8 ms·

Daily pill can double survival time for deadliest cancer, trial shows

172 points by c-oreills 4mo ago

Herodotus38 4mo ago
Source article for those interested: https://www.nejm.org/doi/full/10.1056/NEJMoa2505783 https://www.nejm.org/doi/full/10.1056/NEJMoa2505783 Paywalled but has a free access option if you make an account.
maxall4 4mo ago
Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2605555?query=featured_home https://www.nejm.org/doi/full/10.1056/NEJMoa2605555?query=fe...
amluto 4mo ago
Derek Lowe’s writeup is good: https://www.science.org/content/blog-post/progress-against-pancreatic-cancer-part-one https://www.science.org/content/blog-post/progress-against-p...
- matheist 4mo ago
  > The company says that the drug was generally well tolerated, but that’s on the oncology scale. > ... > He’s been on daraxonrasib since early this year, and describes it this way: “. . .it’s a nasty drug. It causes crazy stuff like my body can’t grow skin and so I bleed all out of a whole bunch of parts of me that shouldn’t be bleeding” If you go to that link above, be prepared, because he also looks like he’s had aqua regia thrown all over him (and apparently feels a bit like that, too). But his tumor volume has gone down by about 75%, and there’s a very strong chance that he wouldn’t still be alive at all without having gone on the drug.
  - stouset 4mo ago
    I am in the enviable position to not be actively dying from an untreatable disease, so obviously haven’t seen things from the other side of this sort of situation. But to me, that doesn’t sound like a life worth living. Obviously different people will have different thresholds for when to throw in the towel, and I’m glad that we are finding medicines to allow people to make the choices that align with their own drives. Still, I can’t help but think that this is the sort of life virtually none of us would choose to inflict on our pets, even if cost was no option. We give them a far more graceful exit from this world than we give ourselves, and I think that’s worth considering. I am truly terrified of death. I wish I wasn’t, but an infinity of nonexistence somehow seems unbearable (though, obviously, it will be trivial to bear in practice). I still hope that when my time comes, I will find the strength to exit gracefully if my life ever gets to the point where each day is filled with pain and discomfort, and where I can’t actually take part in any of the things I enjoy about life. I hope that this is only a temporary treatment for this guy to get the tumor to a point where it can be operated on or treated with other therapies. Because his life sounds like a living hell and that breaks my heart.
    - 317070 4mo ago
      I mean, he looks uncomfortable, but you would be surprised at how much people can tolerate when there is no alternative. Here is an interview I found [0]. I think he looks better than every 90 year old. But he also mentions that it still is terminal. [0] https://www.nytimes.com/video/opinion/100000010826256/what-dying-feels-like.html https://www.nytimes.com/video/opinion/100000010826256/what-d...
    - KittenInABox 4mo ago
      This may sound condescending but: you sound young, not disabled, and extremely sheltered from being exposed to disabled people. I am in a position to be intimately familiar with illness. I will say that health is a spectrum and the mind is incredibly resilient. You will surprise yourself as you inevitably age how much your mind will adapt to always hurting. There is more to life than body discomfort. This patient sounds like he has his faculties and is making an informed decision to continue living, because his life is worth the discomfort he is going through. I am reminded of a line along the lines of every day you experience, no matter how terrible, is very likely a day that someone else yesterday would have desperately wanted.
      - U4E4 4mo ago
        I find both the honesty and tact of your comment a generous gift. After watching the Sasse interview, reading the parent comment and reading your comment, I’m reminded abstractly how much of the emotional and psychological work of reconciling biological mortality is built on personal cognitive context that a mind-body builds over its cycles living in the world. So much about mortality is shared. But so much of the context for interpreting mortality is radically personal.
      - stouset 4mo ago
        There has been recent attention on what treatments oncologists choose for themselves when diagnosed with terminal illnesses—having seen firsthand what happens to quality of life for their patients—and what members of the general population choose. Doctors tend to choose the treatments that bias quality of life over quantity of life. That’s all I’m getting at here. I personally hope that if it ever comes to it, I will have the strength to choose something like three months of high QoL over one year of grinding daily misery as I have personally seen others do. Having your skin fail to regenerate, bleeding everywhere, and having skin that looks like you’ve had aqua regia poured over it seems to me like a poor quality of life. It sounded like a life of pain and one in which it would be difficult to do a lot of the things that bring me joy. Perhaps it’s not as bad as it sounds, and this is a poor example of it. I’m not judging this guy for his choices; they’re his to make. And maybe I’ve overestimated the amount of pain he’s in. But from the description above, it sounded awful.
  - dredmorbius 4mo ago
