Pancreatic cancer remains one of the most challenging cancers to treat. In most cases, it is diagnosed at an advanced stage and is initially treated with chemotherapy. However, once the disease progresses despite this treatment, the available options become much more limited¹.

At the 2026 Annual Meeting of the American Society of Clinical Oncology (ASCO), one of the world’s largest cancer conferences, researchers presented results from the Phase 3 RASolute 302 trial, evaluating a targeted oral therapy called Daraxonrasib in people with previously treated metastatic pancreatic cancer². The findings attracted considerable attention from the oncology community and general public because improvements of this magnitude have not been previously seen in pancreatic cancer care, particularly after standard treatments have stopped working.

What was studied

The trial enrolled people with metastatic pancreatic cancer whose disease had progressed after one previous treatment, such as fluoropyrimidine- or gemcitabine-based chemotherapy. Patients were randomly assigned to receive either Daraxonrasib, taken as a once-daily oral treatment, or standard chemotherapy (FOLFIRINOX, gemcitabine plus nab-paclitaxel, and others) selected by their treating physician.

Importantly, the study included patients whose tumours carried a KRAS mutation (the most common type in pancreatic cancer), as well as patients whose tumours did not have an identified KRAS mutation.

Key results presented at ASCO

The results showed that:

• Patients receiving Daraxonrasib lived longer than those receiving standard chemotherapy. Median overall survival was 13.2 months for patients treated with Daraxonrasib, compared with 6.7 months for those receiving standard chemotherapy. This corresponded to an approximately 60% reduction in the risk of death during the study.
• The treatment also helped keep the cancer under control for longer. Patients receiving Daraxonrasib experienced a median progression-free survival of just over seven months, compared with around three and a half months for those receiving standard chemotherapy.
• Daraxonrasib was also more effective at shrinking tumours. Around one in three patients experienced a meaningful tumour response, compared with approximately one in ten patients treated with standard chemotherapy.
• One of the most interesting findings was that benefits were observed not only in patients whose tumours had a KRAS mutation, but also in those without an identified KRAS mutation.
• For many people living with pancreatic cancer, maintaining quality of life is just as important as extending survival. Importantly, patients receiving Daraxonrasib not only lived longer, but also maintained their quality of life for longer. The study showed a significant delay in the worsening of pain (9.2 versus 3.8 months) and a longer period before overall health and quality of life declined compared with chemotherapy (5.7 versus 2.6 months). These findings suggest that the treatment may help people remain active and manage symptoms for longer while living with metastatic disease.
• The treatment was generally well tolerated. Most side effects could be managed with supportive care or dose adjustments, and fewer patients stopped treatment because of side effects compared with those receiving standard chemotherapy. The most common side effects included skin rash and mild gastrointestinal symptoms, while serious treatment-related discontinuations were uncommon. Overall, the safety profile was considered manageable and consistent with previous studies.

How this treatment works

Around 90% of pancreatic cancers are driven by alterations in the KRAS gene, which acts like a permanently “switched on” signal telling cancer cells to grow. For decades, KRAS was considered extremely difficult to target directly. Daraxonrasib belongs to a new class of medicines called RAS(ON) inhibitors, designed to block the protein in its active state, essentially turning off this growth signal³. A key feature of this drug is that it targets a broad range of RAS alterations, rather than only one specific mutation. This helps explain why benefits were observed across different patient groups in the study.

What happens next?

Although these results are encouraging, Daraxonrasib has not yet been approved by regulatory authorities and is not currently available as a standard treatment. Pancreatic cancer remains a serious disease, and additional research is needed to better understand the long-term benefits of treatment. Further studies are already underway, including the RASolute 303 trial that is exploring this treatment earlier in treatment (first-line treatment) and in combination with chemotherapy (such as Gemcitabine and Nab-paclitaxel) in patients with metastatic pancreatic cancer, to determine whether patients may benefit even sooner after diagnosis.

Key takeaway: The RASolute 302 results presented at ASCO 2026 strengthen the evidence that directly targeting KRAS can meaningfully improve outcomes in previously treated metastatic pancreatic cancer.

Patients receiving Daraxonrasib lived longer, experienced better disease control, and maintained their quality of life for longer than those receiving standard chemotherapy. While not a cure, this represents a significant step forward in a disease where progress has been slow for many years and offers renewed hope for the development of new targeted therapies for pancreatic cancer.

If you are interested in clinical trials or emerging treatments, your healthcare team can help you understand what options may be right for you. You can also search for trials through the DiCE Clinical Trials Database.

References:

1. Rozengurt, E. & Eibl, G. Pancreatic cancer: molecular pathogenesis and emerging therapeutic strategies. Signal Transduct. Target. Ther. 11, 6 (2026).

2. O’Reilly, E. M. et al. Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer. New England Journal of Medicine https://doi.org/10.1056/NEJMoa2605555 (2026) doi:10.1056/NEJMoa2605555.

3.        Cregg, J. et al. Discovery of Daraxonrasib (RMC-6236), a Potent and Orally Bioavailable RAS(ON) Multi-selective, Noncovalent Tri-complex Inhibitor for the Treatment of Patients with Multiple RAS-Addicted Cancers. J. Med. Chem. 68, 6064–6083 (2025).

Author:

Juliana Calheiros