HMGA1 Activates FGFBP1 Transcription to Enhance Angiogenesis Induction and Tumor Progression via FGF2/FGFR1 Pathway

High mobility group AT-hook 1 (HMGA1) is a chromatin regulator overexpressed in various cancers, often predicting poor outcomes. However, its role in head and neck squamous cell carcinoma (HNSCC) remains unclear. A hallmark of HNSCC is the rapid growth of its vasculature. Here, we identify an epigenetic mechanism whereby HMGA1 promotes tumor progression and angiogenesis via upregulation of fibroblast growth factor-binding protein 1 (FGFBP1). HMGA1 silencing suppressed oncogenic properties in vitro and reduced tumor initiating cells in HNSCC xenograft mice. RNA sequencing revealed that HMGA1 regulated transcriptional networks involved in tumor progression and angiogenesis, including the FGFBP1 gene. HMGA1 directly binds to the FGFBP1 promoter to induce its expression. This upregulation increased secretion of FGFBP1's target, FGF2. Interestingly, disrupting FGFBP1 via gene silencing or the FGFR1 inhibitor PD166866 recapitulated phenotypes observed with HMGA1 silencing. Blocking HMGA1, FGFBP1, or FGFR1 also reduced stromal formation and increased tumor necrosis. In human HNSCC, the combined analysis of HMGA1 and FGFBP1 provides a more detailed evaluation of patient prognosis. Our findings highlight a novel paradigm where HMGA1 and FGFBP1 drive tumor progression and angiogenesis, presenting them as potential therapeutic targets for HNSCC.