ADME related patterns to predict the prognosis and immune therapy of colon cancer patients

Genes involved in absorption, distribution, metabolism, and excretion (ADME) regulate drug pharmacokinetics, yet their prognostic value in colorectal cancer (CRC) remains underexplored. This study develops an ADME-related prognostic index for colorectal adenocarcinoma (COAD). Gene expression and clinical data from 430 COAD patients in The Cancer Genome Atlas (TCGA) were analyzed to identify differentially expressed ADME genes. Functional enrichment analysis, immune cell infiltration profiling, immunotherapy response prediction, and mutation burden comparison were performed between high-risk (HR) and low-risk (LR) groups. ADME genes demonstrated distinct functional patterns between risk groups. The LR group exhibited enrichment in drug metabolism pathways, whereas the HR group was predominantly associated with extracellular matrix-receptor interactions and focal adhesion signaling. The ADME-related prognostic index correlates with immune cell infiltration and may serve as a therapeutic biomarker for CRC patients.