I was in my forties when I heard the words “you have cancer”. In that moment, the future I had taken for granted was replaced by scans, treatment decisions and uncertainty. Seven years after my diagnosis with pancreatic cancer, I know that time is not an abstract measure. It is birthdays, family occasions, conversations, plans and ordinary days that once felt uncertain.

Today, as a patient advocate working across pancreatic cancer research, policy and patient involvement in Ireland and Europe, I see the news about daraxonrasib through two lenses. One is deeply personal. The other is shaped by the patients whose experiences I bring into rooms where research priorities, policies and access decisions are made.

For someone living with metastatic pancreatic cancer, another treatment option is never “just another drug”. When options are becoming frighteningly limited, it can bring the possibility of more time and renewed hope. That is why the approval of daraxonrasib by the US Food and Drug Administration is so significant.

The approval covers adults with metastatic pancreatic adenocarcinoma who have received at least one previous systemic treatment or who are not candidates for multiagent systemic treatment. In the Phase 3 RASolute 302 trial, involving 500 adults with previously treated metastatic disease, median overall survival was 13.2 months with daraxonrasib, compared with 6.7 months with standard chemotherapy. Tumour response rates were also higher. These figures describe outcomes across groups, not what any one person can expect, but the difference is meaningful.

I was particularly pleased to hear Dr Eileen O’Reilly, one of the trial investigators and lead author of the published results, speak at the DiCE Masterclass in Munich in July. Hearing the science explained alongside the realities patients face was a reminder of what patient involvement should achieve: not celebration of innovation for its own sake, but a relentless focus on whether it changes people’s lives.

For patients in Europe, however, this progress comes with a hard truth. Approval in the United States does not give European patients access. The European Medicines Agency has begun a phased review of daraxonrasib, an important step that allows evidence to be assessed as it becomes available. But a review is not an authorisation. Even if European marketing authorisation follows, access will not be automatic or equal.

National health technology assessments, price negotiations, reimbursement decisions and funding arrangements will still influence whether and when the treatment becomes available in each country. For patients, these are not remote policy details. They determine what can actually be offered in the clinic.

A medicine that exists somewhere in the world is very different from one a doctor can prescribe to the person sitting in front of them. Scientific success can become regulatory approval and still remain out of reach. That is why our advocacy must follow the full journey from research to real access. Innovation must reach patients in time, wherever in Europe they live.

Our work also cannot stop with one medicine. We need progress across the entire pancreatic cancer pathway: earlier diagnosis, more effective options for locally advanced and resectable disease, better treatment before and after surgery, more inclusive clinical trials, stronger management of side effects, and care that protects quality of life. Patients must be meaningfully involved in deciding which questions research asks and how health systems judge value.

I am seven years beyond my diagnosis. I do not take that time for granted. I also know that my experience is not typical. Through my advocacy, I want to ensure that the voices of people who did not have those years are not lost or reduced to a statistic.

I welcome daraxonrasib as an important step forward and a genuine reason for hope. But hope must be matched by urgency. Europe must move from review to decisions, and from decisions to genuine access, without avoidable delays between countries.

People affected by pancreatic cancer deserve research that changes outcomes, innovation that reaches the clinic and healthcare systems capable of delivering it fairly. We cannot accept today’s survival figures as tomorrow’s future. Research can change the story. Our responsibility is to make sure every patient has a fair chance to be part of it.

Editorial sources

• US Food and Drug Administration approval
• Published Phase 3 RASolute 302 results
• European Medicines Agency phased review