DeCure for Gastric Small Cell Neuroendocrine Carcinoma
DeCure's autonomous Cancer AI scientist is researching a drug-repurposing hypothesis for Gastric Small Cell Neuroendocrine Carcinoma — 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 moduleGastric Small Cell Neuroendocrine Carcinoma 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 gastric 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
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 gastric small cell neuroendocrine carcinoma is a rare and aggressive tumour. A 70-year-old man who underwent total gastrectomy for a diffuse infiltrating tumour died of multiple liver metastases and peritonitis carcinomatosa 69 days after surgery. The pathological diagnosis was moderately to poorly differentiated adenocarcinoma and small cell carcinoma containing alpha-fetoprotein-positive cells. The tumour cells were positive for neuron-specific enolase and synaptophysin on immunocytochemistry.
A 58-year-old man with an antro-pyloric poorly differentiated grade III gastric small cell carcinoma (cT4 cN+ cM0) received neoadjuvant treatment with six cycles of cisplatin-etoposide, with the last two cycles combined with radiotherapy. Re-staging showed a good partial response, and he underwent radical gastrectomy with D2 lymph node dissection. The pathology report showed a mixed large and small cell neuroendocrine carcinoma ypT4a N3a (9/28) G3 L1 V1 Pn1 R0. Ten months after surgery, the patient was disease free. A separate 57-year-old Chinese male with mixed large and small cell neuroendocrine carcinoma of the stomach refused adjuvant treatment after laparoscopic-assisted radical proximal subtotal gastrectomy and showed no evidence of local recurrence or distant metastasis at eight months.
The rarity of this entity makes treatment challenging. A systematic review of the literature limited to gastric small cell carcinoma recommended a multi-modal approach combining surgery, radiotherapy and platinum-based adjuvant chemotherapy. The authors note that there is no difference in pathological features, response to chemotherapy, incidence of progression or survival between different anatomical locations of these tumours. They advocate conducting further genomic studies to explore the origin of gastric large cell and small cell neuroendocrine carcinoma and using different chemotherapy schemes according to cell type in clinical research. What is still missing are prospective trials with sufficient patient numbers, standardised treatment protocols, and molecular stratification to clarify the heterogeneity of this disease and improve prognosis.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Acta Cytologica · 2005 · 4 citations
Paranuclear Blue Inclusions of Small Cell Carcinoma of the Stomach
AbstractBACKGROUND: Primary gastric small cell carcinoma is a rare but important entity. We describe a case that we diagnosed by peritoneal washing cytology. CASE: A 70-year-old male presented with upper abdominal discomfort and underwent endoscopic evaluation. Gastric endoscopy revealed a diffuse, infiltrating tumor from the body to the antrum. Total gastrectomy with lymph node dissection and intraoperative peritoneal washing cytology were carried out. Peritoneal washing cytology showed the presence of many undifferentiated malignant small cells with a necrotic background. The tumor cells were small and round, with naked, hyperchromatic nuclei and finely granular chromatin. Some tumor cells contained paranuclear blue inclusions (PBls) in the cytoplasm. The tumor cells were positive for neuron-specific enolase and synaptophysin on immunocyto-chemistry. Carcinoembryonic antigen, alpha-fetoprotein (AFP) and leukocyte common antigen were negative. Pathologic diagnosis after the operation was moderately to poorly differentiated adenocarcinoma and small cell carcinoma containing AFP-positive cells. CONCLUSION: The prognosis of primary gastric small cell carcinoma is usually poor. Our patient died of multiple liver metastases and peritonitis carcinomatosa 69 days after surgery. When a gastric small cell carcinoma is suspected in peritoneal washings, immunocytochemical demonstration of neuroendocrine differentiation is required to arrive at the final diagnosis.
