Machine learning and multi-omics data reveal driver gene-based molecular subtypes in hepatocellular carcinoma for precision treatment.

The heterogeneity of Hepatocellular Carcinoma (HCC) poses a barrier to effective treatment. Stratifying highly heterogeneous HCC into molecular subtypes with similar features is crucial for personalized anti-tumor therapies. Although driver genes play pivotal roles in cancer progression, their potential in HCC subtyping has been largely overlooked. This study aims to utilize driver genes to construct HCC subtype models and unravel their molecular mechanisms. Utilizing a novel computational framework, we expanded the initially identified 96 driver genes to 1192 based on mutational aspects and an additional 233 considering driver dysregulation. These genes were subsequently employed as stratification markers for further analyses. A novel multi-omics subtype classification algorithm was developed, leveraging mutation and expression data of the identified stratification genes. This algorithm successfully categorized HCC into two distinct subtypes, CLASS A and CLASS B, demonstrating significant differences in survival outcomes. Integrating multi-omics and single-cell data unveiled substantial distinctions between these subtypes regarding transcriptomics, mutations, copy number variations, and epigenomics. Moreover, our prognostic model exhibited excellent predictive performance in training and external validation cohorts. Finally, a 10-gene classification model for these subtypes identified TTK as a promising therapeutic target with robust classification capabilities. This comprehensive study provides a novel perspective on HCC stratification, offering crucial insights for a deeper understanding of its pathogenesis and the development of promising treatment strategies. Author summary: Dividing highly heterogeneous HCC into molecular subtypes with similar characteristics is crucial for personalized anti-tumor therapies. Although driver genes play pivotal roles in cancer progression, their potential in HCC subtyping has been largely overlooked. In this work, we developed a multi-omics network-based stratification algorithm that utilizes patient mutation data and requires smaller computational resources for subtype assignment. Through this algorithm, we categorized HCC into two subtypes, CLASS A and CLASS B. Using multi-omics and single-cell data, we identified differences between these subtypes in gene expression, methylation, immune infiltration, and other aspects. Beyond subtype characterization, our study established a robust clinical prediction model (https://mike-wang-bjut.shinyapps.io/DynNomapp%5fHCC%5fSutypes/) incorporating subtype information and typical clinical features, enabling precise survival predictions. Finally, we developed a high-performing machine learning classifier for our subtype. Analyzing this classification model and reviewing previous experimental papers, we identified TTK as a potential diagnostic marker and therapeutic target specific to our subtypes. In conclusion, our research offers a novel perspective on HCC stratification, which is crucial for a deeper understanding of its pathogenesis and developing promising treatment strategies. [ABSTRACT FROM AUTHOR]