DeCure for Ovarian large-cell neuroendocrine carcinoma
DeCure's autonomous Cancer AI scientist is researching a drug-repurposing hypothesis for ovarian large-cell neuroendocrine carcinoma — screening already-approved drugs against its 3-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleOvarian large-cell neuroendocrine carcinoma maps to a 3-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 ovarian large-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
IKAROS family zinc finger 1 (IKZF1) — IKZF1 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 3-chloro-4-methylphenyldrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 9Q2D · 2.94 Å · ligand 1-(3-chloro-4-methylphenyl)-3-({2-[(3S)-2,6-dioxopiperidin-3-yl]-1-oxo-2,3-dihydro-1H-isoindol-5-yl}methyl)urea (85C). Experimental structure, not a prediction.
What the evidence adds up to
Ovarian large-cell neuroendocrine carcinoma is a rare diagnosis, representing less than 1% of all ovarian neoplasms and 0.9% of cases in a Surveillance, Epidemiology, and End Results database study that identified 219 such patients among 23,917 women with ovarian cancer. That same study found that women with ovarian large-cell neuroendocrine carcinoma were less likely to receive adjuvant chemotherapy (54.8% versus 81.9%) and more likely to receive radiotherapy (3.2% versus 1.5%) than women with high-grade serous ovarian cancer. Overall and cancer-specific survival rates were significantly lower for ovarian large-cell neuroendocrine carcinoma than for high-grade serous ovarian cancer, and stage, chemotherapy, and tumour size were independent predictors of overall survival.
A 2013 case report described a patient whose cancer spread to distant organs within one year of primary surgery despite stage Ia disease and platinum-based adjuvant chemotherapy; the tumour was resistant to that chemotherapy. In a review of published works, the same report noted that ovarian large-cell neuroendocrine carcinoma cases show poor prognoses regardless of adjuvant chemotherapy following complete resection, with a median overall survival of 10 months in stage I cases. Two further case reports from 2022 described a fulminant clinical course with a short period of survival even when diagnosed at an early stage.
A 2025 review of 32 articles published between 2014 and 2024 concluded that ovarian neuroendocrine neoplasms remain understudied, with most data coming from case reports and small series. Treatment strategies are empirical and largely extrapolated from extra-ovarian neuroendocrine tumours because no specific guidelines exist. The same review noted that diagnosis is often incidental after surgery for presumed epithelial ovarian cancer. An earlier editorial proposed that an international tumour registry with an accompanying tissue bank could advance research and identify molecular treatment targets.
What is still missing is a standardised first-line treatment strategy, prospective clinical trials, and a sufficiently large patient cohort to allow robust subgroup analyses. The rarity of the disease means that even large database studies capture only a few hundred cases, and no trial has yet tested a drug specifically for ovarian large-cell neuroendocrine carcinoma. Patient stratification by histotype, stage, and molecular profile remains impossible without a central registry and systematic tissue collection.
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 obstetrics and gynaecology research · 2013 · 15 citations
Poor prognosis of ovarian cancer with large cell neuroendocrine carcinoma: Case report and review of published works
AbstractLarge cell neuroendocrine carcinoma (LCNEC) is well-reported to result in unfavorable prognoses in many organ cancers while being rarely reported in gynecologic cancer, especially ovarian and endometrial cancers. Here we report a case of ovarian cancer with LCNEC which spread to distant organs within 1 year of primary surgery despite the fact that the post-surgical stage was Ia. The case received platinum-based chemotherapy as an adjuvant therapy after her curative surgery. However, LCNEC in the case was resistant to the chemotherapy. In our review of published works, ovarian cancer cases with LCNEC show poor prognoses regardless of adjuvant chemotherapy following complete resection. Median overall survival was 10 months in stage I cases. Development of chemotherapy sensitive for LCNEC is needed.
World Journal of Clinical Oncology · 2014 · 9 citations · open access
Large cell neuroendocrine carcinoma of the ovary: A pathologic entity in search of clinical identity
AbstractLarge cell neuroendocrine carcinoma (LCNEC) of the ovary is a rare diagnosis and only a few dozen cases have been reported in the literature. It is characterized by large pleiomorphic cells with large round or oval nuclei, presence of mitoses and staining for neuroendocrine (NE) markers such as chromogranin A, synaptophysin, neuron specific enolase. This editorial gives a brief overview of this histologic type of ovarian carcinomas. LCNEC of the ovary is a pathologic entity that may not be diagnosed purely on clinical grounds due to the similarity of its clinical features with those of the more common epithelial ovarian cancers. Nevertheless the diagnosis is worth-making from a practical point of view in order to consider treatments tailored towards the NE component if it is dominant or it becomes dominant during the natural evolution of the disease. Establishment of an international tumor registry with an accompanying tumor tissue bank of ovarian LCNEC could be a means of obtaining further knowledge on clinical characteristics and advance research on this rare entity. This will further inform on treatment strategies and could identify future molecular treatment targets.
