A landmark clinical trial has found that the targeted drug daraxonrasib doubled median survival time for patients with metastatic pancreatic cancer compared with standard chemotherapy, offering what researchers describe as a potential turning point in treating one of the most aggressive cancers. Patients on the drug also tolerated side effects better than those receiving chemotherapy, the current standard of care for advanced disease.
Led by gastrointestinal oncologist Dr. Eileen O’Reilly at Memorial Sloan Kettering Cancer Center, the international phase 3 trial enrolled 500 patients with metastatic pancreatic cancer who had received prior treatment. Results presented at the 2026 American Society of Clinical Oncology Annual Meeting and published in the New England Journal of Medicine showed that daraxonrasib directly targets KRAS mutations, which drive more than 90 percent of pancreatic cancers by sending signals that cause uncontrolled cell growth. Until now, no therapy has effectively targeted these mutations despite decades of research. “To date in my career, I have not seen this level of benefit from any single anti-cancer drug in this disease,” Dr. O’Reilly said. “People live better for longer.”
Patients often feel improvement quickly after starting the drug. “Their pain is better. They eat better and feel less fatigued,” Dr. O’Reilly noted. One trial participant, 83-year-old Helene Rubin, said lung nodules shrank after her dose was adjusted. “On chemo, I couldn’t get off the couch and I was always nauseous and lost a ton of weight,” she said. “The drug has worked terrifically for me.” Clinical trials nurse Mary Larsen, who worked on earlier studies of the drug, said the first patient’s turnaround was remarkable. “It gave us chills to see people feeling so much better,” she said. “It feels like we’re helping give people back some of their lives.”
The drug does cause side effects, including a rash that can be inflamed and sore. However, patients report that even severe rash is preferable to the nausea and fatigue of chemotherapy. Researchers stress that daraxonrasib is not a cure, as pancreatic cancer is often detected only after it has spread. Dr. O’Reilly called the drug “a sea change, but we are just at the beginning.” She believes combination therapies may boost effectiveness and reduce resistance. New trials are already underway, including one testing the drug in patients who have not yet received treatment and another comparing it with chemotherapy after surgery. The U.S. Food and Drug Administration granted daraxonrasib Breakthrough Therapy designation in June 2025 and has indicated it will accelerate review. With decades of research finally yielding results against the once “undruggable” RAS mutations, the outlook for pancreatic cancer patients is brighter than it has been in years.