DeCure's autonomous Cancer AI scientist is researching a drug-repurposing hypothesis for Duodenal Adenocarcinoma — screening already-approved drugs against its 45-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleDuodenal Adenocarcinoma maps to a 45-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
No approved-drug candidate for duodenal adenocarcinoma is corroborated in the literature DeepSearch retrieved. Some conditions are managed with non-pharmacological care — a device, surgery or physical therapy — rather than a medicine; that may be the case here, or the literature we found may simply be too sparse yet to support a drug-repurposing angle.
Molecular view
transforming growth factor beta receptor 2 (TGFBR2) — TGFBR2 is one of the genes genetically linked to this disease in Open Targets — shown as context, not as a drug target we're pursuing: no approved-drug candidate for this disease is yet corroborated in the literature we found.
Loading structure…
helix sheet 6-methoxypyridin-3-yldrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 5QIN · 1.57 Å · ligand N-{4-[3-(6-methoxypyridin-3-yl)-1H-pyrrolo[3,2-b]pyridin-2-yl]pyridin-2-yl}acetamide (J2V). Experimental structure, not a prediction.
What the evidence adds up to
Primary duodenal adenocarcinoma is a rare tumour with a poorly defined natural history. A 2008 literature review of 19 articles concluded that all medically fit patients should be offered aggressive surgical resection regardless of tumour size, invasion, or positive lymph nodes, and that early diagnosis might improve long-term survival. A 2015 single-centre series of 39 patients treated between 2000 and 2013 reported a median overall survival of 14.4 months for the entire cohort. Among 21 patients who had curative resection, median survival was 45.4 months with one-, three-, and five-year survival rates of 92.9%, 62.5%, and 16.7% respectively. The 12 non-operative patients had a median survival of 7.4 months. Female gender and curative resection were independently predictive of overall survival. The authors stated that overall survival still hinges on curative resection and that adjuvant chemotherapy and radiation require further investigation.
A 2020 retrospective review of 76 patients with stage I–III duodenal adenocarcinoma who underwent potentially curative resection at a single high-volume centre found that 84% of recurrences occurred within two years, with a median time to recurrence of 11 months. Recurrence rates were 0% for stage I, 50% for stage II, and 71% for stage III. Distant recurrence alone occurred in 42% of patients, while local recurrence alone occurred in only 5%. The most common sites of distant recurrence were peritoneum (38%), liver (33%), distant lymph nodes (12%), and lung (10%). Local recurrence rates were similar whether or not patients received radiation therapy (10% vs 9%). The authors concluded that future therapies should focus on improved systemic therapy and that surveillance should be most intensive in the first two years.
A 2024 single-centre series of 31 patients who underwent surgical resection between 2008 and 2023 reported a 3-year overall survival of 44.3% and a 5-year overall survival of 33.3%. Disease-free survival at 3 and 5 years was 37.0% and 29.6% respectively. Peri-operative mortality was 12.9%. Only 37% of patients received adjuvant chemotherapy. Patients who received adjuvant chemotherapy had a trend towards improved mean overall survival compared to those who did not (80.3 vs 51.2 months, p=0.173), but median disease-free survival was similar between groups (24.0 vs 26.0 months, p=0.901). Major post-operative morbidity (Clavien-Dindo III–V) was significantly associated with poorer overall survival (72.1 vs 3.4 months, p<0.001). Across all studies, the evidence remains limited by small sample sizes, retrospective design, and lack of randomised data. No systemic therapy has been proven to improve outcomes in a controlled trial, and the role of adjuvant chemotherapy or radiation is still not established. What is missing is prospective multi-centre trials, standardised chemotherapy regimens, and reliable methods for early detection and patient stratification.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Tumori Journal · 2008 · 43 citations
Primary Duodenal Adenocarcinoma
AbstractAIMS AND BACKGROUND: Primary duodenal adenocarcinoma is a rare tumor with a poorly defined natural history and prognostic factors. It presents with nonspecific symptoms, and for this reason the diagnosis is often delayed. It is a serious problem for the surgeon because of the difficulty in obtaining an early diagnosis and standardizing basic tenets for an appropriate surgical approach. The aim of this work was to conduct a review of the literature analyzing the points most frequently debated about this pathology. METHODS AND STUDY DESIGN: A bibliographic search was carried out on the main search engines to find studies regarding duodenal adenocarcinoma, published in English, from January 1992 to January 2007. RESULTS: A total of 19 articles was selected. Results concerning symptoms, location of the tumor, diagnostic examinations, surgical treatment, histopathology of the tumor, survival and follow-up were obtained and discussed. CONCLUSIONS: All patients who are medically fit to undergo surgery should be given the option of aggressive resection regardless of tumor size, tumor invasion or appearance of positive lymph nodes. Hopefully, an early diagnosis will correlate with improved long-term survival.
