A few takeaways on how the industry is tackling this extremely difficult-to-treat disease:

Exhibit 1: Pancreatic Cancer Treatment Landscape

#1 This is arguably the deadliest cancer in the US - some morbid stats:

• On track to be the 2nd leading cause of cancer-deaths in the US by 2030
• 5-year survival rate for metastatic disease patients is just 3%
• Incidence has steadily increased over the last decade, even moreso in EU
• Numerous failed treatments due to the aggressive nature of the disease, tricky drug delivery and lack of effective drugs to target known biomarkers
• mOS is <1 year in 1L patients and <6 months in 2L patients

#2 The standard of care (various chemo combinations) has not evolved much in over a decade and the benefit has been fairly pedestrian, but recent novel data has been encouraging

Revolution Medicines ($RVMD) put out a helpful table yesterday summarizing numerous chemo regimens and the ~2-3mo mPFS benefit / ~6-7mo mOS benefit in 2L

Exhibit 2: Summary of Chemo Performance in Pancreatic Cancer

Revolution also provided an update on RMC-6236, their RAS(ON) inhibitor, which nearly tripled SoC performance in 2L, with 8.1mo mPFS. While immature, this compares favorably to Lilly's G12C inhibitor olomorasib (~6.9mo mPFS)

Estimated mPFS across the 2L / 3L ITT population is ~5.5-6mo:

Exhibit 3: Sleuth Estimate of All-Comers KM Curve for PFS

We've seen the transition from smaller Ph1/2 to large RCT Ph3 fail plenty of times in pancreatic cancer, so a lot of investors will be closely watching the announced RASolute 302 study for final validation. Success would unlock $2-3B+ in peak sales and likely trigger plenty of buyout interest

#3 In addition to novel therapeutics, more innovation is needed around non-invasive diagnosis, as most patients are diagnosed at a late, incurable stage

Clinical symptoms tend to be easily conflated with other indications (i.e. nausea, belly pain) and accurate diagnosis requires a cumbersome series of blood tests, CT scans, biopsies and germline testing

As always, the risk with testing innovation is around the sensitivity / specificity of the test vs. the number of false positives, but with a disease as deadly and fast-moving as pancreatic cancer, the bar would be lower