DeCure's autonomous Cancer AI scientist is researching a drug-repurposing hypothesis for Kidney Medullary Carcinoma — screening already-approved drugs against its 23-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleKidney Medullary Carcinoma maps to a 23-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 kidney medullary 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
isocitrate dehydrogenase (NADP(+)) 1 (IDH1) — IDH1 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 ictdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 6BKX · 1.65 Å · ligand ISOCITRIC ACID (ICT). Experimental structure, not a prediction.
What the evidence adds up to
A 1999 case report describes a 12-year-old boy with sickle cell trait and metastatic renal medullary carcinoma. After surgical removal of the primary tumour, he received chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin. The disease was stable for six months, then progressed. He was then given ifosfamide, etoposide, carboplatin, and topotecan. He died of progressive disease 15 months from diagnosis. The report states that renal medullary carcinoma is a highly chemotherapy-resistant tumour, that average survival after diagnosis is 15 weeks, and that the longest survival previously reported in the literature was 12 months from diagnosis. The patient in this report survived longer than previously described patients before dying of progressive disease.
Three cases from 2004 describe young black men with sickle cell trait, aged 20, 33, and 33 years, who presented with haematuria, flank pain, and a renal mass. Cytologic specimens showed cohesive groups of cells with vacuolated cytoplasm and irregular nuclei. Two patients tested for the bcr/abl rearrangement were negative. The authors note that renal medullary carcinoma should be considered in the differential diagnosis for young black men with sickle cell disease or trait who present with haematuria or a renal mass, and that clinical findings are key to diagnosis.
The 2022 NCCN guidelines for kidney cancer stratify treatment recommendations by histology and risk group for clear cell RCC, but do not specifically address renal medullary carcinoma. A 2009 review notes that renal medullary carcinoma is one of several entities for which molecular genetic diagnostic techniques may introduce new biomarkers and that identifying defective signalling pathways could allow development of therapies that selectively target aberrant protein activity. A 2004 gene expression profiling study of renal medullary carcinoma is listed but no results are provided in the abstract.
What is missing is any prospective trial designed specifically for renal medullary carcinoma, a reliable molecular target validated in this tumour, and a patient stratification strategy that accounts for sickle cell trait status. No drug has shown reproducible efficacy in a controlled study.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Journal of the National Comprehensive Cancer Network · 2022 · 664 citations · open access
Kidney Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology
AbstractThe NCCN Guidelines for Kidney Cancer focus on the screening, diagnosis, staging, treatment, and management of renal cell carcinoma (RCC). Patients with relapsed or stage IV RCC typically undergo surgery and/or receive systemic therapy. Tumor histology and risk stratification of patients is important in therapy selection. The NCCN Guidelines for Kidney Cancer stratify treatment recommendations by histology; recommendations for first-line treatment of ccRCC are also stratified by risk group. To further guide management of advanced RCC, the NCCN Kidney Cancer Panel has categorized all systemic kidney cancer therapy regimens as "Preferred," "Other Recommended Regimens," or "Useful in Certain Circumstances." This categorization provides guidance on treatment selection by considering the efficacy, safety, evidence, and other factors that play a role in treatment selection. These factors include pre-existing comorbidities, nature of the disease, and in some cases consideration of access to agents. This article summarizes surgical and systemic therapy recommendations for patients with relapsed or stage IV RCC.
Archives of Pathology & Laboratory Medicine · 2009 · 56 citations
Recent Developments in the Pathology of Renal Tumors: Morphology and Molecular Characteristics of Select Entities
AbstractAbstract Context. —Renal cell carcinoma is a heterogeneous group of tumors with distinct histopathologic features, molecular characteristics, and clinical outcome. These tumors can be sporadic as well as familial or associated with syndromes. The genetic abnormalities underlying these syndromes have been identified and were subsequently found in corresponding sporadic renal tumors. Objective. —To review the recent molecular and genetic advancements relating to sporadic and familial renal carcinomas as well as those related to Xp11.2 translocation– associated renal cell carcinoma and renal medullary carcinoma. Data Sources. —Literature review, personal experience, and material from the University of Chicago. Conclusions. —Molecular genetic diagnostic techniques will continue to introduce new biomarkers that will aid in the differential diagnosis of difficult cases. The identification of specific signaling pathways that are defective in certain renal tumors also makes possible the development of new therapies that selectively target the aberrant activity of the defective proteins.
Journal of Pediatric Hematology/Oncology · 1999 · 47 citations
Prolonged Survival of a Patient With Sickle Cell Trait and Metastatic Renal Medullary Carcinoma
AbstractPURPOSE: The treatment and outcome of a patient with sickle cell trait and metastatic renal medullary carcinoma is described. PATIENT AND METHODS: A 12-year-old boy with sickle cell trait had metastatic renal medullary carcinoma. After surgical resection of the primary tumor, he received chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin. The carcinoma progressed after a 6-month period of stable disease. At that time, he received chemotherapy including ifosfamide, etoposide, carboplatin, and topotecan. RESULTS: The patient died of progressive disease 15 months from diagnosis. The patient's tumor in this report showed no progression while he was receiving methotrexate, vinblastine, doxorubicin, and cisplatin, but eventually became refractory to these and other cytotoxic agents. CONCLUSION: Renal medullary carcinoma is a highly chemotherapy-resistant tumor. Average survival after diagnosis is 15 weeks; the longest survival reported in the literature is 12 months from diagnosis. The patient in this report survived longer than the previously described patients before dying from progressive disease.
AbstractBACKGROUND: Renal medullary carcinoma is a rare tumor that is most common in young black men with sickle cell disease or trait. Patients often present with advanced disease at the time of diagnosis, and their prognosis is poor, even with aggressive therapy. The clinical and pathologic features of renal medullary carcinoma have been described in several articles, but reports describing the cytologic features are rare. METHODS: In the current report, the authors describe the cytologic features of three cases of renal medullary carcinoma. The patients were young black men with sickle cell trait ages 20 years, 33 years, and 33 years. RESULTS: All three patients presented with hematuria, flank pain, and a renal mass. The cytologic specimens from all three patients showed primarily cohesive groups of cells with vacuolated cytoplasm that often displaced or indented the nuclei. The nuclei often had irregular membranes, coarse or vesicular chromatin, and prominent nucleoli. Both of the two patients who were tested with fluorescence in situ hybridization were negative for the bcr/abl rearrangement. CONCLUSIONS: Renal medullary carcinoma should be considered in the differential diagnosis of patients who present with hematuria or a renal mass, especially in young black men with sickle cell disease or trait. Cytologically, renal medullary carcinoma cells appear similar to the cells in high-grade carcinoma. Immunohistochemical studies can be helpful in distinguishing renal medullary carcinoma from other poorly differentiated kidney tumors, except for collecting duct carcinoma. The clinical findings are key to diagnosing renal medullary carcinoma.
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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