Issue #180·

A pill just doubled survival in pancreatic cancer. Wall Street sees billions.

The FDA approved a drug that nearly doubled survival in metastatic pancreatic cancer, a disease that has humbled the entire pharmaceutical industry for decades. Meanwhile, a gene-editing therapy just destroyed hepatitis B's hidden DNA reservoir in a living patient for the first time, and billions of dollars in deals are reshaping oncology, inflammation, and epilepsy.

Top Story Today

Pancreatic Cancer's Worst Odds Just Got Rewritten by a Single Pill

Revolution Medicines' Rasonque (daraxonrasib) just won FDA approval after nearly doubling overall survival in metastatic pancreatic cancer: 13.2 months versus 6.7 months on chemo. The drug cut the risk of death by 60%, a result so striking in a cancer this brutal that analysts are projecting peak sales of up to $7 billion. Rasonque is a pan-RAS inhibitor, meaning it targets the broad family of KRAS mutations that drive most pancreatic tumors. And because the FDA approved it without requiring a companion diagnostic test, any eligible patient can start treatment. One pill, once a day, $39,800 per month.

Why it matters: For decades, KRAS was considered undruggable and pancreatic cancer was precision oncology's most stubborn holdout. This approval proves both assumptions wrong and sets the benchmark the entire KRAS field will chase for years.

Read more →

FDA Approvals and Clinical Wins

The First Targeted Pill for a Disease That Had None

The FDA approved Lisraya (brepocitinib) as the first-ever targeted oral therapy for dermatomyositis, a rare autoimmune disease that attacks muscles and skin. In the VALOR trial, 62% of patients on the drug tapered off high-dose steroids, compared to 34% on placebo. The dual TYK2/JAK1 inhibitor marks a before-and-after moment for patients stuck on blunt-force immunosuppression for decades.

Read more →

Gilead Put Its Best Injectable Drug Inside a Daily Pill

Gilead's Bixlenvo combines lenacapavir (the twice-yearly injectable's active ingredient) with bictegravir in a once-daily HIV pill. The move looks counterintuitive, but it's a chess move: most HIV patients still prefer daily tablets, and every person who starts on oral lenacapavir becomes a future candidate for Gilead's longer-acting formulations.

Read more →

Tezspire Just Crashed Dupixent's Monopoly in EoE

AstraZeneca and Amgen's Tezspire hit both primary endpoints in the Phase III CROSSING trial for eosinophilic esophagitis, reducing inflammation and improving swallowing through week 52. By blocking TSLP (an "upstream" alarm signal), Tezspire could become the first real competitor to Dupixent in EoE and earn a third approved indication.

Read more →

COVID Vaccines Now Update Like iPhone Software

The FDA approved XFG-targeting COVID vaccines from Pfizer, Moderna, and Novavax-Sanofi for the 2026-2027 season. The process felt routine, which is the point; but only 17.5% of U.S. adults got last season's shot, and experts warn the surveillance data guiding variant selection is deteriorating.

Read more →

Deals and Dealmaking

The Team That Sold a Biotech to Pfizer for $10B Is Running It Back

Population Health Partners and ARCH Venture Partners launched Sentivera with $83 million in funding and a $1.5 billion licensing deal for an undisclosed inflammation drug from China's Haisco Pharmaceutical. The asset is preclinical, the target is secret, and the playbook is identical to Metsera, which Pfizer acquired for up to $10 billion.

Read more →

Genentech Bet $1 Billion That ADC Resistance Is Solvable

Genentech signed a deal worth over $1 billion with Shanghai-based DualityBio for its DUPAC platform, which designs novel payloads specifically to overcome resistance to existing antibody-drug conjugates. The deal treats ADC resistance biology as a standalone investment thesis, signaling a shift in how pharma thinks about durability in oncology's hottest drug class.

Read more →

SK Biopharma Paid $795M for a Brain Target That Already Flopped Once

SK Biopharmaceuticals licensed Biohaven's Kv7 epilepsy platform, anchored by opakalim, for up to $795 million. The original Kv7 drug (retigabine) worked but caused bizarre pigmentation side effects. Opakalim's selective design avoids those problems; in trials, patients went 141 days before a second seizure versus 47 on placebo.

Read more →

Science, Policy, and the Bigger Picture

A Gene Editor Just Destroyed Hepatitis B's Hidden DNA Bunker

Precision BioSciences reported the first clinical evidence that a gene-editing therapy can eliminate cccDNA, the hidden viral reservoir that makes hepatitis B impossible to cure with current drugs. After two doses, less than 1% of cccDNA remained in a patient's liver biopsy. It's early data from a tiny sample, but it's a genuine first for the field.

Read more →

The White House Is Coming for Midsize Biotech's Drug Prices

The White House is reportedly preparing voluntary pricing deals with midsize biotech companies, extending its Most Favored Nation framework beyond Big Pharma. For companies that depend on one or two high-priced drugs for most of their revenue, the implications are far more threatening than they were for diversified pharma giants.

Read more →

Alnylam's Heart Drug Has a Wall Street Trust Problem

Alnylam's stock has dropped 30% in a month despite strong vutrisiran data (28% reduction in death or recurrent cardiovascular events in the primary HELIOS-B analysis). A competitor's trial failure, a revenue guidance cut, and slow commercial uptake created a perfect storm of doubt. ESC 2026 presentations this week could reset the narrative, or confirm it.

Read more →

Get tomorrow's biotech intelligence before your competitors.

Join thousands of biotech professionals who start their day with our free, daily briefing.