DeCure for Esophageal small cell neuroendocrine carcinoma
DeCure's autonomous Cancer AI scientist is researching a drug-repurposing hypothesis for esophageal small cell neuroendocrine carcinoma — screening already-approved drugs against its 1-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleEsophageal small cell neuroendocrine carcinoma maps to a 1-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 esophageal small cell neuroendocrine carcinoma 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
epidermal growth factor receptor (EGFR) — EGFR 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 apo structuredrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 7SYD · 3.1 Å · ligand none (apo structure). Experimental structure, not a prediction.
What the evidence adds up to
A 2008 retrospective study of 40 patients with oesophageal neuroendocrine carcinoma found that 13 had small-cell subtype and 27 had large-cell subtype. Overall survival was better for locoregional disease than for distant metastasis (p=0.006), and better when a non-neuroendocrine component was present than in pure NEC (p=0.031). There was no difference in prognosis between the small-cell and large-cell subtypes. Seventeen patients with locoregional disease received preoperative chemoradiation; disease progressed in 7, and 10 had residual tumour in the resection specimen. A 2001 case report described a 50-year-old man with a stage I superficial neuroendocrine carcinoma who received postoperative cisplatin-based chemoradiation; metastatic disease appeared 14 months after surgery, and he died 3 months later.
A 2015 case report from Saudi Arabia described a 66-year-old woman with large-cell neuroendocrine carcinoma of the oesophagus presenting with progressive dysphagia and weight loss, but provided no treatment outcome data. A 2025 review states that oesophageal neuroendocrine carcinoma is rare and highly aggressive, with a markedly worse prognosis than other oesophageal cancer types. It asserts that surgery remains the cornerstone for long-term survival, that neoadjuvant therapy can convert initially unresectable disease to a resectable status, and that combined chemoradiotherapy improves survival rates. The review also mentions that targeted therapy combined with chemotherapy and immune checkpoint inhibitors combined with radiotherapy or targeted drugs have achieved long-term remission in certain cases, but provides no patient numbers, response rates, or survival durations.
What is still missing are prospective trials with sufficient sample sizes to define optimal chemotherapy regimens, reliable biomarkers to stratify patients by likely treatment response, and dedicated funding for a disease so rare that no single institution can enrol enough patients without multi-centre collaboration.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
The American Journal of Surgical Pathology · 2008 · 147 citations
Retrospective Study of Clinicopathologic Features and Prognosis of High-grade Neuroendocrine Carcinoma of the Esophagus
AbstractClinicopathologic features of esophageal neuroendocrine carcinoma (NEC), apart from those of small-cell carcinoma, have not been characterized. We evaluated the clinicopathologic features and prognosis including overall survival of NEC of the esophagus. We identified 40 patients with esophageal NEC from our institutional database. All cancers had been clinically staged using endoscopic ultrasonography, computed tomography, and positron emission tomography. Neuroendocrine differentiation was confirmed by immunohistochemical staining. The NEC component was classified into small-cell and large-cell subtypes, and non-neuroendocrine components were evaluated. Patients with locoregional disease were treated with chemoradiation with or without surgery or with surgery only. Patients with distant metastasis were treated with systemic therapy. The extent of residual tumors was evaluated in esophagectomy specimens after preoperative chemoradiation. Twenty-seven patients had large-cell NEC, and 13 had small-cell neuroendocrine carcinoma. An adenocarcinoma component was present in 15 patients and squamous carcinoma component in 1 patient. Synaptophysin was positive in all cases, and chromogranin was positive in 31 cases. Seventeen patients had distant metastasis, and 21 had locoregional disease. Seventeen patients with locoregional disease received preoperative chemoradiation. Disease progressed in 7 patients, and 10 had residual tumor in resection specimens. Overall survival was better with locoregional disease than with distant metastasis (P=0.006). Overall survival was better in patients with non-neuroendocrine component than in patients with pure NEC (P=0.031). There was no difference in prognosis between patients with large-cell NEC and those with small-cell neuroendocrine carcinoma. Esophageal NEC is an aggressive tumor, and patients with mix NEC have better outcome.
Case Reports in Gastroenterology · 2015 · 16 citations · open access
Large-Cell Neuroendocrine Carcinoma of the Esophagus: A Case from Saudi Arabia
AbstractNeuroendocrine carcinomas of the esophagus are very rare, and the majority are high grade (poorly differentiated). They occur most frequently in males in their sixth and seventh decades of life. There have been no concrete data published on clinical features or on prognosis. We report a case of large-cell neuroendocrine carcinoma of the esophagus in a 66-year-old Saudi female with progressive dysphagia and weight loss. Upper endoscopy revealed an esophageal ulcerated mass.
Superficial neuroendocrine carcinoma of the esophagus
AbstractA 50‐year‐old man underwent subtotal esophagectomy for a superficial ulcerated tumor, 1.8 cm in length, located in the middle third of the esophagus. Histological examination of the resected specimen showed a stage I infiltrating neuroendocrine carcinoma. Tumor cells were immunohistochemically positive for chromogranin A, neuron‐specific enolase, synaptophysin, protein gene product 9.5 and carcinoembryonic antigen. Postoperative cisplatin‐based chemoradiation therapy was administered. Fourteen months after surgery, widely metastatic disease was noted and the patient died 3 months later.
Oncology Letters · 2025 · 2 citations · open access
Progress in the treatment of esophageal neuroendocrine carcinoma (Review)
AbstractEsophageal neuroendocrine carcinoma (ENEC) is a rare and highly aggressive gastrointestinal malignancy with a markedly worse prognosis compared with other pathological types of esophageal cancer. The present study aimed to provide a systematic review of the pathological features, diagnostic strategies and advances in stratified treatment of ENEC, with a focus on current therapeutic approaches. The management of ENEC requires a multimodal approach. Among these modalities, surgery remains the cornerstone for achieving long-term survival. For patients with initially unresectable disease, neoadjuvant therapy can convert cases to a resectable status. Additionally, combined chemoradiotherapy has been demonstrated to markedly improve survival rates. Beyond conventional treatments, the potential of targeted therapy in combination with chemotherapy has been suggested, and the synergy between immune checkpoint inhibitors and either radiotherapy or targeted drugs has achieved long-term remission in certain cases.
Digestive System and Hepatobiliary Diseases · 2024 · 0 citations · open access
Esophageal Large Cell Neuroendocrine Carcinoma: A brief Pathology Review of the Rare Tumor
AbstractEsophageal Large Cell Neuroendocrine Carcinoma (LCNEC) is an exceedingly rare and aggressive neuroendocrine neoplasm (NEN) that originates in the esophagus. This review article aims to provide a concise yet comprehensive overview of LCNEC, touching upon its epidemiology, clinical presentation, diagnostic challenges, histological and molecular characteristics, and current approaches to treatment. LCNEC is marked by rapid progression and a poor prognosis, setting it apart from other esophageal cancers with its unique cellular morphology and neuroendocrine differentiation. Despite its rarity, understanding the pathology, clinical implications, and potential treatment strategies for LCNEC is crucial for improving patient outcomes. This review synthesizes current knowledge, highlighting the importance of accurate diagnosis and the need for further research to develop targeted therapies.
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.
