Metastatic pancreatic cancer is the first indication for this class of RAS-inhibitor, but it certainly won't be the last, and it seems certain that there will be many many more cancers where this drug gets approved. There are mutations to activate KRAS in a substantial fraction of cancers across many organs, and but it's been such a hard protein to target with a drug that even decades ago I was told it was "undruggable."

What's going on with this new drug is a somewhat novel mechanism: instead of gumming up the enzymatic action of the protein, it acts as a glue between KRAS and a common "helper" protein, that then mucks up the RAS signalling. This sort of molecular glue mechanism has had a few examples built up over the past decade, but this is a really knock-it-out-of-the-park drug. Really amazing, and because of it lots of people are focusing lots of effort on how to discover more molecular glues.

My sister was diagnosed with pancreatic cancer in October (48 years old) and died in June from it.

I'm glad to see a drug like this developed for people suffering from pancreatic cancer. I don't wish what my sister went through on anyone.

Damn if I don't wish it had come a little sooner.

Beyond the data, this approval is notable for the speed from FDA acceptance of their new drug application (NDA) to FDA approval - just over a month. Compare this to the typical 8-12 month timelines we've historically seen for priority and standard reviews, respectively. This was enabled by the FDA's CNPV Pilot Program [0]

Previous discussion following the data presentation at ASCO: https://news.ycombinator.com/item?id=48517199

[0] https://www.fda.gov/industry/commissioners-national-priority...

My dad was diagnosed with pancreatic cancer in December 2019 and thankfully caught wind of it in its early stages due to an eagle-eyed nurse going over some routine blood work and noting his liver numbers were off, he should talk to the doctor.

You can imagine how hard it was to be sick in the early days of COVID, much less have to go to the hospital on a regular basis to receive chemotherapy for hours on end. Our family was lucky that he responded well to treatment at least and we had a few extra years with him before he passed away in late 2023.

Cancer is a terrible thing but pancreatic cancer is especially horrible due to the difficulty in detection when you're in otherwise good health. The fact that intense medical research into retrovirals has yielded something so significant as the RAS-inhibitor is nothing short of miraculous.

My mom was diagnosed with borderline stage-4 pancreatic cancer. Fortunately she had an aggressive surgeon willing to do a Whipple procedure, and survived almost 4 years after a 4-6 month prognosis.

We were incredibly lucky to even have that time with her. Pancreatic is one of the worst cancers someone can get — both for survival and quality of life.

I’m very happy to see that we’re finally making meaningful progress on treatment.

My aunt died of this last year. It took all of three months. That has given some food for thought in my family over what the most humane and merciful way to die is; 5 minutes and a heart attack, three months and this, or several years in other forms of cancer and tumours.

Ignoring the pain aspect of the disease, three months seems not to be a bad time to come to grips, say your goodbyes, tie up loose ends but not prolong suffering indefinitely and waste away.

Also, hail to healthcare systems that facilitate legal euthanasia.

My dad passed in 2020 from pancreatic cancer. He'd been to the doctor several times complaining about issues and all they would do is send him home with laxatives. Eventually it got bad enough my mom ran him to the ER when they found the cancer which had progressed into its final stages already. He was dead less than a month later.

Similar story with a guy I worked with. He went home sick one day. A few days later our boss told us he was sick and had pancreatic cancer. He came into the office to say goodbye to us a few weeks later and then died about 10 days after that.

Fuck cancer

Not a nice disease to get. Ranks up there with glioblastoma multiforme, advanced oesophageal cancer and advanced duodenal cancer.

I am aggressive and investigate aggressively to detect pancreatic cancer early. One even had a Whipple procedure (pancreaticoduodenectomy ), since I detected it so early.

Despite that, the longest anyone I diagnosed has lived has only been 8 months.

Sad, they were all nice people.

Pancreatic cancer is one of those diseases where I've gotten used to reading depressing numbers, so seeing 13.2 months vs 6.7 months actually made me stop for a second

stage 4 colon cancer here... Pancreatic cancer is obviously a _very_ different disease, but when i was diagnosed just about a decade ago the conventional wisdom was that KRAS was basically undruggable. I'm KRAS 12D and very excited for future.

No it's not a cure, but this drug is the difference between someone's mother or father making it to one more Christmas, or Birthday, or other life milestone.

My father in law was diagnosed with stage 4 pancreatic cancer that's spread to his lungs about a month ago. This news today raised my wife's hopes immensely and had them immediately doused after hearing the oncologist say that although the drug is approved it will take months before they are able to prescribe it.

Father in law started chemo a few weeks ago and his condition deteriorated quickly, he's been at the hospital since; switching between ICU and general care. His abdomen fills up with fluid, around 6 liters every 5 days, draining the fluid plunges his blood pressure and he end up in ICU. They supply Albumin until blood pressure stabilizes and send him back to general. Only after the first chemo session the oncologists have stopped the treatment saying he's no longer eligible for chemo because of his over all health.

We're lucky enough to live an hour away from Johns Hopkins (though that's not the hospital he's currently at) and had an appointment scheduled but had to cancel since he's unable to walk.

The oncologist mentioned that daraxonrasib was available as an option when he first started chemo, but said he would only be eligible for it after trying chemo, so we know the drug is available.

Are there any tips from HN on how we can approach getting this medicine for my father in law?

This would've likely saved Steve Jobs, had it arrived 15 years earlier.

The therapy does not provide a cure. Just prolongs lives for only few more months, unfortunately .

Fantastic news. Research on Metastatic treatments has been underfunded. Yet immunotherapy and other treatments are showing amazing promise.

Someone I love dearly passed two weeks ago from this awful cancer. She was on a trial for this drug, but it was ineffective, sadly. I can't stop crying. This is a horrible disease and I am so glad there are developments being made in this to extend people's lives, possibly even save them.

Fuck cancer.

We’re nowhere close to it, but if we actually solve the vast majority of cancers, we will have taken several steps towards a true utopia

thats great news !

FDA is just too slow. Whole I’d like to do more radical reform, at a minimum this stupid long wait should be tossed. If someone hits a target endpoint auto approval pending further review or something

Remember in COVID when results. Came in and they took a month to schedule the meeting?