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Article Abstract
Background: The role of alternative splicing events (ASEs) in immune evasion and prognosis in head and neck squamous cell carcinoma (HNSC) is not well characterized.
Methods: Using The Cancer Genome Atlas data, we identified ASEs (using our novel algorithm OutSplice) and characterized associations between splice burden, immune infiltration (quantified by xCell) and prognosis with multivariable logistic regression and survival models.
Results: HSNC tumors with low splice burden and high immune infiltration had significantly better prognosis than tumors with high splice burden and low immune infiltration when controlling for age, pathologic stage, HPV status, and tumor mutational burden (hazard ratio = 0.61). High splice burden predicted decreased immune infiltration in HNSC, which was validated in five other cancer types and supported by murine models of oral squamous cell carcinoma.
Conclusions: High splicing burden, as defined by OutSplice, is a novel biomarker to predict poor both immune infiltration and prognosis in HNSC.
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