PRDM1 Drives Chemoradiotherapy-associated Enrichment of Adaptive NK Cells in Cervical Cancer

Chemoradiotherapy (CRT) induces not only direct tumor cell death but also extensive remodeling of the tumor immune microenvironment. Adaptive natural killer (aNK) cells, initially characterized in chronic viral infection, are increasingly recognized as functionally relevant immune populations in solid tumors, where they may contribute to antitumor immunity and immune memory. However, how aNK cells dynamically respond to chemoradiotherapy and the regulatory mechanisms underlying their activation in solid tumors remain poorly defined. To address this, we analyzed single-cell RNA sequencing data from cervical cancer patients collected before CRT, after the first CRT fraction, and after the second fraction. Single-cell profiling revealed a significant enrichment of aNK cells following CRT. Differential gene expression and pathway enrichment analyses demonstrated that CRT-associated aNK cells exhibit enhanced virus-defending programs with increased cytotoxicity. Among the differentially expressed genes, the transcription factor PRDM1 was consistently and robustly upregulated in aNK cells after both the first and second rounds of CRT. To investigate the functional role of PRDM1, we applied in silico perturbation analyses using scTenifoldKnk and CellOracle. Virtual knockout of PRDM1 resulted in a marked attenuation of effector programs and disruption of metabolic networks in aNK cells. Moreover, PRDM1 perturbation altered inferred cellular trajectories, reversing the progression toward the aNK cell state, suggesting a requirement for PRDM1 in maintaining aNK identity and functional maturation within the CRT-conditioned tumor microenvironment. Together, these findings identify PRDM1 as a key regulatory factor associated with the enrichment, functional activation, and trajectory stabilization of aNK cells following CRT in cervical cancer, providing insight into innate immune remodeling during CRT and highlighting PRDM1 as a potential target for enhancing radiotherapy-induced antitumor immunity.