A diagnosis of metastatic pancreatic cancer has until now meant a statistical survival of only six to seven months. A new phase 3 trial shows that the drug daraxonrasib doubles that to 13.2 months and cuts the risk of death by 60 percent compared to standard chemotherapy. For one of the world's deadliest cancers, this is a historic turning point.
Why Pancreatic Cancer Is So Hard to Treat
Roughly 500,000 people worldwide are diagnosed with pancreatic cancer each year, and nearly as many die of it. Five-year survival sits below 12 percent, making it deadlier than lung or colon cancer. The core reason: the tumour sits deep in the abdomen, causes no symptoms for a long time and is usually discovered only at an advanced stage, when surgery is no longer possible.
The decisive biological background: more than 90 percent of pancreatic carcinomas carry mutations in the RAS oncogene. Mutated RAS proteins drive uncontrolled tumour growth. For decades, RAS mutations were considered pharmacologically untouchable. The first approved RAS inhibitors, like sotorasib and adagrasib, each target only a specific mutation, mainly in lung cancer. For pancreatic cancer, no breakthrough of this kind had emerged.
The Trial and Its Results
US company Revolution Medicines has developed daraxonrasib, a so-called pan-RAS inhibitor that blocks a broad spectrum of RAS mutation variants. A notable detail: the drug is taken as a once-daily tablet, not as an intravenous infusion.
The phase 3 trial RASolute 302 enrolled patients with metastatic pancreatic carcinoma who had already received a first-line therapy. The central result: compared to standard chemotherapy, patients on daraxonrasib lived a median of 13.2 months instead of 6.7. The hazard ratio of 0.40 means the risk of death at any point was 60 percent lower than in the comparison group. All primary and secondary endpoints were met, with a p-value under 0.0001.
Particularly surprising: the improvement applied not only to patients with RAS-G12 mutations but to all trial participants, including those without detected RAS mutations. That suggests daraxonrasib acts more broadly than initially expected. The side-effect profile, according to the company, was manageable with no unexpected new risks.
What the Finding Means
The Pancreatic Cancer Action Network, one of the largest patient organizations in the US, called the trial results historic. Former US Senator Ben Sasse, himself diagnosed with a pancreatic tumour, participated in the trial and publicly spoke as its face.
For context: most oncological advances in pancreatic cancer over recent decades extended survival by only weeks. Doubling median survival is pharmacologically extraordinary. By comparison, pembrolizumab, considered a milestone in lung cancer, extended median first-line survival over chemotherapy by roughly four months. Daraxonrasib achieves more than double that in second-line treatment.
Outlook
Revolution Medicines has announced it will file for accelerated approval with the US FDA. Full trial data will be presented at the ASCO congress in June 2026. A European application with the EMA is planned for summer. Further trials are underway to test how daraxonrasib performs in first-line treatment and in combinations.