Direxonrasib is showing unprecedented response rates (e.g., 47% in frontline) for metastatic pancreatic cancer, a historically difficult-to-treat disease. This high performance prompts comparisons to the targeted therapy successes seen in lung cancer, signaling a potential paradigm shift in treatment expectations for PDAC.

Progress in drug development often hides inside failures. A therapy that fails in one clinical trial can provide critical scientific learnings. One company leveraged insights from a failed study to redesign a subsequent trial, which was successful and led to the drug's approval.

The KRAS G12D mutation, unlike the more common G12C, often occurs in younger, never-smoking lung cancer patients who previously lacked targeted therapy options. The high response rate (61%) and good tolerability of the G12D inhibitor Zoldanrasib could fill a significant unmet need in this specific demographic.

Pathways like integrins have long been of interest but lacked effective therapeutic approaches. The advent of new technologies, such as antibody-drug conjugates and checkpoint inhibitors, has created opportunities to re-explore these older targets with potent, modern drugs, breathing new life into decades-old research.

Zelenorstat inhibits NMT, an enzyme that attaches a "GPS tag" to proteins, guiding them within the cell. By blocking this process, it renders key cancer-driving proteins useless, effectively confusing the cancer's operating system rather than using brute-force poison like chemotherapy.

Cancer should be viewed not just as rogue cells, but as a complex system with its own supply chains and communication infrastructure. This perspective shift justifies novel therapies like Zelenorstat, which aim to dismantle this entire operating system by cutting its power source.

In oncology R&D, a successful two-drug combination isn't the final goal but the new standard of care to build upon. Researchers immediately begin planning for "triplets"—adding a third agent to the successful doublet—demonstrating a relentless, forward-looking strategy to incrementally improve patient outcomes.

Despite billions invested over 20 years in targeted and genome-based therapies, the real-world benefit to cancer patients has been minimal, helping only a small fraction of the population. This highlights a profound gap and the urgent need for new paradigms like functional precision oncology.

Targeting the MYC cancer protein presents a dual challenge. Biologically, it's vital for healthy cells, creating a high risk of toxicity. Biophysically, its disordered, 'floppy' structure lacks the defined pockets that traditional drugs need to bind to, making it a 'holy grail' target.