    Hand-foot syndrome, a/k/a chemotherapy-induced acral erythema, is a similar condition, though there may be another I'm confusing with. <https://en.wikipedia.org/wiki/Chemotherapy-induced_acral_erythema https://en.wikipedia.org/wiki/Chemotherapy-induced_acral_ery...> I'd first run across this decades ago in the context of FDA drugs trials, in which adverse incidents were noted. My understanding at the time was that certain chemotherapies tended to interfere with skin regeneration, particularly in areas subject to high wearing (hands, feet, elbows), or rapid replacement (particularly mucous membranes, lips and mouth especially). Not all chemotherapies are brutal, but some can be quite fiendish, and quality of life is a legitimate consideration when considering whether to proceed with treatment. Informed decisionmaking and consent in a context where expertise is rare and clinicians don't directly experience the adverse effects is difficult at best.
chilldsgn 4mo ago
I hope they can get this to people quickly. Someone I love has been diagnosed with stage 3 end of Feb this year and it's utter hell. For everyone, not just the patient.
- thowland 4mo ago
  While not fully approved, the company has early access available to people who meet the treatment criteria and would potentially benefit. Their HCP should evaluate this (it's not all types of pancreatic cancer, and it's not a silver bullet - but it looks like its double the survival time than current chemo). Hopefully this evolves into a new class of treatment.
- kennyadam 4mo ago
  Honestly. for the ~2 months my mum had between a totally out-of-the-blue stage 4 melanoma diagnosis and the day she died in the hospice, I don’t think there’s anything she would have wanted less than to endure more of that existence, if someone had offered her that pill.
  - chilldsgn 4mo ago
    I'm sorry your mom had to suffer like that :( My loved one really wants to live, and I suppose some people are at different stages of mind with this horrible disease. I wouldn't want to extend suffering too, but if the patient wants to fight the disease, it is up to them.
- adrian_b 4mo ago
  Unfortunately, it seems that this just provides an extra year of life or so. Of course this is better than nothing, but it is not a cure. Moreover, the link provided by another poster to an article that discusses the side effects, shows that they are unpleasant. Still, an extra year of life may provide a chance to survive until the appearance of a better solution.
  - ltbarcly3 4mo ago
    It's an extra 6 months or so, and it's almost certain a better solution won't be come available in that 6 months, and even if it did you are very close to death and unlikely to recover even if a miracle cure is developed. In the meantime you are in intense pain and suffering wild side effects.
StephenAmar 4mo ago
If you want to see what the side effects look like, look at ex Senator Ben Sasse: https://youtu.be/7CFo6-6BN9k?si=2B3dqB4rOhAnPiZl https://youtu.be/7CFo6-6BN9k?si=2B3dqB4rOhAnPiZl
rvnx 4mo ago
The founders of Lovable and Builder.ai individually received more funds than the whole group of the researchers behind this medicine...
- Retric 4mo ago
  That’s like talking about the ROI of a winning lottery ticket. We can’t know ahead of time which medicine works so you need to fund many teams at the beginning.
  - dredmorbius 4mo ago
    The pharmaceutical new drug development R&D market saw about $200 billion invested in 2025. <https://hardmanandco.com/research/corporate-research/2025-pharma-statistics/ https://hardmanandco.com/research/corporate-research/2025-ph...> Total VC tech investment in 2025 was $425 billion. <https://news.crunchbase.com/venture/funding-data-third-largest-year-2025/ https://news.crunchbase.com/venture/funding-data-third-large...>
    - deleted 4mo ago
      [deleted]
    - Retric 4mo ago
      You are excluding most government and charity funding into medical research. VC funding includes firms inside of the medical industry, but also companies operating across most of the economy. It’s not just IT, but food, solar, EV’s, rockets, etc. So, IMO these numbers are pretty reasonable.
      - dredmorbius 4mo ago
        I'm happy to see corrections with citations. I'd posted what information I could find. I found your original dismissal without any documentation unsatisfactory, and wanted to quantify overall rather than specific-firm-instance funding. And you're still not providing any citations for your claims. I suspect that the overall spend going into AI / adtech / digital media is disproportionately large relative to pharma spending. Particularly given the relative social benefits of each. I'd like to be able to make an evidence-based assessment rather than just a gut feel, however. Clear breakouts of total investment spend by sector are hard to find, presumably much of the accurate information is paywalled. However from a Bain report I'd turned up earlier: AI pulled in about half of all US venture funding in the fourth quarter, with investment spanning infrastructure, model training platforms, and AI-native developer tools. <https://www.bain.com/insights/global-venture-capital-outlook-latest-trends-snap-chart/ https://www.bain.com/insights/global-venture-capital-outlook...> Other significant sectors include, presumably in order, "robotics, AI, semiconductors, and Web3 sectors", and "Early-stage activity was strengthened by AI, robotics, defense tech, and biotech". All of which suggests that biotech is a small fraction of the overall total, and new drug discovery a smaller fraction of that. Total US pharmaceutical industry R&D spend per a 2021 Congressional Budget Office report was $83 billion. <https://www.cbo.gov/publication/57126 https://www.cbo.gov/publication/57126> US federally-funded medical research largely occurs through the National Institutes of Health, which has an annual budget of $48 billion. I'd be quite surprised if state-level and other countries' spend doubled that. It increases my earlier figure by about 20%, which isn't nothing, but pales next to the venture tech investment. Again, that's all medical spending, not limited to new drug discovery. <https://www.nih.gov/about-nih/organization/budget https://www.nih.gov/about-nih/organization/budget> As the previously-cited CBO report notes: "Much of that [NIH] funding has supported basic research (in genomics, molecular biology, and other life sciences) that has identified new disease mechanisms." So, not strictly new drug discovery, though not entirely unrelated either. Most new drug discovery is likely not venture-backed, so considering my top-line $400 billion vs. $200 billion still seems to point to a roughly-appropriate comparison ratio. If anything, further research suggests the $200 billion value for pharma is probably high-side when it comes to drugs.
