Experimental Drug Nearly Doubles Survival in Advanced Pancreatic Cancer, Drawing a Standing Ovation at ASCO

An experimental pill nearly doubled how long patients with advanced pancreatic cancer lived, according to results presented Sunday at the American Society of Clinical Oncology's annual meeting in Chicago that drew a standing ovation from oncologists and were hailed as a turning point against one of the deadliest cancers in medicine.

In the international Phase 3 trial, known as RASolute 302, the drug daraxonrasib extended median overall survival to 13.2 months, compared with 6.7 months for patients who received standard chemotherapy. That translated to a hazard ratio of 0.40 — a 60% reduction in the risk of death — while the drug also nearly doubled progression-free survival and produced fewer serious side effects than chemotherapy.

"These are the kind of results we have been waiting decades to see in pancreatic cancer," said Dr. Brian Wolpin of the Dana-Farber Cancer Institute, who presented the data. The trial enrolled 500 patients with previously treated metastatic pancreatic ductal adenocarcinoma at sites across North America, Europe and Asia, and the findings were published simultaneously in The New England Journal of Medicine.

Daraxonrasib, developed by Revolution Medicines, belongs to a new class of multiselective "RAS(ON)" inhibitors. Unlike earlier KRAS-targeting drugs that work only against a single specific mutation, daraxonrasib blocks activated RAS signaling across multiple variants — and showed activity in tumors both with and without RAS mutations. Roughly 90% of pancreatic cancers are driven by mutations in the KRAS gene, a target long considered "undruggable."

Pancreatic cancer kills the vast majority of those it strikes; the five-year survival rate hovers around 13%, and most patients are diagnosed only after the disease has spread. The Food and Drug Administration granted Revolution Medicines permission on May 1 to open an expanded-access program, allowing some previously treated patients to receive daraxonrasib before formal approval.

Researchers cautioned that the drug is not a cure and that longer follow-up is needed to understand how durable the benefit will be. But doctors at the meeting said the mechanism — hitting RAS regardless of the specific mutation — could make daraxonrasib relevant to lung, colorectal and ovarian cancers, which are also frequently RAS-driven. Trials in those tumor types are already underway. "If this holds up, it changes the conversation for a huge number of patients," Wolpin said.