DeCure's autonomous Cancer AI scientist is researching a drug-repurposing hypothesis for bladder urachal adenocarcinoma — screening already-approved drugs against its 24-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleBladder urachal adenocarcinoma maps to a 24-gene Open Targets module — the target space DeCure's AI scientist screens approved drugs against.
DeCure.ai methodSignature reversal (LINCS) plus network proximity (STRING) rank already-approved drugs likely to perturb this module — the same engine that produces DeCure.ai's repurposing hypotheses.
Repurposing thesisScreening approved medicines against this disease module, then publishing the evidence for the strongest candidate. Known pharmacology and human exposure data make the first question sharper — they do not establish safety or efficacy in a new indication.
Research record
01
ResearchComing soon
Candidate research + dossier — target rationale, drug-repurposing thesis and evidence pack.proof: Published dossier + on-chain hash
02
ValidationComing soon
In-vitro biological validation at a contract research org (CRO).proof: CRO contract + in-vitro report
03
Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Current lead
approvedSunitinibApproved drug
Structures already discussed alongside bladder urachal adenocarcinoma in the retrieved literature, rendered from public PubChem SMILES. Which drugs appear here reflects the evidence found, not a ranked prediction.
Molecular view
KIT kinase domain — Sunitinib has a real, experimentally solved structure in complex with this target (PDB 3G0E, 1.6 Å). This is the drug's own deposited structure, not a prediction, and confirms it is a structurally characterised molecule rather than an untested guess.
Loading structure…
helix sheet b49drag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 3G0E · 1.6 Å · ligand Sunitinib (B49). Experimental structure, not a prediction.
What the evidence adds up to
A 2014 case report described a young woman with metastatic urachal carcinoma whose disease progressed after surgery and two chemotherapy regimens (neoadjuvant capecitabine + irinotecan + oxaliplatin, then docetaxel + cisplatin). Treatment with sunitinib produced stable disease and symptom improvement, but was interrupted due to metrorrhagia. Disease eventually progressed and the patient died 18 months after symptom onset. This is the only published report of sunitinib in urachal carcinoma.
A 2019 surgical series of 16 patients treated between 2005 and 2015 reported that 11 (68.76%) underwent partial cystectomy and 5 (31.25%) underwent radical cystectomy with omphalectomy. Postoperative pathology showed 7 (43.75%) had localised tumours, 6 (37.5%) had locally advanced Sheldon III disease, and 3 had distant metastasis at surgery. Lymph node involvement was present in 3 patients (18.75%). Mean follow-up was 2.5 years (range 4 months to 7.6 years). Three patients (18.75%) were lost to follow-up but were cancer-free at last evaluation. The authors stated that adjuvant chemotherapy has limited impact on overall survival and questioned the utility of navel resection due to rarity of direct invasion or local recurrence.
A 2023 systematic review concluded that surgical resection remains the mainstay for localised urachal adenocarcinoma. It noted that chemotherapy has shown promising response rates and survival outcomes in small retrospective studies, particularly for metastatic disease, but that randomised trial data are required. The role of checkpoint inhibitors remains under investigation. A 2024 review reiterated that surgery is the primary treatment for prolonging overall survival, and that urachal adenocarcinoma constitutes about 0.5 to 2% of all bladder malignancies, typically presenting in adults aged 47 to 56 with equal gender distribution.
What is still missing: prospective randomised trials comparing systemic therapy to surgery alone or to placebo, validated biomarkers to select patients for targeted or immune-based treatments, and a standardised follow-up regimen that incorporates both cross-sectional imaging and cystoscopy. The rarity of the disease makes accrual to any trial difficult without multi-centre collaboration and dedicated funding.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Rare Tumors · 2014 · 25 citations · open access
Response to Targeted Therapy in Urachal Adenocarcinoma
AbstractWe report the case of a young woman diagnosed with metastatic urachal carcinoma. A multimodal approach was used for the management of this patient. Due to disease progression despite surgery and two different chemotherapy regimens (neoadjuvant capecitabine + irinotecan + oxaliplatin and docetaxel + cisplatin after surgery), treatment with sunitinib was eventually started. Treatment with sunitinib resulted in stable disease and improvement of symptoms. Sunitinib was discontinued due to the occurrence of metrorrhagia, and restarted one week later. Disease eventually progressed and the patient died 18 months after the onset of symptoms. This is the first report on the use of sunitinib for the management of urachal carcinoma and provides initial evidence supporting the use of targeted therapy in this setting.
