DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for rectum adenoma — screening already-approved drugs against its 16-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleRectum adenoma maps to a 16-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
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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 rectum adenoma 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
NRAS proto-oncogene, GTPase (NRAS) — NRAS 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 gdpdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 6ZIO · 1.55 Å · ligand GUANOSINE-5'-DIPHOSPHATE (GDP). Experimental structure, not a prediction.
What the evidence adds up to
A 2016 retrospective series of 51 patients treated with transanal minimally invasive surgery (TAMIS) for rectal adenoma reported a median tumour diameter of 32 mm (range 4–60 mm) and a median distance from the anal verge of 8 cm. Median operative time was 40 minutes and median hospital stay was 1 day. Overall 30-day morbidity was 12%, comprising four grade 1, one grade 2, and one grade 3 complications by the Accordion classification. However, 22% of patients had a positive resection margin and a further 31% had an indefinable margin status, mostly due to tissue fragmentation. Median follow-up was only 7 months, and the authors concluded that the role of TAMIS remains undefined pending comparative studies.
An earlier Swedish series from 2005 described 180 endoscopic transanal resection procedures in 131 patients, with adenoma confirmed in 160 operative cases. Among adenoma patients, a single resection sufficed in 77 cases, 16 required more than one session because of large size, and 27 developed recurrences needing further resection or surgery. Median time to recurrence was 7 months, but no recurrent rectal carcinomas were seen. Complications occurred in 16 operative cases, including two bowel perforations requiring a Hartmann's procedure and one reoperation for bleeding; there were no perioperative deaths. Median follow-up without recurrence was 32 months. A 1984 report of four cases described successful resection of large rectal adenomas using a standard 28Fr urological resectoscope, noting speed, ease, and rapid recovery, but provided no long-term outcome data. A 2013 case report described a 14 cm sessile villous adenoma resected by rectal stump eversion with external coloanal anastomosis, with free margins and satisfactory surgery, but again represents only a single case.
A 2000 retrospective examination of 340 rectosigmoid adenomas in 255 patients found 102 adenomas in the rectum and 238 in the sigmoid colon. High-grade dysplasia was present in 39 rectal adenomas versus 48 sigmoid adenomas, a significantly higher proportion in the rectum (p < 0.02). The authors suggested that cancer development may differ between rectal and sigmoid adenomas. A 1939 review noted that rectal adenomas are uncommon in childhood, citing series where only 25 tumours were found among 58,970 children and 4 cases among 120,000 children, with no adenomas in 1,783 autopsies of children under 11 years. A 2011 Russian review reiterated the adenoma–carcinoma sequence and argued for endoscopic diagnosis and ablation as effective prophylaxis, but provided no new data.
The evidence base is limited to retrospective case series and case reports, with no randomised or comparative trials. The 2016 TAMIS series shows a substantial rate of positive or indefinable margins, which is a direct concern for completeness of excision. Follow-up durations are short, and recurrence data are inconsistent across techniques. What is missing is a prospective comparative trial of TAMIS versus endoscopic transanal resection or transanal endoscopic microsurgery, with standardised margin assessment, longer follow-up, and stratification by adenoma size, location, and dysplasia grade. Without such data, the optimal surgical approach for rectal adenoma, particularly for large or high-grade lesions, remains unresolved.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Scandinavian Journal of Gastroenterology · 2016 · 25 citations
A critical appraisal of transanal minimally invasive surgery (TAMIS) in the treatment of rectal adenoma: a 4-year experience with 51 cases
AbstractOBJECTIVE: The aim of this study was to describe feasibility, postoperative morbidity, and histological outcome of transanal minimally-invasive surgery (TAMIS) in patients with rectal adenoma. MATERIAL AND METHODS: All patients who underwent TAMIS at a single institution from December 2011 to December 2015 were retrospectively included in the study. Feasibility was based on tumor size, distance of tumor from the anal verge, operative time, and hospital stay. Thirty-day morbidity was defined by the revised Accordion Classification system. Histological outcome included microscopic resection margin status, specimen fragmentation status, and grading of dysplasia in rectal adenoma. RESULTS: A total of 51 patients with rectal adenoma underwent TAMIS. The median tumor diameter was 32 (4-60) mm and the median distance from the anal verge 8 (3-14) cm. Median operative time was 40 (13-116) min and median length of hospital stay was 1 (0-25) days. Overall morbidity was 12% (four grade 1, one grade 2, and one grade 3 complications). 22% had a positive resection margin, whereas 31% had an indefinable resection margin status mostly due to tissue fragmentation. Median follow-up time was 7 (0-40) months. CONCLUSIONS: TAMIS is a challenging surgical technique for treatment of rectal adenoma. Our initial experience among 51 patients resulted in a high proportion of positive resection margins and a high fragmentation rate. The role of TAMIS in the treatment of rectal adenoma is to be defined through comparative studies.
