Median survival of 13.2 months, against 6.7 months on standard chemotherapy. Those are the headline figures from a Phase 3 trial of daraxonrasib, an oral drug for metastatic pancreatic cancer, and they come from a disease where treatment options have been few for a very long time.
Revolution Medicines, the company developing the drug, presented the results on May 31, 2026. The trial enrolled 500 patients with metastatic pancreatic cancer who had already received treatment. Compared with chemotherapy, daraxonrasib reduced the risk of death by 60%. The trial was published in the New England Journal of Medicine under the title “Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer.”
Why KRAS was thought out of reach
More than 90% of pancreatic tumors are driven by mutations in a gene called KRAS. The gene codes for proteins that work as switches turning cell growth on and off. A mutation leaves the switch stuck “on,” telling cancer cells to multiply without end.
For decades, scientists called KRAS “undruggable.” The protein’s surface is exceptionally smooth and lacks the molecular pockets that standard drugs need in order to grip it. Treatment has leaned instead on chemotherapy, which kills rapidly dividing cells widely and damages healthy tissue along the way. Pancreatic cancer cells also tend to develop resistance to those drugs.
Daraxonrasib is taken daily by mouth. It does not bind KRAS directly. It attaches to cyclophilin A, a molecule in cells that helps fold proteins into their final 3D shape, and the resulting complex binds the active KRAS protein and shuts down its signal to multiply.
Side effects and quality of life
The most common side effect was a prominent skin rash, which affected more than 86% of patients in the study. Many also had stomatitis, meaning painful swelling and sores inside the mouth, along with diarrhea, nausea and vomiting. Even so, patients on daraxonrasib were far less likely than those on chemotherapy to stop treatment because of severe side effects. They also reported improved quality of life, with less pain.
The outlook for this cancer has been grim. Of patients diagnosed with metastatic pancreatic cancer between 2015 and 2021, about 97% died within five years. There is no effective screening test, and the disease rarely causes noticeable symptoms early on. By the time jaundice or abdominal pain appears, the cancer has often spread to other organs.
Christopher Lieu, a professor of medical oncology at the University of Colorado Anschutz who wrote about the findings, called the result a likely shift in pancreatic cancer treatment. He said he expects more trials pairing KRAS inhibitors with other drugs to keep tumors from developing resistance.
What comes next
The drug is not yet approved. Revolution Medicines is expected to use the published data to seek approval from the Food and Drug Administration and other regulators. Lieu noted that breakthrough therapies with this kind of survival benefit are often granted expedited or priority review, and said that if the drug is approved it could reach clinics within months. The timing depends on the review.
Anyone with pancreatic cancer who wants to know whether this treatment could apply to them should talk to their oncologist.
