Pegasus and the Next Way In

Pegasus does not depend on one door.

The surveillance software developed by the Israeli company NSO Group can use different routes to gain access to a smartphone. Before an attempted infection, the system can check technical characteristics of the target device and determine which of its available approaches might work.

Researchers have even seen evidence suggesting that, in some cases, different routes were tested against the same phone.

That matters because a door that is open today may be closed tomorrow.

Phone makers patch vulnerabilities. Software changes. A way in that works today may eventually stop working.

Pegasus therefore cannot rely on finding one vulnerability.

It has to be ready for the next one.

Cancer drug development has a remarkably similar problem.

Scientists analyze a cancer, identify a vulnerability and develop a drug capable of attacking it.

The drug works.

The cancer shrinks.

And then:

Access denied.

Cancer evolves, adapts and finds ways to survive.

The cancer is still there.

But the vulnerability we were exploiting may no longer give us the same way in.

This is where Pegasus becomes interesting.

What if we designed cancer drug development more like that?

When developing Drug A, we would not think only about the vulnerability Drug A is attacking.

We would also analyze where else the cancer might be vulnerable, how it might escape the first attack and which vulnerabilities could matter next.

And then we would do something more important than simply make a list.

We would prepare for them.

Where the science allows it, several drugs or combinations could be developed around those vulnerabilities at the same time.

Drug A may be the first way in.

But if that door closes, Drug B should not still be an idea on a whiteboard.

It should already be moving through development.

And perhaps Drug C should not be far behind.

Not every escape route can be predicted.

Cancer is considerably less cooperative than a smartphone.

And parts of oncology already work this way.

But perhaps the principle should become much broader.

We spend enormous effort developing a drug that can exploit one vulnerability in cancer.

Perhaps the clinical development strategy should also ask:

What will we have ready when that vulnerability is no longer enough?

Pegasus is not designed around the hope that one door will remain open forever.

Cancer drug development should not be either.

A pharmaceutical pipeline is usually a pipeline of drugs.

Maybe it should be designed as something more:

a pipeline of next moves.