DeCure's autonomous Cancer AI scientist is researching a drug-repurposing hypothesis for urethra clear cell adenocarcinoma — screening already-approved drugs against its 15-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleUrethra clear cell adenocarcinoma maps to a 15-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 urethra clear cell 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
KRas proto-oncogene, GTPase (KRAS) — KRAS 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 gnpdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 7VVB · 1.7 Å · ligand PHOSPHOAMINOPHOSPHONIC ACID-GUANYLATE ESTER (GNP). Experimental structure, not a prediction.
What the evidence adds up to
Clear cell adenocarcinoma of the urethra is a very rare entity; a 1981 case report describes the fourth case in the literature, a 35-year-old woman whose tumour infiltrated the outer muscular layer of the bladder and spread to paraaortic lymph nodes. The final outcome was fatal despite combined extensive surgery, cytostatic drugs and radiotherapy.
A 2020 case report describes a 40-year-old woman with metastatic clear cell adenocarcinoma of the urethra who received personalised chemotherapy after genetic testing. She was treated with non-platinum-based paclitaxel and bevacizumab. After three cycles she had significant clinical improvement and a definite improvement in size and metabolic activity on FDG-PET. She achieved a complete response after six cycles by PET scan. After 11 cycles of paclitaxel and bevacizumab a subsequent PET scan confirmed progression of metastatic disease. She then received two cycles of doxorubicin, after which a PET scan showed a mixed response.
A 2021 case report describes a patient with advanced primary clear cell adenocarcinoma of the urethra who had a dramatic and almost complete response to anti-PD-1 therapy in the fourth line setting. The authors note there is no high-level evidence to guide treatment for these rare tumours. A 2023 review states that primary urethral carcinomas account for less than one percent of all genitourinary cancers; English literature to that date describes only 17 previous cases in males, and the authors present an 18th case in a 29-year-old man. There are no definitive treatment guidelines.
What is still missing: prospective trials are impossible for a tumour this rare, so evidence will remain limited to single case reports. There is no standardised genetic testing protocol to guide chemotherapy selection, and no data on which patients might benefit from immunotherapy versus chemotherapy. The durability of responses to any regimen is unknown, and no biomarker for patient stratification exists.
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 Urology and Nephrology · 1981 · 10 citations
Clear Cell Adenocarcinoma of the Urethra
AbstractClear cell adenocarcinoma of the urethra is a very rare entity. The presented case in a 35-year-old woman is the fourth in the literature. The tumour was localized in the wall of the urethra and infiltrated into the outer muscular layer of the urinary bladder. Metastatic spread was found in the paraaortic lymph nodes up to the level of the renal arteries. The final outcome was fatal in spite of the combined treatment with extensive surgery, cytostatic drugs and radiotherapy.
World Journal of Clinical Oncology · 2020 · 5 citations · open access
Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report
AbstractBACKGROUND: Clear cell adenocarcinoma of the urethra is a rare type of aggressive cancer with a poor prognosis. Clear cell carcinoma of the urethra represents less than 0.02% of all malignancies in women. Adenocarcinomas account for 10% of female urethral carcinomas, of which 40% are the clear cell variant. Determining the presence or absence of certain mutations through genetic testing may predict whether a patient with cancer may benefit from a particular chemotherapy regimen. CASE SUMMARY: A 40-year-old woman presented with a 3-year history of slow urinary flow and a 3-mo history of urinary urgency and frequency as well as gross hematuria. An abdominal and pelvic computed tomography scan demonstrated enlarged lymph nodes in the abdomen and pelvis. A biopsy of a left inguinal lymph node microscopically confirmed a metastatic adenocarcinoma of the urethra. Specialized genetic testing determined personalized chemotherapy. She was treated successfully with a non-platinum-based chemotherapy consisting of paclitaxel and bevacizumab. Following 3 cycles of paclitaxel and bevacizumab, she attained significant clinical improvement, and response by FDG-Positron emission tomography (PET) imaging showed a definite improvement in size and metabolic activity. She achieved complete response after 6 cycles of therapy by PET scan. The patient concluded 11 cycles of paclitaxel and bevacizumab, and a subsequent PET scan confirmed progression of metastatic disease. The patient was then treated with two cycles of doxorubicin after which a PET scan revealed a mixed response to the treatment. CONCLUSION: We report the first case of a patient with metastatic clear cell adenocarcinoma of the urethra who underwent personalized chemotherapy after testing for cancer gene alterations. Our unique case represents the safe and effective use of non-platinum-based chemotherapy in clear cell adenocarcinoma of the urethra.
Clear cell urethral adenocarcinoma – a case report of an exceptional response to immunotherapy in a metastatic rare tumour
AbstractPrimary clear cell adenocarcinoma of the urethra is extremely rare. Given the rarity of these tumours there is no high-level evidence available to guide treatments. Localized disease is typically treated with primary surgery or concurrent chemo-radiotherapy. In the advanced disease setting treatment options are limited and decisions are based on evidence in disease subtypes where similarities exist. Immuno-oncology and the use of checkpoint inhibitors, particularly for metastatic disease has transformed clinical practice over the past few years and patient outcomes continue to improve as a result of their introduction. Here we report the first case, to our knowledge, of a patient with advanced primary clear cell adenocarcinoma of the urethra who had a dramatic and almost complete response to anti-PD-1 therapy in the fourth line setting. Level of evidence: 4
Journal of Urological Surgery · 2023 · 0 citations · open access
Male Urethral Clear Cell Adenocarcinoma: Case Presentation and Literature Review of a Rare Cancer
AbstractPrimary urethral carcinomas account for less than one percent of all genitourinary cancers. Primary clear cell adenocarcinoma of the urethra (CCAU) is an extremely rare and aggressive tumor which predominantly presents in adult women but has rarely been documented in males. Diagnosis of CCAU is difficult as its clinical presentation shows significant overlap with various other conditions and carcinomas. Controversies remain regarding the histogenesis of CCAU. The histological diagnosis can be challenging and there are no definitive treatment guidelines. English literature to date only describes 17 previous cases of CCAU in males. Here we present an 18th case in a 29-year-old man.
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.
