Immune-related signature predicts the prognosis and immunotherapy benefit in bladder cancer

Background: There is no good prognostic model that could predict the prognosis of bladder cancer (BCa) and the benefit of immunotherapy. Methods: Through the least absolute shrinkage and selection operator (LASSO) algorithm, we constructed a 13-mRNA immune signature from the TCGA cohort (n = 406). We validated its prognostic value and predictive value for the benefit of immunotherapy with four independent validation cohort ([n = 256], [n = 93], [n = 308], and IMvigor210 cohort [n = 298]). Results: Our results indicating that high-risk group with higher inhibitory immune cell infiltration (regulatory T cells [Tregs] and macrophage, etc), higher expression of immune checkpoints, and more T cell suppressive pathways (transforming growth factor beta [TGF-beta], epithelial-mesenchymal transition [EMT], etc) were activated. Besides, the immune signature showed a good predictive value for the benefit of immunotherapy in a cohort of urothelial carcinoma patients treated with PD-L1. Conclusions: The immune signature constructed is convenient to classify the immunotherapeutic susceptibility of patients with BCa, so as to achieve precision immunotherapy for BCa.