mrandish 4mo ago
Totally naive question: is this a situation where stacking the drug with chemo might be even better?
- deleted 4mo ago
  [deleted]
- Drunk_Engineer 4mo ago
  There are some trials underway testing that hypothesis.
- mft_ 4mo ago
  Yes, with nuances. The recently-read-out trial is in the 'second line' - meaning patients will have received one 'line' of treatment before this - typically chemotherapy +/- surgery. The chemotherapy regimes used for pancreatic cancer can be pretty brutal, and patients can usually tolerate one, max two lines overall. As such, this trial administering only daraxonrasib monotherapy made sense. The first line trial of daraxonrasib is already underway, and includes both darax monotherapy and darax + chemo arms. (They are combining with a slightly less brutal chemotherapy called GnP, with an eye to the overall side effect burden considering the non-trial side effects that darax also brings.) It'll be very interesting to see the outcome of this trial; there are some examples elsewhere in oncology where a treatment is recommended by guidelines without chemotherapy over a combination with chemotherapy, as the small survival benefit the addition of chemotherapy brings is seen as outweighed by the additional toxicity.
shevy-java 4mo ago
[flagged]
- hackyhacky 4mo ago
  Always baffling to me that people accuse researchers and doctors, people who have devoted their life to helping others, of brazen greed and deception. With no evidence, of course. Maybe the accusation says more about you than about them?
  - SoftTalker 4mo ago
    The researchers and doctors probably have better motives but the pharmaceutical industry wants nothing more than getting you on a lifetime of prescriptions. They are just like street dealers but they dress better and blend in with normal society.
modzu 4mo ago
"survival" is the wrong word; its terminal. honestly the drugs and chemo and treatments they put pancreatic patients through for possibly a few more (not very nice) weeks is almost criminal. a good doctor will tell you to go make the most of those 3 months post diagnosis. that said its nice to see progress against one of the worst cancers out there and i hope it leads to genuine breakthroughs. but this drug is nothing anybody wants, even if they think they do
- infamia 4mo ago
  > "survival" is the wrong word; its terminal. No one actually knows that one way or the other since some patients were still taking it after the study ended according to the article.
  - adrian_b 4mo ago
    According to the abstract of the article, there were 2 groups of patients. One group had median values of 8.5 months for progression-free survival and 13.1 months for overall survival. The other group had median values of 8.1 months for progression-free survival and 15.6 months for overall survival. Overall Survival (OS) measures the time until death from any cause. Progression-Free Survival (PFS) evaluates how long a treatment can delay disease progression or death. So at least most of the patients from the study have died, because otherwise median values could not have been computed. Thus the treatment had provided them a median life extension of about 3/4 years. The lucky ones probably have got more than an extra year.
    - mft_ 4mo ago
      Your numbers are a little off. The NEJM article was published a few hours ago: https://www.nejm.org/doi/full/10.1056/NEJMoa2605555 https://www.nejm.org/doi/full/10.1056/NEJMoa2605555 RAS G12 population mOS: daraxonrasib 13.2 months / chemotherapy 6.6 months Overall population mOS: daraxonrasib 13.2 months / chemotherapy 6.7 months RAS G12 population mPFS: daraxonrasib 7.3 months / chemotherapy 3.5 months Overall population PFS: daraxonrasib 7.2 months / chemotherapy 3.6 months > Thus the treatment had provided them a median life extension of about 3/4 years. The lucky ones probably have got more than an extra year. The 'median' patient in this trial lived ~6.6m longer if they received daraxonrasib. It's worth noting that the performance of the chemotherapy arms was stronger in this trial than previous trials of second-line chemotherapy; whether this reflects better care or a prognostically-superior trial population remains to be seen.
ltbarcly3 4mo ago
While it's a useful scientific achievement, and I am not second guessing any individuals decision, and any time is likely tempting to take if even to have time to make arrangements, this still only gives about 1 year survival on average to the scenario being quoted in the title, and that year is gruesomely painful.
siva7 4mo ago
> More than 90% of patients with the most common form of pancreatic cancer, pancreatic ductal adenocarcinoma (mPDAC), have a mutation in the Kras gene. So pancreatic cancer is basically a genetic disease for most patients instead of environmental?
- roadnottaken 4mo ago
  No, the KRAS mutations are somatic (spontaneous), not inherited
  - AustinDev 4mo ago
    So presumably something causes the spontaneous mutations?
    - M95D 4mo ago
      Nature. DNA is unstable. Lots of stuff cause mutations: background radiation, chemicals, viruses, even our own normal metabolism [1]. [1] https://en.wikipedia.org/wiki/Reactive_oxygen_species#Oxidative_damage https://en.wikipedia.org/wiki/Reactive_oxygen_species#Oxidat...
HDBaseT 4mo ago
Why would you want to double the survival time for cancer cells?

