Class of 2026
16 things have changed since you graduated
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What’s changed since 2026
Everything here shifted in 2026 or later, some of it too recently to be in any textbook you were handed. These are the corrections the next edition hasn’t printed yet.
Revision level: Lightly corrected. 6% of the archive changed after 2026. You got a fairly current edition. A few pages have been reprinted since.
- 16things changed
- 9were actually wrong
- 7just got sharper
- 6subjects affected
TaughtMedicines work by binding a target protein and blocking it, like a key jammed in a lock. The drug has to stay bound to keep working, and proteins the body considers 'undruggable', with no good pocket to grab, are simply out of reach.
NowOn 1 May 2026 the FDA approved vepdegestrant (Veppanu), the first PROTAC ever authorized anywhere. Instead of blocking its target, it tags the protein for the cell's own disposal machinery, so the protein is destroyed rather than merely occupied.
TaughtThe CRISPR therapy Casgevy that can functionally cure sickle cell disease was approved for people twelve and older. Young children, who suffer the most damage from the disease early on, were left waiting on the sidelines.
NowOn 1 July 2026 the FDA expanded Casgevy (exagamglogene autotemcel) to children as young as two with severe sickle cell disease or transfusion-dependent beta thalassemia: the first one-time genetic therapy approved for that age group, adding roughly 5,500 eligible children in the US.
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Cerebral folate deficiency has no treatment
Changed in2026TaughtWhen a genetic fault blocks folate from reaching the brain, children develop seizures, movement disorders, and severe developmental delay. It is a devastating, untreatable condition; you manage the symptoms and little else.
NowOn 10 March 2026 the FDA approved Wellcovorin (leucovorin calcium) as the first treatment for cerebral folate transport deficiency caused by variants in the FOLR1 gene. Leucovorin is a form of folate that can slip into the brain by a different route, bypassing the broken transporter.
TaughtWhen a child is born deaf because of a genetic defect, the ear is broken at the source. A cochlear implant can route sound around the damage, but there is no way to fix the underlying biology and give the ear its own hearing back.
NowOn 23 April 2026 the FDA approved Otarmeni (lunsotogene parvec), a one-time gene therapy for deafness caused by variants in the OTOF gene. It delivers a working copy of the gene to the inner ear, and most treated patients gained usable hearing, some reaching normal levels, including whispers.
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TaughtArginase 1 deficiency lets the amino acid arginine build to toxic levels, causing stiffness, seizures, and developmental regression. There is no drug for it. Management means a severely protein-restricted diet, for life, and it is rarely enough.
NowOn 23 February 2026 the FDA granted accelerated approval to Loargys (pegzilarginase), an engineered enzyme injected to break down the excess arginine the body cannot clear on its own, the first therapy that directly targets the disease.
For early bladder cancer, BCG is the only option, and nothing has improved on it in decades
Changed in2026TaughtHigh-risk bladder cancer that hasn't invaded the muscle is treated by putting BCG, a tuberculosis vaccine, into the bladder. It has been the standard since the 1970s, and despite the cancer often coming back, nothing has been added to it in a generation.
NowOn 28 May 2026 the FDA approved durvalumab (Imfinzi) in combination with BCG for high-risk, non-muscle-invasive bladder cancer: the first immunotherapy combination for the disease, and the first genuinely new approach layered onto BCG in decades.
TaughtThree hundred million years ago, dragonfly-like insects grew to the size of hawks. The standard explanation: atmospheric oxygen was around 45% higher than today, and because insects breathe through passive tubes rather than lungs, only that oxygen-rich air could supply a body that large. When oxygen fell, giant insects became impossible.
NowA 2026 study in Nature found that the insect breathing system is nowhere near its oxygen-delivery limit, so oxygen alone cannot explain the giants. The prevailing high-oxygen theory of insect gigantism doesn't hold up.
TaughtFinding a new asteroid, or catching a supernova as it flares, is painstaking work: an astronomer comparing images, spotting a moving dot or a new point of light, confirming it night by night. Discoveries come in ones and tens, and the vast majority of the sky's changes pass unseen.
NowOn 30 June 2026, the NSF–DOE Vera C. Rubin Observatory began its 10-year Legacy Survey of Space and Time, imaging the entire southern sky every few nights. In just six weeks of early optimization runs it had already found over 11,000 new asteroids, and in full operation it issues up to about 7 million alerts of changes in the sky every single night.
