Integration of single-cell transcriptomics and genomic mutation analysis identifies an immunotherapy-resistant tumor subcluster and validates ARNTL2 as a malignant driver in lung adenocarcinoma
Background Immunotherapy resistance in lung adenocarcinoma (LUAD) remains a critical clinical challenge, and the mechanisms underlying resistance-associated intratumoral heterogeneity are poorly characterized. Methods We performed single-cell RNA sequencing of LUAD patients receiving neoadjuvant immunotherapy (responders vs. non-responders), integrating inferCNV, GSVA, and differential expression analyses. Cluster-specific genes were validated across seven independent cohorts (TCGA-LUAD, GSE13213, GSE26939, GSE29016, GSE30219, GSE31210, GSE42127). A multi-algorithm machine learning framework was used to construct a prognostic model, and the immune microenvironment was characterized using TCIA scoring, seven infiltration algorithms, and ESTIMATE. ARNTL2 function was assessed by CCK-8 and Transwell assays in A549 and H1299 cells. Results Non-responders showed significant enrichment of epithelial cells, depletion of cytotoxic T/NK cells, and elevated copy number variation burden versus responders ( p < 0.0001). A resistance-enriched malignant subcluster (Cluster 2) exhibited hyperproliferative and metabolic reprogramming signatures with upregulated KRT17, S100A2, and CST6, which showed tumor-specific overexpression, adverse prognostic value, and genomic amplification across cohorts. CoxBoost combined with survivalSVM achieved optimal predictive performance (C-index = 0.686), yielding robust risk stratification (HR: 2.54–10.51, all p < 0.05). Low-risk patients showed greater immune infiltration and higher TCIA immunophenoscores. ARNTL2 was an independent prognostic factor (HR: 2.07–4.64) strongly correlated with risk score ( r = 0.69), and its knockdown suppressed proliferation and invasion in both LUAD cell lines (all p < 0.05). Conclusion This study identifies a resistance-associated malignant subcluster in LUAD, constructs a validated CoxBoost + survivalSVM prognostic model with robust immune stratification, and establishes ARNTL2 as a core oncogenic driver and therapeutic target.
Authors
- Qiujiang Xi
- Wenjuan Zhong (ORCID: https://orcid.org/0000-0001-6615-3809)
- Hui Zhao (ORCID: https://orcid.org/0000-0002-8881-6818)
- Zhengang Qiu
- Xiang Cao (ORCID: https://orcid.org/0009-0008-8488-9535)
- Zhigang Li (ORCID: https://orcid.org/0009-0008-6510-8676)
- Qiong Lyu (ORCID: https://orcid.org/0000-0003-3298-7674)
- Yu Zhang
- Zhengxin Lai
- Bingqing Ye
- Rongrong Liu
- Qianshan Long
Institutions
- Ganzhou People's Hospital (CN)
- Jiangxi Provincial Cancer Hospital (CN)
- First Affiliated Hospital of Guangzhou Medical University (CN)
- Gannan Medical University (CN)
- First Affiliated Hospital of Gannan Medical University (CN)
- Guangzhou Medical University (CN)
Publication Details
- Journal
- Translational Oncology
- Published
- 2026-08-15
- DOI
- https://doi.org/10.1016/j.tranon.2026.102971
- Primary Topic
- Ferroptosis and cancer prognosis
- Type
- article
- Field-Weighted Citation Impact
- 0.00