery. To achieve this, we will employ the revolutionary new Warwick Toponome Imaging System (TIS) which allows the simultaneous capture of highly multiplexed fluorescence images for multiple proteins. A major challenge facing this technology is the processing and analysis of vast amounts of data to mine for useful molecular patterns, an area in which we have considerable expertise. Our hypothesis, strongly supported by our preliminary data and by the opinion of many cancer experts, is that different types of colon cancer cells may have unique protein signatures, revealed by simultaneous mapping of multiple cancer-relevant proteins. We will test this hypothesis by using TIS to study tissue samples of colon cancer patients, both UK Caucasian and local Qatari patients, particularly those with TNM Stage II. In these two populations, we aim to mine for combinatorial prognostic biomarkers which can be correlated to the retrospective metastatic outcome. The project involves Qatari scientists and clinicians who will have access to our multi-tag TIS imaging system at Warwick, the first of its kind in the UK, and one of the first worldwide.