Frontiers in Oncology · 2022 · 8 citations · open access
Differences in Characteristics and Outcomes Between Large-Cell Neuroendocrine Carcinoma of the Ovary and High-Grade Serous Ovarian Cancer: A Retrospective Observational Cohort Study
AbstractBackground: Owing to its extremely low incidence and the paucity of relevant reports, there is currently no recognized first-line treatment strategy for ovarian large-cell neuroendocrine carcinoma, and there are no statistics related to prognosis derived from large samples. This study aimed to investigate the characteristics, outcomes, and independent predictors of survival for ovarian large-cell neuroendocrine carcinoma and compare them with those of high-grade serous ovarian cancer. Methods: The Surveillance, Epidemiology, and End Results database was used to identify women diagnosed with ovarian large-cell neuroendocrine carcinoma or high-grade serous ovarian cancer from 1988 to 2015. Clinical, demographic, and treatment characteristics were compared between the groups. Propensity-score matching, Cox risk regression analysis, and Kaplan-Meier survival curves were used to analyze the data. Results: In total, 23,917 women, including 23,698 (99.1%) diagnosed with high-grade serous ovarian cancer and 219 (0.9%) diagnosed with ovarian large-cell neuroendocrine carcinoma, were identified. Age >77 years, diagnosis before 2003-2010, and advanced-stage disease were more common in patients with ovarian large-cell neuroendocrine carcinoma than in those with high-grade serous ovarian cancer. Women with ovarian large-cell neuroendocrine carcinoma were less likely to receive adjuvant chemotherapy (54.8% vs. 81.9%) but more likely to receive radiotherapy (3.2% vs. 1.5%; both P<0.001) than women with high-grade serous ovarian cancer. Stage, chemotherapy, and tumor size were independent predictors of overall survival, and the risk of death was greater in the advanced stage than in the early stage (P=0.047). Chemotherapy and tumor size were also independent predictors of cancer-specific survival. Overall and cancer-specific survival rates were significantly low for ovarian large-cell neuroendocrine carcinoma than for more malignant high-grade serous ovarian cancer. Conclusions: Compared to patients with high-grade serous ovarian cancer, those with ovarian large-cell neuroendocrine carcinoma presented more often with advanced-stage disease and had decreased overall and cancer-specific survival rates.
Indian Journal of Pathology and Microbiology · 2022 · 3 citations · open access
Neuroendocrine carcinoma of ovary: Hitherto rare entity in primary ovarian tumors
AbstractNeuroendocrine neoplasms (NEN) of the female genital tract are extremely uncommon. These tumors can be broadly divided into well differentiated (carcinoid) and poorly differentiated NEN (small cell and large cell carcinomas). Occurrence of neuroendocrine carcinomas (NECs) in ovary has rarely been reported. These high-grade malignant tumors have a fulminant clinical course with a short period of survival, even when diagnosed at an early stage. We hereby report two cases of primary neuroendocrine carcinoma of the ovary.
Journal of Clinical Medicine · 2025 · 1 citations · open access
Ovarian Neuroendocrine Neoplasms: Challenges and Future Perspectives
AbstractBackground: Ovarian neuroendocrine neoplasms (O-NENs) are extremely rare, representing less than 1% of all ovarian neoplasms and under 5% of all neuroendocrine tumors (NETs). They encompass two primary histological subtypes: well-differentiated carcinoids and poorly differentiated neuroendocrine carcinomas, which display distinct biological behaviors and prognoses. The ovary can also be a site of metastasis from extra-ovarian NETs. Owing to their rarity, clinical management lacks standardization, and diagnosis is often incidental following surgery for presumed epithelial ovarian neoplasms. Objectives: This review aims to provide an updated synthesis of current evidence on the epidemiology, pathogenesis, clinical presentation, diagnosis, treatment strategies, and prognosis of O-NENs, highlighting unmet clinical needs. Methods: A literature search was performed on PubMed for the years 2014–2024 using the keywords: “ovarian neuroendocrine tumor”, “ovarian neuroendocrine neoplasm”, “ovarian neuroendocrine carcinoma”, and “ovarian carcinoid”. Only articles published in English were considered. Given the rarity of the disease, in addition to meta-analyses and systematic reviews, relevant case reports and case series were also included to provide a comprehensive clinical picture, yielding 32 eligible articles. Results: Evidence indicates that O-NENs remain understudied, with most data derived from case reports and small series. Clinical presentations vary from asymptomatic masses to hormone-related syndromes, often mimicking other ovarian pathologies. Diagnostic work-up typically follows the same protocol as epithelial ovarian cancer, with the neuroendocrine nature only recognized postoperatively. Treatment strategies are empirical and largely extrapolated from extra-ovarian NETs due to the absence of specific guidelines. Prognosis varies widely depending on histotype, stage, and secretory activity. Conclusions: O-NENs pose significant diagnostic and therapeutic challenges due to their rarity and heterogeneity. Greater clinical awareness, multidisciplinary management, and multicenter research are essential to establish evidence-based protocols and improve patient outcomes.
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.
