Identification of cuproptosis-related long noncoding RNA signature for predicting prognosis and immunotherapy response in bladder cancer

Bladder cancer (BC) is the most common malignant tumour of the urinary system and one of the leading causes of cancer-related death. Cuproptosis is a novel form of programmed cell death, and its mechanism in tumours remains unclear. This study aimed to establish the prognostic signatures of cuproptosis-related lncRNAs and determine their clinical prognostic value. RNA sequencing data from The Cancer Genome Atlas were used to detect the expression levels of cuproptosis-related genes in BC. Cuproptosis-related lncRNAs linked to survival were identified using co-expression and univariate Cox regression. Furthermore, consensus cluster analysis divided the lncRNAs into two subtypes. Subsequently, we established a signature model consisting of seven cuproptosis-related lncRNAs (AC073534.2, AC021321.1, HYI-AS1, PPP1R26-AS1, AC010328.1, AC012568.1 and MIR4435-2Hg) using least absolute shrinkage and selection operator regression. Survival analysis based on risk score showed that the overall survival and progression-free survival of patients in the high-risk group were worse than those in the low-risk group. Multivariate Cox analysis demonstrated the independent prognostic potential of this signature model for patients with BC. Moreover, age and clinical stage were also significantly correlated with prognosis. The constructed nomogram plots revealed good predictive power for the prognosis of patients with BC and were validated using calibration plots. Additionally, enrichment analysis, Single sample gene set enrichment analysis and immune infiltration abundance analysis revealed significant differences in immune infiltration between the two risk groups, with high levels of immune cell subset infiltrations observed in the high-risk group accompanied by various immune pathway activation. Moreover, almost all the immune checkpoint genes showed high expression levels in the high-risk group. Moreover, TIDE analysis suggested that the high-risk group was more responsive to immunotherapy. Finally, eight drugs with low IC50 values were screened, which may prove to be beneficial for patients in the high-risk group.

Automated summary

This study established prognostic signatures of cuproptosis-related lncRNAs and determined their clinical prognostic value in bladder cancer. The signature model showed predictive power for overall survival and progression-free survival, and it was also correlated with age and clinical stage. Significant differences in immune infiltration and immune pathway activation were observed between the high-risk and low-risk groups, suggesting the potential of immunotherapy for the high-risk group.