172 points by c-oreills 4mo ago

Source article for those interested: https://www.nejm.org/doi/full/10.1056/NEJMoa2505783 https://www.nejm.org/doi/full/10.1056/NEJMoa2505783 Paywalled but has a free access option if you make an account.

maxall4 4mo ago

Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2605555?query=featured_home https://www.nejm.org/doi/full/10.1056/NEJMoa2605555?query=fe...

amluto 4mo ago

Derek Lowe’s writeup is good: https://www.science.org/content/blog-post/progress-against-pancreatic-cancer-part-one https://www.science.org/content/blog-post/progress-against-p...

matheist 4mo ago
> The company says that the drug was generally well tolerated, but that’s on the oncology scale. > ... > He’s been on daraxonrasib since early this year, and describes it this way: “. . .it’s a nasty drug. It causes crazy stuff like my body can’t grow skin and so I bleed all out of a whole bunch of parts of me that shouldn’t be bleeding” If you go to that link above, be prepared, because he also looks like he’s had aqua regia thrown all over him (and apparently feels a bit like that, too). But his tumor volume has gone down by about 75%, and there’s a very strong chance that he wouldn’t still be alive at all without having gone on the drug.
- stouset 4mo ago
  I am in the enviable position to not be actively dying from an untreatable disease, so obviously haven’t seen things from the other side of this sort of situation. But to me, that doesn’t sound like a life worth living. Obviously different people will have different thresholds for when to throw in the towel, and I’m glad that we are finding medicines to allow people to make the choices that align with their own drives. Still, I can’t help but think that this is the sort of life virtually none of us would choose to inflict on our pets, even if cost was no option. We give them a far more graceful exit from this world than we give ourselves, and I think that’s worth considering. I am truly terrified of death. I wish I wasn’t, but an infinity of nonexistence somehow seems unbearable (though, obviously, it will be trivial to bear in practice). I still hope that when my time comes, I will find the strength to exit gracefully if my life ever gets to the point where each day is filled with pain and discomfort, and where I can’t actually take part in any of the things I enjoy about life. I hope that this is only a temporary treatment for this guy to get the tumor to a point where it can be operated on or treated with other therapies. Because his life sounds like a living hell and that breaks my heart.
  - 317070 4mo ago
    I mean, he looks uncomfortable, but you would be surprised at how much people can tolerate when there is no alternative. Here is an interview I found [0]. I think he looks better than every 90 year old. But he also mentions that it still is terminal. [0] https://www.nytimes.com/video/opinion/100000010826256/what-dying-feels-like.html https://www.nytimes.com/video/opinion/100000010826256/what-d...
  - KittenInABox 4mo ago
    This may sound condescending but: you sound young, not disabled, and extremely sheltered from being exposed to disabled people. I am in a position to be intimately familiar with illness. I will say that health is a spectrum and the mind is incredibly resilient. You will surprise yourself as you inevitably age how much your mind will adapt to always hurting. There is more to life than body discomfort. This patient sounds like he has his faculties and is making an informed decision to continue living, because his life is worth the discomfort he is going through. I am reminded of a line along the lines of every day you experience, no matter how terrible, is very likely a day that someone else yesterday would have desperately wanted.
    - U4E4 4mo ago
      I find both the honesty and tact of your comment a generous gift. After watching the Sasse interview, reading the parent comment and reading your comment, I’m reminded abstractly how much of the emotional and psychological work of reconciling biological mortality is built on personal cognitive context that a mind-body builds over its cycles living in the world. So much about mortality is shared. But so much of the context for interpreting mortality is radically personal.
