Identification and characterization of lncRNA-stemness-immune regulatory patterns.

Long noncoding RNAs (lncRNAs) play critical roles in regulating stemness signature genes (SSGs) and tumor immunity, thereby shaping the tumor microenvironment and antitumor immune responses. Increasing evidence suggests that cancer stem cell traits are closely associated with immune evasion and therapeutic resistance, underscoring the need to systematically characterize the pan-cancer interplay among SSGs, lncRNAs, and tumor immunity. Here, we developed an integrative analytical framework that combines network-based modeling with Bayesian network inference to identify core regulatory triplets (STEM-LncCRTs), each consisting of an lncRNA, an SSG, and an immune gene. We demonstrate that specific stemness-related lncRNAs can distinguish cancer subtypes, and that common stemness-related lncRNAs correlate significantly with immune cell infiltration. Notably, the ATAD5/PRR11-AS1/SKP2 triplet exhibits favorable prognostic potential across multiple cancers and consistently outperforms individual gene markers in predicting 1-, 3-, and 5-year overall survival. Furthermore, using four machine learning algorithms across three independent immunotherapy cohorts, we validate the predictive value of STEM-LncCRTs for immune checkpoint inhibitor response. Importantly, integrating STEM-LncCRTs with tumor mutation burden further improves predictive accuracy. Collectively, this study provides a systems-level view of stemness-related lncRNA regulation in tumor immunity and offers practical biomarkers for predicting immunotherapy efficacy.