American journal of diseases of children · 1939 · 24 citations
ADENOMA OF THE RECTUM IN CHILDREN
AbstractAdenoma of the rectum in children has received little attention in the literature. Its importance as a causal factor in rectal bleeding, in prolapse, in discharge and in constipation should be given consideration. Dewis,<sup>1</sup>in 1906, reviewing 219 cases of benign tumor of the gastrointestinal tract, found 101 cases of tumor in the rectum. Of these, 81, or 80 per cent, were cases of adenoma. Erdmann and Morris,<sup>2</sup>in 1925, stated that in their series 63 per cent of the tumors of the rectum were adenomas. Rectal adenomas are uncommon in childhood. Bokay,<sup>3</sup>in studying the records of 58,970 children, found only 25 such tumors. Kronenberg,<sup>4</sup>examining 120,000 children, reported only 4 cases. Lawrence,<sup>5</sup>reviewing 7,000 cases of gastrointestinal adenoma from the autopsy records of the Cook County Hospital, noted that among 1,783 children under 11 years of age there was no instance of adenoma
Diseases of the Colon & Rectum · 2005 · 10 citations
Experience of Endoscopic Transanal Resections With a Urologic Resectoscope in 131 Patients
AbstractPURPOSE: Endoscopic transanal resection of rectal adenomas and other presumably benign lesions is not widespread. The purpose of this study was to evaluate the efficacy and the safety of endoscopic transanal resection. METHODS: Patients who underwent endoscopic transanal resection at three Stockholm hospitals between 1993 and 2004 were studied retrospectively with respect to patient and lesion characteristics, complications, follow-up time, and recurrence rates. RESULTS: One hundred eighty endoscopic transanal resection procedures were performed in 131 patients. The tissue diagnosis was adenoma in 160 operative cases, cancer in 12 operative cases, and hyperplasia, fibrosis, or normal mucosa in the remaining 8 operative cases. Among the patients with rectal adenomas, one endoscopic transanal resection was sufficient in 77 cases and in 16 cases the surgery was performed in more than one session because of the large size of the adenoma. In 27 cases there were recurrences that needed additional endoscopic transanal resection or other surgery. The median time until recurrence was seven months, but there were no recurrent rectal carcinomas. In 16 operative cases there were complications. Two patients had to undergo a Hartman's procedure as a result of a bowel perforation, and one patient had to be reoperated on because of bleeding. There were no perioperative deaths. The median follow-up time without recurrence was 32 (range, 0-67) months. CONCLUSIONS: Endoscopic transanal resection is a feasible and oncologically safe option for treatment of rectal adenomas, especially in cases where conventional transanal resection or transanal endoscopic microsurgery are unavailable or unsuitable because of the characteristics and localization of the lesion.
Australian and New Zealand Journal of Surgery · 1984 · 9 citations
RESECTOSCOPICTRANSANAL RESECTION OF EXTENSIVE RECTAL ADENOMAS
AbstractTreatment of many rectal adenomas has hitherto been technically difficult because of poor access and extensive lesion size. Four cases are presented where a large rectal adenoma has been successfully resected using a Standard 28Fr urological resectoscope. This is the first known report of this means of treatment. The speed and ease of the technique and the usually pain-free and rapid recovery of the patients has been encouraging.
