hsa-miR-21-5p can serve as a standard biomarker in clear cell renal cell carcinoma by promoting tumor progression and influencing immune evasion.

The increased expression of hsa-miR-21-5p in clear cell renal cell carcinoma (ccRCC) patients is closely linked to poor overall survival. Our predictive model, validated through tumor grading and staging, corresponds with enrichment analysis results and is further supported by PCR findings. Target gene predictions highlight the role of calcium ion transport and basement membrane functionality, with links to critical signaling pathways like JAK-STAT, cGMP-PKG, and sphingolipid, which play crucial roles in biological processes. Patients with higher levels of hsa-miR-21-5p show reduced responses to immunotherapy. In contrast, drug sensitivity analysis reveals increased vulnerability to drugs such as axitinib, sunitinib, and cabozantinib. This extensive investigation reveals the molecular complexities of ccRCC and suggests potential therapeutic options. In conclusion, upregulation of hsa-miR-21-5p in ccRCC is closely associated with tumor initiation and progression, indicating a poor prognosis. Its impact on the tumor microenvironment impairs the efficacy of immune therapies, contributing to adverse prognostic outcomes.