Alzheimer’s disease drug development has long focused on slowing memory loss, but for many families, the tipping point that makes home care impossible is not cognition—it is psychosis. Hallucinations and delusions in Alzheimer’s are a distinct, prevalent, and under-recognized target for therapy. We spoke to Elizabeth Thompson, executive vice president and head of R&D at Acadia Pharmaceuticals, about the biology behind psychosis in dementia, the company’s experimental therapy to treat the condition in people with Alzheimer’s disease, and the forces reshaping the drug development landscape to enable the development of such treatments.

RICO, the Racketeer Influenced and Corrupt Organizations Act, may have been created to tackle mobsters, but today it is at the center of a landmark class action against two of the world’s largest pharmaceutical companies over the diabetes drug Actos. Attorney Harrison James of Wissner Baum discusses Painters and Allied Trades District Council 82 Health Care Fund v. Takeda, a national civil RICO class action alleging that Takeda and Eli Lilly engaged in a coordinated, years-long scheme to downplay known bladder cancer risks, misleading regulators, physicians, and third-party payers who reimbursed billions of dollars for the drug. James discusses how RICO’s concepts apply in the pharmaceutical context, what it took to get a civil RICO class certified where others have failed, and the broader implication the case may have for the pharmaceutical industry.

Pancreatic cancer remains one of oncology’s deadliest diagnoses, with standard treatments often offering only transient tumor shrinkage at the cost of grueling side effects and rapid resistance. Immuneering is using transcriptomic and informatics tools to design a MEK inhibitor dosed in intense daily pulses rather than continuously. This approach aims to restore a more normal signaling rhythm in healthy cells while repeatedly ambushing tumors. Ben Zeskind, CEO of Immuneering, discusses how the company is using its informatics-driven dosing regimen to re-engineer targeted cancer therapy so it extends survival, delays resistance, and is better tolerated.