WWOX/HIF1A Balance Delineates Context-Dependent Molecular States in Breast Cancer Subtypes and Ovarian Carcinoma

WWOX and HIF1A are linked to hypoxia-driven metabolic and immune modulation in cancer. We examined whether the WWOX/HIF1A expression ratio acts as a context-dependent molecular integrator across breast cancer (BRCA) subtypes and ovarian carcinoma (OV). We analyzsed TCGA RNA-seq and clinical data from BRCA (n = 390) and OV (n = 228), using neoplasm cancer status as a proxy for disease-free survival (DFS). Patients were stratified by subtype-specific WWOX/HIF1A ratio cutpoints for exploratory Kaplan–-Meier analyses, and the ratio was also modelled as a standardizsed continuous covariate in Cox regression. Transcriptomic, pathway, immune-cell and hormone-related profiles were examined in relation to ratio status, with all multivariable and cutpoint-based findings treated as hypothesis-generating. The WWOX/HIF1A ratio does not act as a uniform or strongly predictive prognostic marker but instead delineates distinct biological states whose association with DFS is modest, context-dependent and statistically fragile in TCGA. Higher ratios are linked to more favourable DFS only in basal-like and HER2-enriched BRCA, together with oxidative phosphorylation, ribosomal and reduced ADAM10-linked Notch and monocyte/macrophage signatures. In luminal A BRCA and OV, lower ratios are linked to relatively favourable DFS and coincide with cytokine/JAK–STAT signalling, cytotoxic immune signatures and coordinated metabolic–endocrine programmes, whereas luminal B shows mixed immune and metabolic patterns. In this TCGA-based analysis, the WWOX/HIF1A ratio functions as a context-dependent molecular index of hypoxia, immune and hormone-related states rather than a strong, generalisable DFS predictor. The observed subtype-specific survival trends (high-ratio favourability in basal/HER2, low-ratio favourability in luminal A,B and OV) are non-significant and exploratory, and all ratio-based survival patterns require confirmation in independent cohorts and functional studies.