四十年拿不下来的靶点被拿下了。胰腺癌病人多活半年，代价是一个月三万九千八百美元。

Last week the FDA approved a new pancreatic cancer drug called daraxonrasib.

It was approved more than six months ahead of its original deadline.

Pancreatic cancer is one of the hardest solid tumours to treat. For decades there has been almost no good news.

The old figure was this: after diagnosis, median survival was under seven months.

Median means half of all patients do not live past that point.

With daraxonrasib, that number becomes thirteen months, and the risk of death falls by sixty percent.

The difference is half a year.

Now, why this drug was so hard to make.

There is a protein in our cells called RAS that governs whether a cell should keep growing.

Once it mutates, it keeps sending the signal to keep growing.

In pancreatic cancer, over ninety percent of patients have a mutation in this one protein.

The direction was never the problem. Scientists knew exactly where to press.

The problem was that you could not press it.

The surface of RAS is unusually smooth, with almost no pocket for a drug to bind to.

So for forty years the medical world had a special name for it: the undruggable target.

That name has now stopped being true.

The form is worth noting too: it is not chemotherapy, there is no drip, it is a tablet taken once a day by mouth.

Patients take it at home. They do not have to move their lives into a hospital.

The side effects are not minor: more than eighty-six percent of patients get a skin rash.

But what is worth comparing is whether patients can keep going.

Chemotherapy is often heavy enough that patients give up partway. On this drug, far fewer stop, and the pain is lighter.

The extra half year it gives is a half year you can use.

Up to this point, it is the best cancer story in decades.

And then, the price.

One month of the drug: thirty-nine thousand eight hundred dollars.

One month, not one year.

A target that could not be taken for forty years has been taken, and the price is thirty-nine thousand eight hundred a month.

The drug exists. Who gets to take it is a different problem.

Think about it:

If a drug can give someone another half a year but many people cannot afford it, does it count as good news?