DeCure for Gastroesophageal junction adenocarcinoma
DeCure's autonomous Cancer AI scientist is researching a drug-repurposing hypothesis for gastroesophageal junction adenocarcinoma — screening already-approved drugs against its 46-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleGastroesophageal junction adenocarcinoma maps to a 46-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 gastroesophageal junction 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
axin 1 (AXIN1) — AXIN1 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 dttdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 1DK8 · 1.57 Å · ligand 2,3-DIHYDROXY-1,4-DITHIOBUTANE (DTT). Experimental structure, not a prediction.
What the evidence adds up to
Gastroesophageal junction adenocarcinoma is an aggressive malignancy with rising incidence, linked to obesity and GERD. A review of 52 adenocarcinomas invading the oesophagus and oesophagogastric junction noted that cardio-oesophageal junction tumours appear to have distinctive prognostic and pathological features, possibly warranting their own classification. A retrospective analysis of 187 patients treated between 2005 and 2014 reported a median age of 62, with roughly 70% male. Among these, 10.2% had Siewert type I tumours, 21.4% type II, and 64.4% type III. Siewert III tumours presented at more advanced pathologic and T stages. Preoperative chemoradiotherapy was applied mostly to Siewert I patients.
The same retrospective study found no difference in recurrence between the three Siewert groups. Median overall survival was 26.6 months, with a 2-year overall survival rate of 39.6%. Median disease-free survival was 16.5 months, with a disease-free survival rate of 30.1%. N stage, pathologic stage, vascular invasion, lymphatic invasion, perineural invasion, surgical margin, and grade were all associated with both overall and disease-free survival. Pathologic stage and presence of recurrence were significant factors for overall survival. Median disease-free survival was 20 months for Siewert III, 11.3 months for Siewert I, and 14 months for Siewert II, but this difference was not statistically significant (p=0.08). The authors concluded that although the tumours show different clinicopathologic properties by location, their prognosis is similar.
Management has evolved over the last two decades to incorporate a multidisciplinary approach including endoscopic intervention, neoadjuvant chemotherapy or chemoradiation, and minimally invasive or limited surgical approaches such as esophagectomy, total gastrectomy, or proximal gastrectomy. A review of landmark clinical trials notes that neoadjuvant therapy has transformed management, offering the possibility to reverse disease progression and eliminate micrometastasis, but also acknowledges areas of continued controversy and investigation. The same review mentions potential therapeutic agents on the horizon but does not name any specific drug or report survival or response rates from those agents.
What remains missing is prospective data that reliably stratifies patients by Siewert type to guide treatment selection, randomised trials comparing the various surgical approaches head-to-head for survival rather than just feasibility, and funding for trials of the potential therapeutic agents mentioned only in passing. No drug is named in any of these abstracts, and no efficacy claim for any drug can be made from them.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
British journal of surgery · 1978 · 68 citations
Adenocarcinoma of the oesophagus and of the oesophagogastric junction
AbstractThe clinical and pathological features of 52 adenocarcinomas invading the oesophagus and the oesophagogastric junction are reviewed. The relationship of these tumours to the presence of a concomitant hiatal hernia and the histogenesis of primary oesophageal adenocarcinomas are discussed. Adenocarcinomas of the cardio-oesophageal junction appear to have distinctive prognostic and pathological features and there may be a case for their classification into a separate category of alimentary neoplasms.
The Multidisciplinary Approach and Surgical Management of GE Junction Adenocarcinoma
AbstractGastroesophageal (GE) junction adenocarcinoma is an aggressive malignancy of growing incidence and is associated with public health issues such as obesity and GERD. Management has evolved over the last two decades to incorporate a multidisciplinary approach, including endoscopic intervention, neoadjuvant chemotherapy/chemoradiation, and minimally invasive or more limited surgical approaches. Surgical approaches include esophagectomy, total gastrectomy, and, more recently, proximal gastrectomy. This review analyzes the evidence for and applicability of these varied approaches in management, as well as areas of continued controversy and investigation.
Turkish Journal of Surgery · 2017 · 9 citations · open access
The clinicopathologic characteristics and prognostic factors of gastroesophageal junction tumors according to Siewert classification
AbstractOBJECTIVE: The treatment of gastroesophageal junction tumors remains controversial due to confusion on whether they should be considered as primary esophageal or as gastric tumors. The incidence of these tumors with poor prognosis has increased, thus creating scientific interest on gastroesophageal cancers. Esophagogastric cancers are classified according to their location by Siewert, and the treatment of each type varies. We evaluated the prognostic factors and differences in clinicopathologic factors of patients with gastroesophageal junction tumor, who have been treated and followed-up in our clinics. MATERIAL AND METHODS: We retrospectively analyzed 187 patients with gastroesophageal junction tumors who have been operated and treated in the Oncology Department between 2005 and 2014. The chi-square test was used to evaluate differences in clinicopathologic factors among Siewert groups I, II and III. Prognostic factors were analyzed by univariate and multivariate analysis. RESULTS: The median age of our patients was 62 years, and approximately 70% was male. Nineteen patients (10.2%) had Siewert I tumors, 40 (21.4%) II, and the remaining 128 (64.4%) had Siewert III tumors. Siewert III tumors were at more advanced pathologic and T stages. Preoperative chemoradiotherapy was mostly applied to Siewert group I patients. There was no difference between the 3 groups in terms of recurrence. While the median overall survival and 2-year overall survival rate were 26.6 months and 39.6%, the median disease free survival and disease free survival rates were 16.5 months and 30.1%, respectively. The N stage, pathologic stage, vascular invasion, lymphatic invasion, perineural invasion, surgical margin, and grade were associated with both overall survival and disease free survival, while pathologic stage and presence of recurrence were significant factors for overall survival. The median disease free survival for Siewert III tumors was 20 months, 11.3 month for Siewert I tumors, and 14 months for Siewert II tumors, but the finding was not statistically significant (p=0.08). CONCLUSION: Although gastroesophageal junction tumors were grouped according to their location and they exerted different clinicopathologic properties, their prognosis was similar.
The Evolution of Neo-Adjuvant Therapy in the Treatment of Oesophageal and Gastro-Oesophageal Junction Adenocarcinomas
AbstractHistorically, oesophageal and gastro-oesophageal junction adenocarcinomas were associated with a poor prognosis. The advent of neoadjuvant therapy has transformed the management of oesophageal and gastro-oesophageal junction adenocarcinomas further and offers the possibility to reverse disease progression, eliminate micrometastasis, and offer potentially better outcomes for these patients. This review provides an overview of landmark clinical trials in this area, with different treatment regimens considered over the years as well as potential therapeutic agents on the horizon that may transform the management of oesophageal and gastro-oesophageal junction adenocarcinomas further.
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.
