Scientists Built a Molecule From Ordinary Atoms—and It Doubled Survival for a ‘Hidden’ Cancer

3 min readHere’s what you’ll learn when you read this story:Deadly pancreatic cancer has a new treatment that shows a doubling of life expectancy.This cancer has a tendency to hide, and is usually not diagnosed until it has already spread outside the pancreas.The large molecule treatment, made with common elements, takes down rogue proteins.The FDA recently approved a new pancreatic cancer drug called daraxonrasib, branded as Rasonque. The new drug—part of a category called RAS inhibitors—nearly doubled the survival time in a study of 500 patients with metastatic pancreatic adenocarcinoma (cancer that has spread beyond the pancreas): “13.2 months compared to 6.7 months,” the FDA explained in a press release. Daraxonrasib candidates “have received at least one prior systemic therapy or are not candidates for multiagent systemic therapy,” the agency said.Pancreatic cancer is one of the deadliest cancers by number of deaths, despite affecting far fewer people overall than other forms, and is often informally considered a “death sentence” because of the lack of early symptoms and the lack of clarity surrounding screening. In large part, this is because it typically hides in the body until it begins to affect other organs through metastasis. One 2010 paper explained that “roughly 85% of patients show an organ overlapping growth of the tumor when the disease is first discovered.” That paper also described how tumors in the pancreas are particularly resistant to apoptosis, which is the intentional cell death that is programmed in our DNA and in the cells themselves.The drug is a single (but enormous) molecule—C44H58N8O5S. Together, this combination of elements works to grab certain proteins and hold them in place, so they cannot continue to flip the chemical switches that lead to the runaway growth of tumors.Those particular proteins—the RAS, or Ras, family—are responsible for the lack of apoptosis (cell death). The human body is largely self regulating, and normally, dead cells are cleared by the body’s filters and immune system. When these cells don’t get the signal to die because the RAS protein is damaged or mutated, they instead accumulate and lead to a cascade of unwanted and harmful growth. Daraxonrasib acts like a line of glue that catches loose glitter.The FDA safely fast-tracked the approval of daraxonrasib for metastatic pancreatic ductal adenocarcinoma (PDAC) because of a recent program established to push “national priorities” including “large unmet medical needs.” RAS proteins are found throughout the body, and adenocarcinoma affects glands in particular, so there are adenocarcinomas that affect other internal organs—the skin, breast tissue, and so forth. But those other cancers can be detected much earlier, as they have symptoms earlier.This news pairs with Moderna and Merck’s study of their new bespoke cancer vaccination, intismeran autogene, which is crafted individually based on each patient’s tumor profile and is still in trials. Intismeran autogene, which is made using mRNA, works by intentionally making damaged proteins in order to provoke an immune response. The drug has a completely different makeup and mechanism than the new pancreatic cancer drug, so the cancers it treats don’t include PDAC—in a way, in fact, its mechanism is almost the opposite of daraxonrasib.Together, the two drugs show how diverse the “next big things” in cancer treatment can be. Daraxonrasib for pancreatic cancer is almost unbelievably simple in makeup, with a combination of atoms that can tackle rogue proteins using a chemical bond. Intismeran autogene is based on a massive amount of observed data from real cancer patients and their individual tumors, and works like “print on demand” for the specific proteins that help the body flush out cancer cells.Indeed, like the combination of traditional petroleum energy, nuclear, and renewables that will likely form our near future, cancer treatment is certainly multifaceted.Caroline Delbert is a writer, avid reader, and contributing editor at Pop Mech. She's also an enthusiast of just about everything. Her favorite topics include nuclear energy, cosmology, math of everyday things, and the philosophy of it all.