Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer
Eileen M. O’Reilly, M.D., Zev A. Wainberg, M.D., Andrew E. Hendifar, M.D., Mitesh J. Borad, M.D., Filippo Pietrantonio, M.D., Shubham Pant, M.D., Pascal Hammel, M.D., Chiara Cremolini, M.D., Ph.D., Gulam A. Manji, M.D., Ph.D., Paul E. Oberstein, M.D., Ignacio Garrido-Laguna, M.D., Ph.D., Christoph Springfeld, M.D., Ph.D., Nilofer S. Azad, M.D., Makoto Ueno, M.D., Ph.D., Stephen Y. Chui, M.D., Ying Zhang, Ph.D., Hina Patel, Pharm.D., Yeonju Lee, Ph.D., Zeena Salman, M.P.H., and Brian M. Wolpin, M.D., M.P.H., for the RASolute 302 Trial Investigators*
For patients with pancreatic cancer, treatment options remain limited and outcomes are often poor, particularly in advanced stages of the disease. In previously treated metastatic pancreatic ductal adenocarcinoma (PDAC), the most common form of pancreatic cancer, median overall survival with standard chemotherapy is approximately 6–7 months.
PDAC is strongly driven by underlying genetic changes. Around 90% of tumors contain mutations in a gene called KRAS, which plays a central role in regulating normal cell growth and survival. When KRAS is permanently activated due to mutation, it can contribute to uncontrolled cell growth and cancer development.
A recent Phase III clinical trial involving more than 500 patients evaluated daraxonrasib, an oral therapy designed to target cancers driven by abnormal KRAS activity. The study compared daraxonrasib with standard chemotherapy in patients with previously treated metastatic PDAC.
Results showed that the 248 patients receiving daraxonrasib had a 60% reduction in the risk of death compared with 252 patients receiving chemotherapy. Median overall survival increased from 6.7 months with chemotherapy to 13.2 months with daraxonrasib. Patients treated with daraxonrasib also reported improvements in pain and quality of life.
These findings represent an important advance in the treatment of pancreatic cancer, particularly for a disease subtype that has historically had few targeted treatment options. By addressing a key genetic driver of PDAC, daraxonrasib may offer a new therapeutic option for patients who have progressed on prior treatments.
As of June 3, 2026, daraxonrasib remains an investigational therapy and has not yet received FDA approval. However, it is available to eligible patients through an FDA-authorized expanded access program while regulatory review continues.