No human has traveled beyond Earth orbit since 1972, and none will for the foreseeable future
Changed in2026TaughtThe last people to leave low-Earth orbit were the Apollo 17 astronauts in December 1972. Ever since, human spaceflight has been stuck circling a few hundred kilometres up (the Space Shuttle, the ISS) and returning to deep space felt perpetually a decade away.
NowOn 1 April 2026, NASA's Artemis II launched four astronauts on a flight around the Moon, the first crewed mission beyond low-Earth orbit since Apollo 17. They looped around the far side and splashed down safely on 10 April, traveling farther from Earth than any humans in history.
Nothing can reach the brain damage of Hunter syndrome
Changed in2026TaughtIn Hunter syndrome, a missing enzyme lets sugary molecules pile up in cells throughout the body and the brain. Enzyme replacement can help the body, but the replacement enzyme cannot cross the blood-brain barrier, so the cognitive decline is untouchable.
NowOn 25 March 2026 the FDA approved Avlayah (tividenofusp alfa), an enzyme replacement engineered to cross the blood-brain barrier: the first treatment for Hunter syndrome aimed at its neurological damage, and the first FDA approval for the disease in nearly twenty years.
The charred Herculaneum scrolls can never be read
Changed in2026TaughtThe library of carbonized papyrus scrolls from Herculaneum, charred solid by the same eruption that buried Pompeii, is unreadable. Unrolling them destroys them, so their contents are lost forever, a whole ancient library we can see but never open.
NowThey can be read without being opened. Using high-resolution CT scans and machine learning, the Vesuvius Challenge recovered the first words in 2023 and full passages in 2024, and in 2026 an entire scroll, PHerc. 1667, was virtually unwrapped and read end to end for the first time.
TaughtThe blockbuster weight-loss and diabetes drugs (semaglutide, tirzepatide) are peptides, fragile protein-like chains your stomach digests. That is why they come as weekly injections. You cannot simply put them in a swallowable, mass-produced tablet.
NowOn 1 April 2026 the FDA approved Foundayo (orforglipron), the first small-molecule GLP-1 receptor agonist: a once-daily pill you can take any time of day, with no food or water restrictions, and that can be manufactured at pharmaceutical scale like an ordinary tablet.
TaughtThe biologics that clear moderate-to-severe psoriasis are large antibody proteins. Swallow one and your gut digests it like food, so they only work as injections. A pill that targets the same pathway is not chemically possible.
NowOn 18 March 2026 the FDA approved Icotyde (icotrokinra), the first oral IL-23 pathway drug for plaque psoriasis. It is a small engineered peptide designed to survive the gut and block the same target the injected biologics hit.
TaughtHigh blood pressure is treated with the same handful of drug families your parents took: diuretics, ACE inhibitors, ARBs, calcium-channel blockers, beta-blockers. Nothing mechanistically new has arrived in decades, and for resistant patients the cupboard is bare.
NowOn 18 May 2026 the FDA approved baxdrostat (Baxfendy), an aldosterone synthase inhibitor, the first mechanistically new class of blood-pressure drug in decades. It blocks the enzyme that makes aldosterone, a hormone that drives hard-to-treat hypertension.
TaughtFocal segmental glomerulosclerosis scars the kidney's filters and marches toward dialysis or a transplant. There is no drug approved specifically for it; doctors borrow steroids and blood-pressure medicines off-label and hope.
NowOn 13 April 2026 the FDA gave full approval to sparsentan (Filspari) as the first medicine ever approved specifically to treat FSGS, based on the phase 3 DUPLEX trial showing it reduced the protein leakage that drives the disease.
TaughtTriple-negative breast cancer lacks the three receptors that targeted drugs aim at, which is what 'triple-negative' means. With no target to hit, treatment falls back on general chemotherapy, and outcomes are poor.
NowOn 22 May 2026 the FDA approved Datroway (datopotamab deruxtecan), the first targeted therapy to beat chemotherapy on survival in first-line metastatic triple-negative breast cancer. It homes in on a protein called TROP2 and delivers a chemotherapy payload directly to the tumor cells.
That’s 16 revisions since 2026.
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