    - stouset 4mo ago
      There has been recent attention on what treatments oncologists choose for themselves when diagnosed with terminal illnesses—having seen firsthand what happens to quality of life for their patients—and what members of the general population choose. Doctors tend to choose the treatments that bias quality of life over quantity of life. That’s all I’m getting at here. I personally hope that if it ever comes to it, I will have the strength to choose something like three months of high QoL over one year of grinding daily misery as I have personally seen others do. Having your skin fail to regenerate, bleeding everywhere, and having skin that looks like you’ve had aqua regia poured over it seems to me like a poor quality of life. It sounded like a life of pain and one in which it would be difficult to do a lot of the things that bring me joy. Perhaps it’s not as bad as it sounds, and this is a poor example of it. I’m not judging this guy for his choices; they’re his to make. And maybe I’ve overestimated the amount of pain he’s in. But from the description above, it sounded awful.
- dredmorbius 4mo ago
  Hand-foot syndrome, a/k/a chemotherapy-induced acral erythema, is a similar condition, though there may be another I'm confusing with. <https://en.wikipedia.org/wiki/Chemotherapy-induced_acral_erythema https://en.wikipedia.org/wiki/Chemotherapy-induced_acral_ery...> I'd first run across this decades ago in the context of FDA drugs trials, in which adverse incidents were noted. My understanding at the time was that certain chemotherapies tended to interfere with skin regeneration, particularly in areas subject to high wearing (hands, feet, elbows), or rapid replacement (particularly mucous membranes, lips and mouth especially). Not all chemotherapies are brutal, but some can be quite fiendish, and quality of life is a legitimate consideration when considering whether to proceed with treatment. Informed decisionmaking and consent in a context where expertise is rare and clinicians don't directly experience the adverse effects is difficult at best.

chilldsgn 4mo ago

I hope they can get this to people quickly. Someone I love has been diagnosed with stage 3 end of Feb this year and it's utter hell. For everyone, not just the patient.

thowland 4mo ago
While not fully approved, the company has early access available to people who meet the treatment criteria and would potentially benefit. Their HCP should evaluate this (it's not all types of pancreatic cancer, and it's not a silver bullet - but it looks like its double the survival time than current chemo). Hopefully this evolves into a new class of treatment.
kennyadam 4mo ago
Honestly. for the ~2 months my mum had between a totally out-of-the-blue stage 4 melanoma diagnosis and the day she died in the hospice, I don’t think there’s anything she would have wanted less than to endure more of that existence, if someone had offered her that pill.
- chilldsgn 4mo ago
  I'm sorry your mom had to suffer like that :( My loved one really wants to live, and I suppose some people are at different stages of mind with this horrible disease. I wouldn't want to extend suffering too, but if the patient wants to fight the disease, it is up to them.
adrian_b 4mo ago
Unfortunately, it seems that this just provides an extra year of life or so. Of course this is better than nothing, but it is not a cure. Moreover, the link provided by another poster to an article that discusses the side effects, shows that they are unpleasant. Still, an extra year of life may provide a chance to survive until the appearance of a better solution.
- ltbarcly3 4mo ago
  It's an extra 6 months or so, and it's almost certain a better solution won't be come available in that 6 months, and even if it did you are very close to death and unlikely to recover even if a miracle cure is developed. In the meantime you are in intense pain and suffering wild side effects.

