The First Drug to Crack KRAS
Most pancreatic cancers are driven by a mutation called KRAS, long considered undruggable. Daraxonrasib, developed by Revolution Medicines, is the first treatment to shut down those growth signals directly, and it did so in the first large randomized trial of a RAS inhibitor in this disease.
The Phase 3 results, published in the New England Journal of Medicine, drew a standing ovation when presented at this year's American Society of Clinical Oncology meeting. Nearly 32 percent of patients on the pill saw substantial tumor shrinkage, versus 11 percent on chemotherapy.
"This is a big leap forward, and frankly, this is the start," said Dr. Mark Lewis, director of gastrointestinal oncology at Intermountain Health, who called it the biggest breakthrough of his career. He was clear it is not a cure: side effects include rash, diarrhea and mouth sores, and surgery remains the only cure, rarely an option at stage 4.
Patients Are Not Waiting for Approval
The FDA authorized an expanded access program in May, letting approved patients receive the drug before full approval. Ten Intermountain Health hospitals across Utah, Colorado and Montana now offer it, alongside the Huntsman Cancer Institute and Utah Cancer Specialists; nine Intermountain patients are awaiting their first shipment.
The stakes are stark. About 67,000 Americans are diagnosed with pancreatic cancer each year and roughly 52,000 die, making it the third leading cause of cancer death, according to the American Cancer Society. There is no screening test, so most cases are caught late.
What Comes Next
Revolution Medicines filed for FDA approval on July 22 under a priority pathway that could deliver a decision within weeks, not months. Trials are also underway testing the drug as a first-line pancreatic cancer treatment and in RAS-mutated lung cancer. "This is about more than a new drug, it's about giving patients more time and more options," said Dr. Alicia Swink, an oncologist in Grand Junction, Colorado.
Frequently Asked Questions
- What is daraxonrasib?
- A daily pill from Revolution Medicines that blocks RAS proteins, the mutated growth drivers behind most pancreatic cancers. It is the first treatment to target that mutation directly.
- How much longer do patients live on daraxonrasib?
- In the Phase 3 trial, median survival was 13.2 months versus 6.7 months on chemotherapy, with a 60 percent lower risk of death during the study.
- Is daraxonrasib FDA approved?
- Not yet. An approval application was filed on July 22, 2026, but eligible patients can already receive it through an FDA-authorized expanded access program via their physician.
