Big Pharma Bets on Body’s Garbage-Disposal System to Beat Cancer

At their most basic level, many of the deadliest diseases are caused by nests of misguided proteins. Most medicines work by attaching themselves to these proteins and temporarily shutting them down. In the 1990s, Yale University scientist Craig Crews and a colleague had a radical idea: What if a drug could destroy a bad protein by making it a target of the body’s own molecular trash disposal machines?

For years, the idea remained a lab curiosity. Biotech investors wouldn’t initially back a company based on the concept, which Crews and a few other academics labored to prove could be a practical way to make drugs. The field got a big boost earlier this decade when scientists started discovering that some of the most successful medicines turned out to work by piggybacking onto these human trash collectors. Now it’s become one of the hottest new technologies for making pills. Crews and a biotech he founded, Arvinas Inc., are racing some of the world’s biggest pharmaceutical and biotech companies—Novartis, Amgen, and Gilead Sciences—to turn protein-degrading compounds into drugs. “By hijacking natural quality-control machinery inside cells, we are literally making problem proteins go away,” Crews says.