Breakthrough drug daraxonrasib doubles survival in patients with advanced pancreatic cancer

Gastrointestinal medical oncologist Dr. Eileen O'Reilly led the phase 3 clinical trial of daraxonrasib for pancreatic cancer at MSK. (Photo credit – Memorial Sloan Kettering)

CANCER DIGEST – July 4, 2026 – In a clinical trial, an experimental oral targeted medication nearly doubled overall survival in pancreatic cancer patients with a specific genetic mutation, compared to standard chemotherapy.

Published May 31, 2026 in The New England Journal of Medicine, the international Phase 3 RASolute 302 clinical trial evaluated a new targeted drug called, daraxonrasib, that works like a "molecular glue" designed for patients with previously treated metastatic pancreatic ductal adenocarcinoma.

The trial involved 500 patients, 91.8 percent of who had a specific genetic mutation called RAS G12. All patients had been previously treated for metastatic pancreatic cancer, meaning the cancer had spread to other tissues in the body. Patients were randomly assigned to receive either daraxonrasib (248 patients) or standard chemotherapy (252 patients). The results showed:

• Overall Survival reached a median of 13.2 months in the daraxonrasib group compared to 6.7 months for the chemotherapy group.

• The drug demonstrated a highly significant 60 percent reduction in the risk of death (hazard ratio of 0.40; P<0.001) across both patient populations.

Daraxonrasib also significantly outperformed chemotherapy in progression-free survival (PFS), which measures the time a patient lives without their cancer worsening. The progression-free period for patients in the draxonrasib group reached a median of 7.3 months compared to 3.5 months for chemotherapy only group.

“To date in my career, I have not seen this level of benefit from any single anti-cancer drug in this disease,” Memorial Sloan Kettering gastrointestinal medical oncologist Eileen O’Reilly, MD, and lead author of the NEJM article said in a press release. 

While side effects were common in both groups, the targeted therapy proved much easier for patients to tolerate than traditional, toxic chemotherapy regimens. Severe adverse events (grade 3 or higher) occurred in 61.8% of daraxonrasib patients compared to 69.6% of chemotherapy patients. Only 1.2 percent of patients taking daraxonrasib had to stop treatment due to drug-related side effects. In contrast, 11.2 percent of chemotherapy patients were forced to halt treatment due to toxicities.

Pancreatic cancer remains one of the most deadly cancers worldwide, historically plagued by a lack of effective targeted treatments. Patients whose tumors have the RAS G12 mutations have been particularly difficult to treat with targeted therapies because while the cancer cells are locked into a continuous growth cycle, the cells also lack the cell surface proteins that targeted therapies usually zero in on. 

Daraxonrasib, however, enters inside the cell and acts as a "molecular glue," attaching to a naturally occurring protein called cyclophilin A, and "gums" up the works. It shuts down the growth signals, thus effectively causing the tumor to shrink.  Daraxonrasib represents a major shift toward precision medicine for a notoriously difficult-to-treat disease.

Daraxonrasib may represent a new class of targeted therapies and marks a significant advance in the treatment of pancreatic cancer. “It’s very encouraging that we are seeing these kinds of results for people with pancreas cancer on a large scale,” O’Reilly said.

Sources: New England Journal of Medicine, and Memorial Sloan Kettering press release.