BACKGROUND: Colon adenocarcinoma (COAD) remains the most prevalent pathological subtype of colorectal carcinoma, yet its long-term survival outcomes remain suboptimal despite advances in clinical management. Ferroptosis is an iron-dependent regulated cell death modality that participates critically in tumor growth and development. Long noncoding RNAs (lncRNAs) are important regulators of ferroptosis pathways in cancer. Accordingly, the present study aimed to explore the prognostic value and therapeutic response of ferroptosis-related lncRNAs in COAD. METHODS: Ferroptosis-related lncRNAs were initially screened via co-expression analysis, then a ferroptosis-related lncRNA prognostic signature was established by univariate and multivariate Cox regression analyses. We comprehensively validated using multiple approaches, which included survival analysis, receiver operating characteristic (ROC) curve analysis and a nomogram. In addition, we analyzed the potential associations of this signature with immunotherapeutic and chemotherapy responsiveness. RESULTS: We established and subjected to validation a risk signature based on seven ferroptosis-related lncRNAs (AC107308.1, ZKSCAN2-DT, LINC02381, SFTA1P, SNHG16, AL137782.1 and LINC01138). The risk model showed potential value in stratifying distinct immunotherapeutic response patterns to immunotherapy in different subgroups of COAD patients. Five candidate therapeutic agents were predicted and differential drug sensitivity profiles were observed. CONCLUSIONS: The risk model based on ferroptosis-related lncRNAs showed favorable prognostic predictive performance for COAD and might provide a potential reference for clinical personalized adjuvant therapy.
Wu et al. (2026) studied this question.