Immune infiltration and clinical significance analyses of the cancer‐associated fibroblast‐related signature in skin cutaneous melanoma

Abstract Background Skin cutaneous melanoma (SKCM) is one of the most aggressive cancers with high mortality rates. Cancer‐associated fibroblasts (CAFs) play essential roles in tumor growth, metastasis and the establishment of a pro‐tumor microenvironment. This study aimed to establish a CAF‐related signature for providing a new perspective for indicating prognosis and guiding therapeutic regimens of SKCM patients. Methods In this study, the CAF‐related genes were screened out based on melanoma‐associated fibroblast markers identified from single‐cell transcriptome analysis in the Gene Expression Omnibus (GEO) database and a CAF‐related module identified from weighted gene co‐expression analysis using The Cancer Genome Atlas (TCGA) dataset. We extracted these gene expression data of SKCM samples from TCGA and constructed a prognostic CAF‐related signature. The prediction abilities of the signature for survival prognosis, tumor immune landscape and responses to chemo‐/immunotherapies were evaluated in the TCGA‐SKCM cohort. Results We suggested that CAFs were significantly involved in the clinical outcomes of SKCM. A 10‐gene CAF‐related model was constructed, and the high‐CAF risk group exhibited immunosuppressive features and worse prognosis. Patients with high CAF score were more likely to not respond to immune checkpoint inhibitors but were more sensitive to some chemotherapeutic agents, suggesting a potential approach of chemotherapy/anti‐CAF combination treatment to improve the SKCM patient response rate of current immunotherapies. Conclusions The CAF‐related risk score could serve as a robust prognostic indicator and personal assessment of this score could uncover the degree of immunosuppression and provide treatment strategies to improve outcomes in clinical decision‐making in SKCM patients.