Two approved cancer medications plus one research compound never given to a person. Each blocks a different growth signal. Together they prevented relapse in animal work whose report was withdrawn over undisclosed author financial interests, then republished. Each approved drug works alone; the trio is untested in people, and added toxicity is certain. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Hemoglobin | 13.5-15.0 (men), 12.5-14.5 g/dL (women) | Detects the anemia seen with daraxonrasib |
| Absolute neutrophil count | 2.0-5.0 ×10&sup9;/L | Flags infection risk alongside pneumonia |
| ALT | 10-26 U/L | Earliest marker of the class's liver toxicity |
| AST | 10-26 U/L | Confirms and grades a liver signal seen on ALT |
| Total bilirubin | 0.3-1.0 mg/dL | Separates enzyme leak from impaired function |
| Serum sodium | 138-142 mmol/L | Agents and diarrhea both lower sodium |
| Potassium and magnesium | K 4.0-4.5 mmol/L; Mg 2.0-2.5 mg/dL | Diarrhea depletes both; both drive arrhythmia |
| eGFR with creatinine | eGFR ≥90 mL/min/1.73 m² | Renal impairment raises afatinib exposure |
| Circulating tumor DNA (mutant RAS) | No target; change from own baseline | Falls earlier than imaging changes |
| CA 19-9 (pancreatic disease) | No optimal value; trend from own baseline | Corroborates response between scans |
Cadence: Baseline panel before the first dose; bloodwork weeks 2 and 4, 4-weekly for 6 months, then 8-12-weekly. Imaging 8-weekly for a year, then 12-weekly. New respiratory symptoms trigger imaging.