Colorectal cancer (CRC) ranks as the third most frequent cancer type, and its incidence continues to rise gradually worldwide, highlighting the need to identify previously unrecognized molecular events that propel development of this malignancy. Recent evidence suggests that dysregulated expression of FOX family of transcription factors may be critical in various genetic disorders as well as cancer; however, the functional and clinical significance of this pathway in CRC remains unclear.

Herein, we performed a systematic and comprehensive discovery step by evaluating the expression of FOX family members, and identified that FOXM1 and FOXQ1 are frequently overexpressed in CRC. We subsequently confirmed these findings in two large testing cohorts (n=550), and an independent clinical validation cohort (n=134), in which high expression of FOXM1 and FOXQ1 emerged as an independent prognostic factor in CRC patients. We supported these findings by performing functional assays in which knockdown of FOXM1 and FOXQ1 resulted in inhibited cell proliferation, and suppressed migration and invasion in CRC cells. Furthermore, using bioinformatics approaches, we identified miR-342 as a novel regulator of both FOXM1 and FOXQ1. Overexpression or inhibition of miR-342 modulated the expression of both genes and contributed to phenotypic alterations in CRC cells, which was subsequently validated in a xenograft animal model.

Collectively, we have firstly identified FOXM1 and FOXQ1 as promising prognostic biomarkers in CRC patients, and provide novel evidence that therapeutic targeting of these genes or miR-342 may be a potential treatment approach in CRC patients.