Surgical management of urachal tumors: Can the umbilicus be sparred in localized disease?
AbstractUrachal adenocarcinoma represents the third most common histological type of non-urotelial bladder cancer. A very low incidence of this disease and the lack of prospective studies have led to a rich and heterogeneous treatment history. Currently, the standard of care for these patients is represented by partial cystectomy en bloc with resection of the urachal ligament and total omphalectomy. The aim of this article is to present our experience and results in the management of patients with urachal adenocarcinoma. Between 2005 and 2015, 16 patients have undergone surgical treatment for urachal adenocarcinoma in "Fundeni" Clinical Institute and Madrid University Hospital "Infanta Sofia." Partial cystectomy was performed in 11 (68.76%) patients, while radical cystectomy en bloc with omphalectomy was performed in 5 (31.25%) patients, which were not amendable to a limited resection. The Sheldon classification was used, as it provides appropriate disease staging and is the most commonly utilized. Postoperative pathological results showed that 7 (43.75%) patients had localized tumors, and more than one-third (37.5%) of the patients had locally advanced Sheldon III disease, while 3 patients had distant metastasis at the time of surgery. Lymph node involvement was present in 3 patients (18.75%). Mean follow-up time was 2.5 years, ranging from 4 months to 7.6 years. Three patients (18.75%) were lost to follow-up, without any documented signs of local or systemic recurrence and were cancer free at the time of the last evaluation. In cases with lymph node involvement, local recurrence or distant metastasis, patients underwent cisplatin- or 5-fluorouracil-based salvage chemotherapy. Surgical treatment represents the gold standard, while adjuvant chemotherapy has a limited impact on overall survival. The utility of navel resection is questionable due to the rarity of direct invasion or local recurrence.
Current Urology · 2023 · 5 citations · open access
Modern methods in managing urachal adenocarcinoma
AbstractObjectives: We sought to evaluate modern diagnostic and treatment options for urachal adenocarcinoma (UAC) and to provide clarity regarding the available options and their outcomes for this poorly understood yet damaging disease. Material and methods: We conducted a systematic literature search in PubMed and Medline focusing on updated management of UAC. Results: Surgical intervention continues to be the mainstay of treatment for localized UAC. However, with the increased availability of molecular and genetic profiling, chemotherapy has consistently demonstrated promising response rates and survival outcomes, especially for a disease that commonly presents in a metastatic stage. The role of checkpoint inhibitors remains under investigation. Cross-sectional imaging is vital during postoperative surveillance. However, there may also be a role for the adoption of cystoscopy to detect bladder recurrence. Conclusions: Although the importance of surgical resection remains unchanged, improved survival outcomes with chemotherapy have been found in small retrospective studies. Randomized trial data are required to further assess the influence of systemic treatment as a primary or adjuvant therapy. Moreover, a stringent follow-up regimen incorporating evaluation for distant and local recurrence of UAC must be evaluated and adopted.
Urachal adenocarcinoma: a rare bladder tumor management
AbstractUrachal adenocarcinoma is a rare and aggressive form of non-urothelial carcinoma. It commonly encountered the bladder at the dome or along its midline. Adenocarcinoma histology with frequent mucinous or signet ring cell features distinguishes it from traditional urothelial tumours. It usually manifests in adults aged 47 to 56, with an even distribution between genders. It constitutes about 0.5 to 2 % of all bladder malignancies. Surgery remains the primary treatment modality in prolonging patients’ overall survival time. We wish to discuss a case of a patient diagnosed with urachal adenocarcinoma.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works (targeted per-candidate search), resolved on OpenAlex.
DeCure is a research and publication project, not medical advice and not a treatment. "DeCure for X" describes a research goal, not a claim that a cure exists. Backing a cure is a contribution to fund the research — it is not an investment, and confers no yield, royalty, equity or IP ownership. Papers are published open-access by the DeCure.ai DAO.