StephenAmar 4mo ago

If you want to see what the side effects look like, look at ex Senator Ben Sasse: https://youtu.be/7CFo6-6BN9k?si=2B3dqB4rOhAnPiZl https://youtu.be/7CFo6-6BN9k?si=2B3dqB4rOhAnPiZl

rvnx 4mo ago

The founders of Lovable and Builder.ai individually received more funds than the whole group of the researchers behind this medicine...

Retric 4mo ago
That’s like talking about the ROI of a winning lottery ticket. We can’t know ahead of time which medicine works so you need to fund many teams at the beginning.
- dredmorbius 4mo ago
  The pharmaceutical new drug development R&D market saw about $200 billion invested in 2025. <https://hardmanandco.com/research/corporate-research/2025-pharma-statistics/ https://hardmanandco.com/research/corporate-research/2025-ph...> Total VC tech investment in 2025 was $425 billion. <https://news.crunchbase.com/venture/funding-data-third-largest-year-2025/ https://news.crunchbase.com/venture/funding-data-third-large...>
  - deleted 4mo ago
    [deleted]
  - Retric 4mo ago
    You are excluding most government and charity funding into medical research. VC funding includes firms inside of the medical industry, but also companies operating across most of the economy. It’s not just IT, but food, solar, EV’s, rockets, etc. So, IMO these numbers are pretty reasonable.
    - dredmorbius 4mo ago
      I'm happy to see corrections with citations. I'd posted what information I could find. I found your original dismissal without any documentation unsatisfactory, and wanted to quantify overall rather than specific-firm-instance funding. And you're still not providing any citations for your claims. I suspect that the overall spend going into AI / adtech / digital media is disproportionately large relative to pharma spending. Particularly given the relative social benefits of each. I'd like to be able to make an evidence-based assessment rather than just a gut feel, however. Clear breakouts of total investment spend by sector are hard to find, presumably much of the accurate information is paywalled. However from a Bain report I'd turned up earlier: AI pulled in about half of all US venture funding in the fourth quarter, with investment spanning infrastructure, model training platforms, and AI-native developer tools. <https://www.bain.com/insights/global-venture-capital-outlook-latest-trends-snap-chart/ https://www.bain.com/insights/global-venture-capital-outlook...> Other significant sectors include, presumably in order, "robotics, AI, semiconductors, and Web3 sectors", and "Early-stage activity was strengthened by AI, robotics, defense tech, and biotech". All of which suggests that biotech is a small fraction of the overall total, and new drug discovery a smaller fraction of that. Total US pharmaceutical industry R&D spend per a 2021 Congressional Budget Office report was $83 billion. <https://www.cbo.gov/publication/57126 https://www.cbo.gov/publication/57126> US federally-funded medical research largely occurs through the National Institutes of Health, which has an annual budget of $48 billion. I'd be quite surprised if state-level and other countries' spend doubled that. It increases my earlier figure by about 20%, which isn't nothing, but pales next to the venture tech investment. Again, that's all medical spending, not limited to new drug discovery. <https://www.nih.gov/about-nih/organization/budget https://www.nih.gov/about-nih/organization/budget> As the previously-cited CBO report notes: "Much of that [NIH] funding has supported basic research (in genomics, molecular biology, and other life sciences) that has identified new disease mechanisms." So, not strictly new drug discovery, though not entirely unrelated either. Most new drug discovery is likely not venture-backed, so considering my top-line $400 billion vs. $200 billion still seems to point to a roughly-appropriate comparison ratio. If anything, further research suggests the $200 billion value for pharma is probably high-side when it comes to drugs.

mrandish 4mo ago

Totally naive question: is this a situation where stacking the drug with chemo might be even better?

