What You Should Know
- Patients in a major study lived longer: In a large clinical trial, people taking daraxonrasib lived an average of 13.2 months compared with 6.7 months for those receiving standard chemotherapy. Tumors also shrank more often with daraxonrasib, giving many patients renewed hope for better outcomes.
- Experts believe that if daraxonrasib can better control cancer throughout the body, more patients may become candidates for additional treatments such as radiation or surgery. Researchers are now studying whether using the drug earlier in treatment could further improve survival.
- Looking ahead, Dr. Goodman at Mount Sinai says improved systemic control with daraxonrasib may allow more patients to become candidates for focal therapies such as radiation or surgery, noting that “as we get better at controlling the systemic disease,” treating the primary tumor becomes increasingly important.
“We’re all very excited in the world of pancreatic cancer about the drug daraxonrasib, which is a RAS inhibitor,” Dr. Karyn Goodman, Professor and Vice Chair for Research and Quality in the Department of Radiation Oncology at the Icahn School of Medicine at Mount Sinai, tells SurvivorNet.
Read MoreThe Data Behind the Excitement
In the pivotal phase 3 RASolute 302 trial, all patients had been previously treated with one line of chemotherapy for metastatic disease and were randomized to daraxonrasib or second-line chemotherapy.
- People lived longer. Average survival was 13.2 months with daraxonrasib, compared with 6.7 months with chemotherapy, roughly double.
- More tumors shrank. Tumors shrank in 31.6% of patients on daraxonrasib, compared with 11.2% on chemotherapy.
In the overall population, daraxonrasib produced a hazard ratio for death of 0.40.
Why This Could Make Surgery and Radiation Matter More
Doctors think about pancreatic cancer treatment in two ways. Systemic treatments, like chemotherapy or daraxonrasib, travel through the whole body. Local treatments, like surgery and radiation, target the tumor in one spot.
Dr. Goodman says that when systemic treatment works better, local treatment can play a bigger role.
“Our hope is that with the improvement in outcomes with daraxonrasib, there are going to be more patients, even those who have metastatic disease, that may eventually be able to undergo more focal therapies like radiation and surgery,” she says.
“I think as we get better at controlling the systemic disease or the disease that’s going elsewhere in the body, then being able to treat the local disease is going to be even more important.”
What’s Coming Next
Dr. Goodman is especially hopeful about locally advanced pancreatic cancer, meaning cancer that has grown into nearby blood vessels or tissue but hasn’t spread to distant organs.
“I think this is going to be a really exciting area [especially] for locally advanced pancreatic cancer, where they’re now developing studies to give daraxonrasib to patients as an initial treatment with chemotherapy,” Dr. Goodman tells SurvivorNet.
That approach could potentially bring “more improvement in outcomes and better control of the cancer throughout the body. And then we can come in with our local therapies, like radiation, or if surgery eventually becomes possible, to ultimately really improve survival for patients with pancreatic cancer.”
The phase 3 program is already moving into earlier settings:
- Initial or First-line treatment. RASolute 303 is a randomized, open-label phase 3 trial of daraxonrasib alone or with gemcitabine and nab-paclitaxel vs gemcitabine and nab-paclitaxel in previously untreated metastatic PDAC.
- After Surgery (Adjuvant setting). RASolute 304 is evaluating adjuvant treatment in resected pancreatic cancer, and its first patient was randomized in December 2025.
The Open Questions for Multidisciplinary Teams
As systemic options improve, tumor boards will face new questions:
- Which patients with metastatic disease might benefit from consolidative local therapy?
- How to time radiation or surgery around an oral daily RAS inhibitor?
- How to design trials that test those strategies rigorously?
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