International Journal of Surgery Case Reports · 2013 · 6 citations · open access
Giant rectal villous adenoma
AbstractINTRODUCTION: Colorectal cancer is an important cause of death. Most cases of colon and rectal cancer arise from a preexisting adenomatous polyp. However, if colorectal polyps are very large or not accessible for endoscopic ablation, or if they cannot be removed without an increased risk of perforation, surgical procedures are required. PRESENTATION OF CASE: The case of a patient with a giant villous adenoma of the rectum is described. The patient had diarrhea for 2 years associated with asthenia. Colonoscopy revealed a sessile lesion in the rectum measuring 14cm in the largest diameter. Rectal eversion technique was used, resecting the lesion under direct visibility and an external coloanal anastomosis was performed. Surgery was satisfactory and the resection margins were free. DISCUSSION: Removal of these polyps should be performed aiming to reduce the incidence of colorectal cancer, as well as to control local and systemic symptoms, such as diarrhea and fluid and electrolyte disorders, mainly in villous adenomas. Various surgical techniques are proposed, but in extensive circumferential lesions of the rectum they are difficult to apply. The rectal stump eversion technique was described by Maunsell (1892), for rectal cancer. CONCLUSION: Eversion of the rectal stump and external coloanal anastomosis may be a good surgical alternative for resecting giant rectal adenomas.
The American Journal of Gastroenterology · 2000 · 4 citations
Differences Between Features of Adenoma in The Rectum Versus Sigmoid Colon
AbstractOBJECTIVE: Although the prevalence of cancer in the rectosigmoid is high compared with that in the more proximal colon, the features of cancer developing from an adenoma have yet to be elucidated. The aim of this study is to examine the clinicopathological relationship between cancer and adenoma in the rectosigmoid. METHODS: A total of 340 adenomas located in the rectosigmoid in 255 patients were retrospectively examined regarding such clinicopathological factors as location and the grade of dysplasia. RESULTS: The prevalence of adenoma was 102 in the rectum and 238 in the sigmoid colon, respectively, whereas the prevalence of adenoma with high-grade dysplasia was 39 in the rectum and 48 in the sigmoid colon, respectively. This prevalence of adenoma with high-grade dysplasia was thus significantly higher in the rectum than in the sigmoid colon (p < 0.02). CONCLUSIONS: These findings suggest the possibility of different types of cancer development between adenoma of the rectum and sigmoid colon.
The American Journal of Gastroenterology · 2000 · 1 citations
Differences between features of adenoma in the rectum versus sigmoid colon
AbstractOBJECTIVE: Although the prevalence of cancer in the rectosigmoid is high compared with that in the more proximal colon, the features of cancer developing from an adenoma have yet to be eluciated. The aim of this study is to examine the clinicopathological relationship between cancer and adenoma in the rectosigmoid. METHODS: A total of 340 adenomas located in the rectosigmoid in 255 patients were retrospectively examined regarding such clinicopathological factors as location and the grade of dysplasia. RESULTS: The prevalence of adenoma was 102 in the rectum and 238 in the sigmoid colon, respectively, whereas the prevalence of adenoma with high-grade dysplasia was 39 in the rectum and 48 in the sigmoid colon, respectively. This prevalence of adenoma with high-grade dysplasia was thus significantly higher in the rectum than in the sigmoid colon (p < 0.02). CONCLUSIONS: These findings suggest the possibility of different types of cancer development between adenoma of the rectum and sigmoid colon.
Health and Ecology Issues · 2011 · 0 citations · open access
TACTICS OF CARE AFTER PATIENTS WITH RECTAL POLYPI
AbstractThe analysis of the late publications is evidence of the tendency to the rising rectal cancer incidence in the whole world. According to the data of World Health Organization every year more than 500 thousand cases of this disease are registered in the world. In the structure of oncologic incidence rate rectal cancer takes the second-third place in both men and women and goes second among the oncopathology death reasons in the majority of economically developed countries. The adenomatous polypi are known to develop the majority of rectal neoplasms. The chain «adenoma - cancer» has been proved by numerous researches and though not every adenoma tranforms into cancer, this is possible in a considerable number of the present neoplasms. In connection with this, the endoscopic diagnosis and ablation of adenomatous polypi of rectum and large intestine are effective methods of rectal cancer prophylaxis.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works using Disease Ontology synonyms, resolved on OpenAlex.
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