Duodenal Adenocarcinoma: Profile and Predictors of Survival Outcomes
AbstractDuodenal adenocarcinoma is rare. We aimed to evaluate survival outcome and prognostic factors for survival in patients with duodenal adenocarcinoma in recent years, marked by advancement in chemotherapy for gastrointestinal cancers. All patients treated for duodenal adenocarcinoma at our institution between January 2000 and July 2013 were reviewed. Thirty-nine patients were identified: 27 operative patients [21(53.8%) curative and 6 (15.4%) palliative operations] and 12 nonoperative patients [primary systemic chemotherapy, 4 (10.3%), palliative radiotherapy, 1 (2.6%), and no treatment, 7 (17.9%)]. Curative resections included 13 pancreaticoduodenectomies and eight segmental resections. Median overall survival (OS) for entire cohort was 14.4 months. Median OS and one-, three-, and five-year OS were operative group (41.4 months; 79.1%, 50.6%, and 10.6%, respectively); nonoperative group (7.4 months; 25.0%, 8.3%, and 0%, respectively); curative surgery (45.4 months; 92.9%, 62.5%, and 16.7%, respectively) and palliative surgery (5.4 months; 33.3%, 16.7%, and 0%, respectively). Female gender (P = 0.04), curative resection (P = 0.03), nodal metastasis (P = 0.047) and advanced T stage (P = 0.047) were predictive of OS. Two factors were independently predictive of OS--female gender and curative resection. Overall survival still hinges on curative resection. This favors early detection. Adjuvant treatment modalities such as chemotherapy and radiation require further investigation.
Pattern of recurrence after curative resection of stage I-III duodenal adenocarcinoma.
Abstract794 Background: Duodenal adenocarcinoma (DA) is a rare cancer with limited data regarding the pattern of disease recurrence following resection. Methods: A retrospective review of 115 patients with Stage I-III DA from 3/1994 to 6/2018, at a single high-volume cancer center was conducted. Only patients (pts) who underwent a potentially curative surgical resection (R0/R1 margins) and had a postoperative follow-up radiographic evaluation were included. Periampullary adenocarcinomas were excluded. Clinicopathologic features and patterns of recurrence were compared across cohorts. Results: Of 76 patients who met inclusion criteria, 7 (9%) were stage I, 25 (33%) stage II, and 44 (57%) stage III. Histologic grade was moderate in 58% and poor in 38%. Median age was 63 years (range, 29-84), 38% were female, and R0 resection was 97%. Neoadjuvant therapy was given to 14% and adjuvant therapy to 61%. Radiation therapy (XRT) as either adjuvant/neoadjuvant therapy was used in 27%. Median follow-up was 44 (6-293) months. Median time to recurrence was 11mo, with 84% of recurrences occurring within 2 years. Median time to local recurrence (LR) vs. distant recurrence (DR) was 11mo vs. 12mo, respectively, p = 0.42. Stage impacted recurrence rate: 0% in stage 1 vs. 50% stage 2 vs. 71% stage 3 (p = 0.002). Median time to recurrence was 16mo for stage II and 11mo for stage III (p = 0.04). In total, 4 (5%) pts had LR only, 8 (10%) had LR concurrent with DR, and 32 (42%) had DR only. Recurrence distribution was similar across stage II (LR 8%, LR+DR 15%, DR 77%) and stage III (LR 10%, LR+DR 19%, DR 71%). LR was similar in patients that received XRT (10%) compared to those who did not (9%). Most common sites of DR were peritoneal (38%), liver (33%), distant lymph nodes (12%), and lung (10%). Conclusions: The recurrence pattern for resected DA is predominantly distant metastatic disease with the majority of recurrences occurring within the first two years. Future therapies should focus on improved systemic therapy, and surveillance should be most intensive in the first two years.
HPB SO32 - Outcomes Following Surgical Resection for Duodenal Adenocarcinoma – A Single Centre Experience
AbstractAbstract Background Duodenal adenocarcinomas are rare cancers and their clinico-oncological management pathways tend to follow that of small bowel tumours. The aim of this study was to determine the outcomes of patients undergoing surgical resection for duodenal adenocarcinoma. Method Retrospective data of all patients who underwent surgical resection for duodenal adenocarcinoma between January 2008 to December 2023 were included. Collated data included demographics, clinico-pathological features and survival outcomes. Results Thirty-one patients were included, with a mean age of 65.7 (± 9.6) years and a greater proportion were male patients (58.1%). The predominant site of the primary tumour was at D2 section of the duodenum (58.1%). The majority of patients required a pancreatico-duodenectomy (80.6%) and 58.1% experienced minor morbidity (Clavien-Dindo I-II) while 22.6% experienced major morbidity (Clavien-Dindo III-V). There were 4 (12.9%) peri-operative mortalities. Results The median post-operative follow-up was 29.7 (IQR 61.5) months. Only 37.0% of patients received adjuvant chemotherapy while 13 patients (48.1%) experienced disease recurrence. The 3- and 5-year overall survival was 44.3% and 33.3%, respectively, while the disease-free survival at 3 and 5 years were 37.0% and 29.6%, respectively. Patients who received adjuvant chemotherapy had a trend towards improved mean overall survival in comparison to patients who did not receive chemotherapy following surgery [80.3 vs 51.2 months; log rank 1.857, p=0.173]. Nevertheless, the median disease-free survival was similar between both groups [24.0 vs 26.0 months, log rank 0.016, p=0.901]. Patients who experienced major morbidity (Clavien-Dindo III-V) were significantly more likely to have a poorer median overall survival compared to patients with minor morbidity (Clavien-Dindo I-II) [72.1 vs 3.4 months; log rank 16.860, p&lt;0.001]. Conclusion Major morbidity (Clavien-Dindo III-V) following surgery is associated with poorer overall survival. Patients who received adjuvant chemotherapy following surgical resection for duodenal adenocarcinoma may have a trend towards improved overall survival.
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.
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