Daraxonrasib Drug Doubles Pancreatic Cancer Survival Rate in Phase 3 Trial

A drug that targets a molecular pathway involved in many types of cancer extends survival rate of pancreatic cancer patients by more than a year on average, according to new results from a clinical trial presented at the American Society of Clinical Oncology (ASCO) 2026 annual meeting. Researchers published the findings concurrently in The New England Journal of Medicine.¹

The drug, called daraxonrasib, blocks the RAS pathway, alterations in which have long been known to drive pancreatic cancer. More than 90 percent of pancreatic cancer tumors have mutations in a RAS gene. The new phase 3 trial, known as RASolute 302, was run by the drug’s maker, Revolution Medicines. The trial compared daraxonrasib with standard-of-care chemotherapy in 500 people with pancreatic cancer who had previously received treatment.

Pancreatic cancer is extremely lethal, in part because it often goes undetected until late stages. The median survival rate after diagnosis is just one year. It has so far been exceedingly difficult to treat, resisting new approaches such as immunotherapy that have been successful with other cancers. The current standard of care, chemotherapy, also comes with intense side effects.

That makes the new results even more important, said Channing Der, a pharmacologist at the University of North Carolina at Chapel Hill who studies RAS oncoproteins and was not involved in the trial.

“This is the real thing. This is not hyped,” Der said. “I’m always cautious about how I describe advances in cancer treatment because I don’t want to prematurely raise hope in patients. In this case here, this is huge.”

“Practice-Changing” Results

Of the 500 participants—92 percent of whom had the most common RAS mutation—248 received the trial drug, and 252 received the investigator’s choice of chemotherapy. Across the whole group, participants who received the trial drug lived on average 13.2 months, whereas participants in the chemotherapy group lived 6.7 months.

The drug also slowed progression: People receiving it did not see their disease worsen for 7.2 months, compared with 3.6 months for chemotherapy.

The findings were largely the same when looking only at the subset of people with the most common RAS mutation.

The results are “practice-changing, today,” said one of the trial’s principal investigators Eileen O’Reilly, a clinical oncologist at Memorial Sloan Kettering Cancer Center.

Some pancreatic cancer patients die within months or weeks of diagnosis, and those that live longer are often doing so with severe illness from treatment. Another year, with good quality of life, is huge for them, Der said. “Patients have been desperately awaiting these results.”

The Food and Drug Administration granted expanded access to daraxonrasib on May 1, which provides access for people who have already failed chemotherapy and were not eligible for a clinical trial. O’Reilly is hoping for full approval in the coming months.

Daraxonrasib Could Work for Other Cancers Too

Because RAS is so fundamental to pancreatic cancer, researchers are eager to test drugs like daraxonrasib in earlier stages of the disease, O’Reilly said. They also want to understand the ideal combination of the drug with other approaches.

“There’s a whole variety of approaches here that we’ll need to understand quickly whether they have traction and whether they deserve to be more developed and integrated into earlier lines of treatment,” O’Reilly said. “That’s our challenge, but that’s a good challenge to have and one the community and field of pancreas cancer research is more than ready to embrace.”

It’s promising that daraxonrasib outperformed chemotherapy even when given later on in the course of the disease, Der said; drugs that do well as a second-line treatment tend to do even better as a first-line treatment. Early trial data from O’Reilly’s team suggests that is the case: Tumors shrunk in the majority of patients treated with daraxonrasib only, according to results presented at the American Association for Cancer Research’s annual meeting in April.²

RAS inhibitors could also be game-changing for other types of cancer, O’Reilly said. RAS is the most commonly mutated gene in cancer, with mutations appearing in about 19 percent of all cancers.³

There are more than 70 RAS inhibitors in various stages of clinical development and testing, Der said. Some, like daraxonrasib, target the pathway broadly, while others go after only the specific RAS mutations present in tumors.

The trial also demonstrates the power of identifying a molecular driver of cancer and going after it directly, O’Reilly said.

“There’s a chink in the armor here,” she said. “The door, honestly to me, is wide open.”

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