Integrated pan-cancer analysis of RNA binding protein HuR investigates its biomarker potential in prognosis, immunotherapy, and drug sensitivity

Background While the RNA-binding protein HuR is implicated in individual cancers, its comprehensive diagnostic, prognostic, and immunological roles across diverse cancer types remain unexplored. Methods We performed an integrated pan-cancer analysis of HuR using public datasets. This encompassed expression profiling, survival analysis, diagnostic accuracy assessment, immune microenvironment characterization, and drug sensitivity prediction. We investigated HuR’s regulatory mechanisms through pathway correlation and differential gene expression analyses. Results HuR expression was consistently elevated across multiple cancers and correlated with poor patient prognosis. It demonstrated high diagnostic accuracy (>85%) via TMB/PD-L1 biomarkers. High HuR expression was associated with an immunosuppressive tumor microenvironment and reduced efficacy of immune checkpoint inhibitors, establishing it as a key immunoregulatory biomarker. HuR also predicted sensitivity to cell cycle inhibitors and other pathway-targeted drugs. Mechanistically, HuR drives malignancy by dysregulating core processes: cell cycle progression, immune evasion, and cellular metabolism. Conclusions Our pan-cancer analysis establishes HuR as a consistently upregulated oncogenic driver across malignancies, functioning as a potential universal biomarker for prognosis and diagnosis. Its critical roles in modulating the immune response and predicting therapeutic sensitivity highlight its importance for personalized cancer treatment strategies. HuR orchestrates tumorigenesis and malignant progression by integrally regulating vital cellular processes.