About 90% of people with pancreatic cancer have pancreatic ductal adenocarcinoma (PDAC), which is driven by an activating mutation in the KRAS gene.
These genes make KRAS proteins, which act as switches that tell our cells when to grow and divide. The mutation locks the switch in the “on” mode, making the mutated cells grow out of control when they develop additional mutations and become cancerous tumors. This combination is often more aggressive than standard treatments such as chemotherapy or radiotherapy can completely eradicate.
Though pancreatic cancer is one of the most complex cancers to treat, new and effective treatments – ranging from medicine and surgery to radiation oncology – have emerged in recent years.
The latest medical therapy, daraxonrasib, is producing results that are truly revolutionary. In clinical trials, daraxonrasib doubled median survival (from 6.7 months to 13.2 months) for patients with metastatic PDAC that had stopped responding to prior chemotherapy.
This once-daily pill is the beginning of a breakthrough that could deliver better outcomes to more patients with pancreatic cancer. Innovations in medical, surgical, and radiation oncology along with companion diagnostics such as imaging mean patients, even those with metastatic disease, are living longer and maintaining a higher quality of life.
How daraxonrasib works
Daraxonrasib is part of a new class of medications called RAS(ON) inhibitors that target RAS proteins inside cancer cells. RAS proteins are the “brains” or master switch of many tumors, instructing them to divide and spread despite aggressive chemotherapy treatment.
Like a molecular glue, daraxonrasib binds to RAS proteins in their “on” state, gumming up their ability to interact with downstream proteins, effectively silencing the proteins to block tumor growth. Daraxonrasib can target several types of KRAS mutations, of which there are more than 20.
Why daraxonrasib is a game changer
The best cure is to surgically remove pancreatic cancer before it spreads; however, the tumor comes back in most cases. If we cannot safely remove a patient’s pancreatic cancer because of local extent or spread, we attempt to optimize treatment to prolong quantity and quality of life with drug therapies and often radiation therapy.
Chemo drugs such as gemcitabine and nab-paclitaxelor FOLFIRINOX (oxaliplatin, irinotecan, fluorouracil, and leucovorin) can be effective, but they can also be hard on the body. Side effects include fatigue, immune system suppression, diarrhea, pain, and numbness in the hands and feet.
Daraxonrasib will be a new option. It is gentler. Side effects include a skin rash, diarrhea, nausea, and potential inflammation of the mucous lining of the mouth and digestive tract.
Related: Read: "With help from hospice patients, UT Southwestern is rewriting the cancer story"
Eligibility for daraxonrasib
As we await Food and Drug Administration (FDA) approval of the medication, daraxonrasib is available through clinical trials or the drug manufacturer’s expanded access program (EAP). However, patients who are successfully taking another medication for metastatic PDAC are not eligible.
The EAP for daraxonrasib, granted in May 2026, makes the drug available to adults with previously treated metastatic PDAC who cannot join a clinical trial and have no other effective or available therapy. EAPs require patients to meet specific criteria, and participating medical centers must complete detailed paperwork as a treatment site and for each individual patient.
UT Southwestern's Harold C. Simmons Comprehensive Cancer Center is approved as a participating treatment site, allowing eligible patients to be considered for treatment through the EAP. As an Academic and Clinical Center of Excellence recognized by the National Pancreas Foundation, UTSW is consistently focused on providing our patients with the best possible outcomes and an improved quality of life.
Eligibility will change once daraxonrasib is FDA-approved, and we have many patients who could benefit once it is more widely available. Stay up to date on daraxonrasib and other therapies by talking with your doctor and checking with national advocacy organizations such as Pancreatic Cancer Action Network (PanCAN) and Let's Win Pancreatic Cancer.
The future of pancreatic cancer treatment
UT Southwestern will be a site for several studies looking into new ways to treat pancreatic cancer:
- An upcoming clinical trial will determine whether daraxonrasib could extend the cancer-free interval after pancreatic cancer surgery.
- NRG GI-011 is a phase three trial analyzing the role of dose-escalated radiation therapy to extend survival for patients with unresectable pancreatic cancer.
- EXPAND is a phase three trial evaluating ablative radiotherapy or other local therapies plus systemic therapy in patients with limited metastatic disease.
- Setidegrasib KRASG12D is a phase three trial evaluating the efficacy of KRAS G12D degrader in first-line pancreatic cancer combined with chemotherapy.
Participating in a clinical trial offers patients access to some of the latest scientific breakthroughs while also providing valuable information to develop new therapies.
Multiple additional trials are underway or in the works evaluating therapies to improve outcomes, including Optune Pax tumor-treating fields and molecularly targeted drugs.
Nationally, there are clinical trials for daraxonrasib to treat patients with pancreatic adenocarcinoma, colorectal cancer, and non-small cell lung cancer. While daraxonrasib is currently given to patients who have exhausted other treatment options, future clinical trials may study its effectiveness as a standalone therapy. Talk with your doctor about current and upcoming clinical trials.
Patients and providers alike are excited about the early results with daraxonrasib. We answer questions about it daily, and our specialists have been buzzing about it for months. This drug is the start of more breakthroughs to come, which will give more patients with pancreatic cancer a longer, higher quality of life.
To talk with an expert about pancreatic cancer treatment options, make an appointment by calling 214-645-8525 or request an appointment online.
