Oncogenic EME1 promotes tumor progression and immune modulation in human cancers with therapeutic targeting potential.

Background: EME1, a critical DNA repair endonuclease, has emerged as a potential oncogene implicated in genome instability and cancer progression. However, its pan-cancer roles, prognostic significance, immune interactions, and therapeutic targeting remain underexplored.

Methods: We conducted a comprehensive pan-cancer analysis integrating multi-omics data from public databases, including TIMER2.0, GEPIA2, TISIDB, and cBioPortal, to evaluate EME1 expression, genetic alterations, and their association with clinical outcomes, immune infiltration, and molecular pathways. Virtual screening of 3180 FDA-approved drugs and molecular dynamics (MD) simulations were employed to identify and validate potential EME1 inhibitors.

Results: EME1 was significantly overexpressed in various human cancers and positively associated with advanced tumor grade and stage. High EME1 expression and mutations were linked to poor overall and disease-free survival. Immunogenomic profiling revealed strong positive correlations between EME1 and myeloid-derived suppressor cells (MDSCs), alongside a negative association with endothelial cell function, suggesting immunosuppressive roles. Machine learning models based on EME1-associated genes demonstrated high predictive accuracy for liver hepatocellular carcinoma (AUC > 0.90). Virtual screening identified eight promising drug candidates, including Everolimus and Dioscin, with strong binding affinities. MD simulations confirmed the stability of these interactions, particularly for Dioscin.

Conclusion: This study reveals the multifaceted oncogenic roles of EME1 in tumor progression, immune evasion, and prognosis. It proposes EME1 as a promising biomarker and therapeutic target across multiple cancer types. The identified drug candidates warrant further in vitro and in vivo validation for potential repurposing in EME1-targeted cancer therapy.