Revolution Medicines' Rasonque Hits $198 Million in First Quarter

Revolution Medicines' pancreatic cancer drug Rasonque generated $198 million in third-quarter sales after just five weeks on the U.S. market, nearly eight times the $24.9 million FactSet consensus. Jefferies now projects $527 million in fourth-quarter sales and $3.1 billion next year for the drug.

"The combo of breakthrough science + transformative efficacy + high unmet need + strong execution will have us see one of the best drug launches of all time," Jefferies analyst Faisal Khurshid wrote in a note to investors.

The FDA approved Rasonque in late August. About 5,000 patients received the drug in its first five weeks, the company said, driven by widespread physician adoption and solid reimbursement from health insurers. Pent-up demand also came from patients in the compassionate-use program, which provides access to experimental medicines outside clinical trials, and from those who had exhausted existing options.

What is Rasonque and why does it matter?

Rasonque is a pan-RAS inhibitor. It targets RAS proteins such as KRAS and NRAS and "turns off" the mutated versions. Scientists long considered RAS-mutated cancers "undruggable" until RAS-inhibiting treatments emerged. Amgen's Lumakras and Bristol Myers Squibb's Krazati, both KRAS inhibitors, treat KRAS-mutated lung cancer. Revolution is leading the new wave of drugs that hit a broader set of RAS mutations.

The launch numbers stand out even by oncology standards. The quarter "is completely unprecedented amongst oncology drugs & places it among the fastest launches in industry history," Cody Tranbarger, a biotech researcher known as "Professor Oak" on social media who founded a biotech startup now owned by Anthropic, wrote on X.

Why did the stock fall anyway?

Revolution's shares rose about 4% in premarket trading Thursday, then dropped 8% by mid-afternoon as the Dow, S&P 500 and Nasdaq sold off broadly. The State Street SPDR S&P Biotech ETF fell 6.3%.

The pullback also reflects genuine uncertainty. Roughly 5,000 patients in five weeks means some sales came from a one-time wave of built-up demand. That raises the question of whether the pace is repeatable.

"It is hard to model what the run rate is going forward," Khurshid told MarketWatch in an email.

Can Rasonque grow beyond pancreatic cancer?

Rasonque is Revolution's first approved drug in the United States. A European regulatory decision is expected by the end of the year.

The company's bigger bet is expansion. Revolution is running at least four other Phase 3 clinical trials testing the drug in other cancers, including colorectal and lung cancers. Success there would multiply the drug's addressable market well beyond metastatic pancreatic cancer.

Merck, according to news reports, showed interest earlier this year in buying the biotech in a deal valuing Revolution at $30 billion. No transaction materialized, but the reported price tag signals how large strategists size the Rasonque franchise.

Revolution's stock has gained 132% so far this year, against a 23% rise for the XBI biotech ETF. The forward question for investors is whether fourth-quarter sales validate Jefferies' $527 million forecast — or whether the launch's early surge was a backlog effect that fades.