While STRING analysis does not confer great significance to prognosis, it accentuates SLC1A5 as a hub in amino acid metabolism and tumor progression pathways in HNSC. The overexpression of SLC1A5 is linked with unfavorable survival in HNSCC, highlighting its value to the metabolic reprogramming in HNSCC.
Additionally, LSCC was uniquely enriched for a pro-tumor SPP1+ macrophage subset with low phagocytic activity and high angiogenic potential, linked to poor prognosis. Our findings uncover key mechanisms driving LSCC malignant progression, offer insights for early diagnosis and prognosis assessment, and highlight MIF as a promising therapeutic target.
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Journal
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CD8 (cluster of differentiation 8) • SPP1 (Secreted Phosphoprotein 1) • LAMP3 (Lysosomal Associated Membrane Protein 3) • POSTN (Periostin)
Functional assays confirmed that CD44 knockdown in vitro reduced proliferation, migration, invasion, and in vivo tumorigenesis, supporting its role in metastasis. These findings reveal the dynamic remodeling of epithelial and fibroblast compartments in LSCC and identify CD44 as a key driver of metastasis through fibroblast-epithelial interactions.
The combined assessment of CD3 density and PD-L1 expression outperforms either marker alone in predicting survival outcomes in surgically treated patients without immunotherapy. CD3high and PD-L1 CPS ≥ 1 identifies patients with favorable prognosis and response to standard-of-care treatment. Nonetheless, the potential relevance of these markers for guiding immunotherapy in other setting remains to be explored.
Natural killer cells showed only a limited contribution to the killing of HNSCC cells pretreated with RT or RT + DDRi. However, a subset of patients with head and neck tumors-such as those represented by the HSC4 model-might still benefit from combining RT with ATMi rather than ATRi to enhance NK cell-mediated tumor killing.
Clarifying whether NOTCH1 occasionally functions as an oncogenic driver in HNSCC is crucial to prognosis and personalized therapy. The results presented unify the field, reconcile conflicting data, and provide critical insights into the biological and clinical significance of NOTCH1, with broader implications in other squamous carcinomas with NOTCH1 mutations.