DeCure's autonomous Cancer AI scientist is researching a drug-repurposing hypothesis for vulvar melanoma — screening already-approved drugs against its 43-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleVulvar melanoma maps to a 43-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 vulvar melanoma 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
mitogen-activated protein kinase 1 (MAPK1) — MAPK1 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 2~{s}drag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 8AOJ · 1.12 Å · ligand 1-[(2~{S})-2-(5-methyl-3-pyridin-4-yl-1~{H}-pyrazol-4-yl)pyrrolidin-1-yl]propan-1-one (N8L). Experimental structure, not a prediction.
What the evidence adds up to
Vulvar melanoma accounts for 5–10% of all vulvar cancers and 3–7% of melanomas in women. A monocentric retrospective study of 29 patients (diagnosed 1993–2009) reported an average age at diagnosis of 62 years, an average Breslow thickness of 4.91 mm, and ulceration in 11 cases. Median overall survival was 69 months, and 5-year overall survival was 55.4%. Median event-free survival was 34 months. Positive lymph node status was associated with an increased risk of loco-regional recurrence (P=0.04). Positive lymph node status (P=0.06), Breslow thickness greater than 2 mm (P=0.05), and more than 10 mitoses per mm² (P=0.04) increased the risk of distant metastases. Age, ulceration, and type of surgery were not significantly associated with any type of event. The same trends for overall survival were observed but were not statistically significant.
Two case series from 2017 and 2021 describe the standard surgical approach as hemivulvectomy with lymph node dissection, with or without adjuvant therapies. The 2012 study included 11 patients who underwent wide local excision, 11 hemivulvectomy, and 7 radical vulvectomy. Sentinel node biopsy was performed in 23 patients, and at least one positive sentinel node was found in 8 cases. Eight patients received adjuvant therapy. The 2012 study concluded that conservative surgery with adequate margins may replace vulvectomy, and that sentinel node biopsy is feasible but its role requires further investigation. The 2021 review notes that less invasive surgical techniques have been developed to reduce postoperative morbidity and long-lasting sequelae.
Prognosis remains poor and unchanged despite treatment approach, according to the 2017 report. The 2012 study found that 10 patients had a second tumour other than melanoma, including breast cancer in 5 cases, and 4 patients had a second primary melanoma. The 5-year survival rate in the literature ranges from 8% to 55%. No drug therapy is mentioned in any of the three abstracts. What is still missing are prospective trials that can test whether sentinel node biopsy improves outcomes, and studies that stratify patients by the prognostic factors identified (lymph node status, Breslow thickness, mitotic count) to guide surgical and adjuvant decisions. Funding for multi-centre registries or randomised surgical trials is absent.
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 American College of Surgeons · 1999 · 35 citations
A survey of hospital management practices for vulvar melanoma11The National Cancer Data Base is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society.22No competing interests declared.
AbstractBACKGROUND: Vulvar melanoma is a very rare form of cancer. The purpose of this study was to describe practice patterns for the management of vulvar melanoma. STUDY DESIGN: The National Cancer Data Base was reviewed from 1985 through 1994 for patient reports submitted with a diagnosis of vulvar melanoma. RESULTS: Five hundred sixty-nine patients with vulvar melanoma were identified. A substantial number of patients were older; during the latter period of this study (1990 to 1994), 50% were 70 years old or older. Surgery was used in more than 90% of patients with stages 0 to III. Local excision was used mainly in early-stage (0 and I) disease. Adjuvant therapy was used infrequently. Lymph node evaluation was performed in more than half of the patients, with greater frequency for patients who had advanced disease. The overall 5-year relative survival rate was 62%. If the lymph nodes contained metastases, survival was poor. Patients with recurrent disease also had poor survival. CONCLUSIONS: Surgery remains the mainstay of therapy for vulvar melanoma. The use of excision and radical operations remained constant during the 10 years of the study.
Anais Brasileiros de Dermatologia · 2017 · 14 citations · open access
Vulvar melanoma: relevant aspects in therapeutic management
AbstractCancer of the vulva accounts for at least 1% of malignant neoplasms among women. Although rare, vulvar melanoma is the second most common histological type of vulvar cancer, representing 7-10% of all malignant vulvar neoplasms. Initial symptoms are non-specific and complete excision of the lesion is indicated in cases with suspected diagnosis. Prognosis of patients with these neoplasms is poor and remains unchanged despite the treatment approach. Hemivulvectomy with lymph node dissection is the current procedure of choice, associated or not with adjuvant therapies. We report two cases of patients presenting with late diagnosed vulvar melanoma and the relevant aspects in their therapeutic management.
Case Reports in Oncology · 2021 · 4 citations · open access
Surgical Management of Vulvar Melanoma: A Case Series
AbstractVulvar malignant melanoma is the second most common subtype of vulvar cancer, accounting for 5-10% of all vulvar cancers. The prognosis is still very poor, although some advances have been achieved in the last years. One of the most significant changes in its management has been the development of less invasive surgical techniques that diminish the risk of postoperative morbidity and long-lasting sequelae. In this article, we review the surgical management of the pathology, based on the comment of 3 cases with vulvar melanoma treated at our institution.
Vulvar melanoma: A monocentric retrospective study on 29 cases.
Abstracte19036 Background: Vulvar melanoma (VM) represents 3-7% of melanoma in women. The 5-year survival rate ranges from 8 to 55%. Surgical excision represents the best definitive therapy but surgical radicality does not impact on recurrence or survival. Methods: Thirty women with histologically confirmed VM diagnosed between 1993 and 2009 were selected for this monocentric retrospective study. One patient with metastases at time of diagnosis was excluded from the statistical analysis. Clinical, pathological and follow-up data were collected. Cumulative incidences of events were calculated and compared across subgroups by means of the Gray test. Results: Average age at diagnosis was 62 years. Average Breslow thickness was 4.91 mm. Ulceration was present in 11 cases and was unknown in 5. One case of VM was multifocal at presentation. Eleven patients underwent a wide local excision, 11 a hemivulvectomy and 7 a radical vulvectomy Sentinel node biopsy was performed in 23 patients and at least one positive sentinel node was found in 8 cases. Eight patients received adjuvant therapy. Ten patients had a second tumor (other than melanoma); of these, a breast cancer was recorded in 5 cases. Four patients had a second primary melanoma: of the vulva (n=2), vagina (n=1), and urethra (n=1). Median follow-up among ongoing survivors was 79 months and median overall survival was 69 months. The 5-year overall survival was 55.4%. Median event free survival 34 months. Positive lymph nodal status was associated with an increased risk of loco-regional recurrences (P=0.04). Positive lymph nodal status (P=0.06), Breslow thickness > 2mm (P=0.05) and number of mitoses > 10/mm2 (P=0.04) increased the risk of distant metastases. Age, ulceration and type of surgery were not significantly associated with any type of event. Conclusions: Lymph node involvement, elevated depth of invasion and a high number of mitoses were the most important prognostic factors for locoregional recurrence and distant metastases. The same trends were observed for the overall survival, but results were not statistically significant. Conservative surgery in the form of wide local excision with adequate margins may replace vulvectomy. Sentinel node biopsy is feasible and its role in VM should be further investigated.
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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