deleted 4mo ago
[deleted]
Drunk_Engineer 4mo ago
There are some trials underway testing that hypothesis.
mft_ 4mo ago
Yes, with nuances. The recently-read-out trial is in the 'second line' - meaning patients will have received one 'line' of treatment before this - typically chemotherapy +/- surgery. The chemotherapy regimes used for pancreatic cancer can be pretty brutal, and patients can usually tolerate one, max two lines overall. As such, this trial administering only daraxonrasib monotherapy made sense. The first line trial of daraxonrasib is already underway, and includes both darax monotherapy and darax + chemo arms. (They are combining with a slightly less brutal chemotherapy called GnP, with an eye to the overall side effect burden considering the non-trial side effects that darax also brings.) It'll be very interesting to see the outcome of this trial; there are some examples elsewhere in oncology where a treatment is recommended by guidelines without chemotherapy over a combination with chemotherapy, as the small survival benefit the addition of chemotherapy brings is seen as outweighed by the additional toxicity.

shevy-java 4mo ago

[flagged]

hackyhacky 4mo ago
Always baffling to me that people accuse researchers and doctors, people who have devoted their life to helping others, of brazen greed and deception. With no evidence, of course. Maybe the accusation says more about you than about them?
- SoftTalker 4mo ago
  The researchers and doctors probably have better motives but the pharmaceutical industry wants nothing more than getting you on a lifetime of prescriptions. They are just like street dealers but they dress better and blend in with normal society.

modzu 4mo ago

"survival" is the wrong word; its terminal. honestly the drugs and chemo and treatments they put pancreatic patients through for possibly a few more (not very nice) weeks is almost criminal. a good doctor will tell you to go make the most of those 3 months post diagnosis. that said its nice to see progress against one of the worst cancers out there and i hope it leads to genuine breakthroughs. but this drug is nothing anybody wants, even if they think they do

infamia 4mo ago
> "survival" is the wrong word; its terminal. No one actually knows that one way or the other since some patients were still taking it after the study ended according to the article.
- adrian_b 4mo ago
  According to the abstract of the article, there were 2 groups of patients. One group had median values of 8.5 months for progression-free survival and 13.1 months for overall survival. The other group had median values of 8.1 months for progression-free survival and 15.6 months for overall survival. Overall Survival (OS) measures the time until death from any cause. Progression-Free Survival (PFS) evaluates how long a treatment can delay disease progression or death. So at least most of the patients from the study have died, because otherwise median values could not have been computed. Thus the treatment had provided them a median life extension of about 3/4 years. The lucky ones probably have got more than an extra year.
  - mft_ 4mo ago
    Your numbers are a little off. The NEJM article was published a few hours ago: https://www.nejm.org/doi/full/10.1056/NEJMoa2605555 https://www.nejm.org/doi/full/10.1056/NEJMoa2605555 RAS G12 population mOS: daraxonrasib 13.2 months / chemotherapy 6.6 months Overall population mOS: daraxonrasib 13.2 months / chemotherapy 6.7 months RAS G12 population mPFS: daraxonrasib 7.3 months / chemotherapy 3.5 months Overall population PFS: daraxonrasib 7.2 months / chemotherapy 3.6 months > Thus the treatment had provided them a median life extension of about 3/4 years. The lucky ones probably have got more than an extra year. The 'median' patient in this trial lived ~6.6m longer if they received daraxonrasib. It's worth noting that the performance of the chemotherapy arms was stronger in this trial than previous trials of second-line chemotherapy; whether this reflects better care or a prognostically-superior trial population remains to be seen.

ltbarcly3 4mo ago

While it's a useful scientific achievement, and I am not second guessing any individuals decision, and any time is likely tempting to take if even to have time to make arrangements, this still only gives about 1 year survival on average to the scenario being quoted in the title, and that year is gruesomely painful.

siva7 4mo ago

> More than 90% of patients with the most common form of pancreatic cancer, pancreatic ductal adenocarcinoma (mPDAC), have a mutation in the Kras gene. So pancreatic cancer is basically a genetic disease for most patients instead of environmental?

roadnottaken 4mo ago
No, the KRAS mutations are somatic (spontaneous), not inherited
- AustinDev 4mo ago
  So presumably something causes the spontaneous mutations?
  - M95D 4mo ago
    Nature. DNA is unstable. Lots of stuff cause mutations: background radiation, chemicals, viruses, even our own normal metabolism [1]. [1] https://en.wikipedia.org/wiki/Reactive_oxygen_species#Oxidative_damage https://en.wikipedia.org/wiki/Reactive_oxygen_species#Oxidat...

HDBaseT 4mo ago

Why would you want to double the survival time for cancer cells?