My laboratory is actively investigating the physiologic impact of cell fusion hybrids between circulating bone marrow-derived and intestinal tumor epithelial cells in advancing tumorigenesis. We have direct evidence that intestinal epithelial cell fusion hybrids generated after intestinal injury harbor a unique transcriptome that reflects expression potential from both intestinal cells and bone marrow-derived cells. It is our hypothesis that cell fusion may provide acquisition of blood-derived properties to tumor epithelium, permitting them to escape the primary tumor microenvironment and re-establish tumorigenesis at a distant site.A second focus in my laboratory is to determine if cancer stem cell profiling can be used to inform disease behavior. We are currently investigating the expression pattern of these tumor-initiating cells in head and neck carcinoma and colon cancer before and after treatment and correlating our findings with disease aggressiveness. It is our hypothesis that a prevalent cancer stem cell phenotype may correlate with a more aggressive disease course. We hope that these studies will ultimately inform patient treatment and care.