World Journal of Clinical Cases · 2022 · 1 citations · open access
Mixed large and small cell neuroendocrine carcinoma of the stomach: A case report and review of literature
AbstractBACKGROUND: Gastric neuroendocrine carcinoma (GNEC) is a rare histological subtype of gastric cancer, which is categorized into small cell and large cell neuroendocrine carcinomas. It is characterized by strong invasiveness and poor prognosis. Mixed large and small cell neuroendocrine carcinoma (L/SCNEC) is an extremely rare pathological type of gastric cancer, and there have been no reports on this situation until now. CASE SUMMARY: Herein, we first present a 57-year-old patient diagnosed with L/SCNEC of the stomach. A 57-year-old Chinese male presented with epigastric discomfort. Outpatient gastroscopic biopsy was performed, and pathological examination revealed that the cardia was invaded by adenocarcinoma. The patient underwent laparoscopic-assisted radical proximal subtotal gastrectomy and was diagnosed with L/SCNEC. He refused adjuvant treatment and was followed up every 3 mo. Eight months after the operation, the patient showed no evidence of local recurrence or distant metastasis. CONCLUSION: We advocate conducting further genomic studies to explore the origin of gastric large cell and small cell neuroendocrine carcinoma and using different chemotherapy schemes according to large or small cell neuroendocrine carcinoma of the stomach for clinical research to clarify the heterogeneity of GNEC and improve the prognosis of patients with GNEC.
Journal of Cancer Science and Clinical Therapeutics · 2020 · 0 citations · open access
A Rare Case of Mixed Large and Small Cell Neuroendocrine Carcinoma: A Systematic Review of the Literature
AbstractIntroduction: Small cell carcinoma is most frequently found in the lung. Only 4% of small cell carcinomas are present in the urinary bladder, prostate, oesophagus, stomach, colon, rectum, gallbladder, larynx, salivary glands, cervix and skin. Primary gastric small cell carcinoma (GSCC) is a very rare and poorly differentiated neuroendocrine tumour. We present a case of primary gastric small cell carcinoma and a systematic review of literature. Case Presentation: A 58 year-old man presented with epigastric pain, nausea and melena. Several exams showed an antro-pyloric poorly differentiated grade III gastric small cell carcinoma classified as cT4 cN+ cM0. The tumour board recommended neoadjuvant treatment with six cycles of cisplatin-etoposide, with the last two cycles associated with radiotherapy. Re-staging showed a good partial response and no spread of the disease, therefore we completed treatment with a radical gastrectomy with D2 lymph node dissection. The surgery was performed in August 2019 and the patient was discharged after ten days. Pathology report showed a mix large and small cells neuroendocrine carcinoma . Due to the neoadjuvant treatment, the small cell component seen in a preoperative biopsy had largely disappeared and the case was diagnosed as a mixed large and small cell neuroendocrine carcinoma ypT4a N3a (9/28) G3 L1 V1 Pn1 R0. Discussion: Clinical manifestations of gastric small cell carcinoma (GSCC) are similar to classic gastric adenocarcinomas. However, gastric small cell carcinoma can secrete ectopic hormones like parathyroid hormone, antidiuretic hormone, calcitonin or serotonin. Upper gastrointestinal endoscopy is the method of choice for the diagnosis, supplemented with an immunohistochemical examination with a positive reaction to neuro-specific enolase (NSE), chromographin A, synaptophysin, CD56 and Grimelius. The treatment strategy for GSCC is unclear. There is no difference in the pathological features, response to chemotherapy, incidence of progression and survival between the different anatomical locations of these tumours. A review of the literature limited to GSCC recommended multi-modal approach combining surgery, radiotherapy and platinum-based adjuvant chemotherapy. Ten months after surgery, the patient is still disease free. Conclusion: GSCC is a rare and aggressive entity with low survival rate. The rarity of this entity makes treatment challenging. Unlike small cell lung cancer, surgery remains part of the multi-modality treatment of GSCC.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research · 2015 · 0 citations · open access
A Case of a Small Cell Neuroendocrine Carcinoma in the Ampulla of Vater Incidentally Found on Gastroduodenoscopy
AbstractSmall cell neuroendocrine carcinoma in the ampulla of Vater is a rare disease and there have only been three cases reported in Korea. In these three cases, the patients had symptoms of abdominal pain and jaundice. A biopsy via endoscopic retrograde cholangiopancreatography confirmed a small cell neuroendocrine carcinoma; thus, each patient underwent surgical treatment. Recently, we experienced a case of small cell neuroendocrine carcinoma in an asymptomatic patient. An ulcerative lesion was identified during screening gastroduodenoscopy. Here, we report this case and review the relevant literature. (
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.
