For Vicky Stinson, a 65 year old retired landscape architect diagnosed with Stage III pancreatic cancer in 2024, the prognosis was stark: months, not years, to live. But a new class of targeted therapy is rewriting that timeline for patients like her. Stinson participated in a clinical trial for a drug called daraxonrasib, a daily pill that attacks cancer cells carrying a specific genetic mutation, and she says it gave her something chemotherapy could not: a full year of normalcy.
Published last week in the New England Journal of Medicine, the trial data shows daraxonrasib outperformed standard chemotherapy, keeping the disease from progressing for an average of 8 to 9 months, compared to just 2 to 3 months with chemo. That represents a three to fourfold improvement. The drug belongs to a new class of genetically engineered medicines called RAS inhibitors, which target and kill cells with certain cancerous mutations. Similar treatments have already transformed care for colorectal and lung cancers, and researchers believe this could be a turning point for pancreatic cancer, a disease that has long been notoriously difficult to treat.
About 70,000 Americans are diagnosed with pancreatic cancer each year, and roughly 80 percent learn they have it at a late stage. The five year survival rate remains at just 13 percent, according to the American Cancer Society. The pancreas sits deep behind other organs, making it hard to scan or operate on, and its tumors create a protective "cocoon" that shields them from chemotherapy. Tumor cells also tend to spread like "grains of sand" rather than a solid mass, making containment extremely difficult. But with drugs like daraxonrasib, oncologists say treatment is shifting from blunt force chemotherapy to precise, targeted attacks on the genetic drivers of the disease.
A New Era of Combination Therapies
While daraxonrasib is a major step forward, researchers are already exploring how to combine it with other emerging treatments. Last month, a small but promising study showed that individualized mRNA vaccines could activate a powerful immune response in half of 16 patients, extending life for most by up to six years. The vaccines are custom built for each patient based on the genetic profile of their tumor and manufactured in Germany within nine weeks. The technology has since advanced and is now being tested in broader trials.
Stinson, who hiked the Dolomite mountains in Italy and celebrated her 39th wedding anniversary with a 7 mile trek in Colorado while on the drug, says the biggest benefit was ease. Daraxonrasib is a single pill with fewer side effects than chemotherapy. In the study, about a third of patients experienced moderate to severe side effects like rash and diarrhea, but none discontinued the trial. Stinson developed mild acne on her face, neck and back. "Kind of brought me back to my teens," she jokes. "I had a full year of normalcy."
The FDA has already allowed the drug's maker, Revolution Medicines, to expand access to patients before formal approval. Lead investigator Dr. Brian Wolpin of Dana-Farber Cancer Institute says he hopes that means more patients could receive the drug within weeks or months. He believes RAS inhibition will become the backbone of future pancreatic cancer care, potentially leading to longer survival or even a cure when combined with vaccines and other therapies. For patients like Stinson, the hope is that science will help her keep moving forward, one trail at a time.