Pancreatic cancer is one of the most difficult cancers to treat – it has a five-year survival rate of just 13%. But with the advent of a new FDA-approved treatment for advanced pancreatic cancer, that may finally be changing.
Called daraxonrasib, it’s an oral pill taken once daily that was shown in clinical trials to double the average survival of pancreatic cancer patients who have failed prior treatment – from 6.7 months to more than 13 months. It was more effective than regular chemotherapy in reducing the size of the tumor and delaying the spread of the disease.
“It works by targeting tumors with a gene mutation called KRAS, which drives 90% of pancreatic cancers – if not more,” says Philip Philip, M.D., Ph.D., a medical oncologist who specializes in gastrointestinal cancers at Henry Ford Health. “We believe that in most pancreatic cancers, it initiates oncogenesis, or the transformation of a healthy cell into a cancerous cell.
“We’ve known about the KRAS protein for many decades but could not figure out how to silence it. It was very challenging. The KRAS mutation is kind of like an on/off switch. It gets stuck in the ‘on’ position, allowing cancer cells to divide and grow out of control. Daraxonrasib stops KRAS from doing more damage.”
The KRAS mutation is also a player in other cancers like lung, colon, ovarian and endometrial – so this advancement in pancreatic cancer will likely benefit other cancer treatments in the future.
The Beginning Of Breakthrough Pancreatic Cancer Research
Improving the pancreatic cancer survival rate to 13 months might seem like modest gains. But daraxonrasib is an innovative treatment that can be built upon to become even more effective.
“This is really where the excitement lies,” says Dr. Philip. “Daraxonrasib is currently FDA-approved for those with advanced pancreatic cancer who have already failed one line of chemotherapy. This means you must have chemo before being allowed to take it. But it is also being tested as a frontline treatment, meaning people might be able to take it from the beginning.”
Pancreatic Cancer Care at Henry Ford Health
Researchers are also figuring out how to mix other drugs that synergize with daraxonrasib to better control how aggressively the cancer spreads – perhaps turning pancreatic cancer into a chronic disease instead of a deadly one.
“We’re also learning how to combine daraxonrasib with other medicine so cells won’t become immune or resistant to it, as can happen with many cancer treatments,” says Dr. Philip. “And we’ll also use it for patients after undergoing surgery to see if it can help prevent relapse, which unfortunately and not infrequently happens in this disease.”
Better Quality of Life and Less Side Effects with Daraxonrasib
In clinical trials, daraxonrasib didn’t just improve someone’s life span: it also provided a better quality of life compared to regular chemotherapy. “Daraxonrasib has generally fewer side effects than chemotherapy,” says Dr. Philip. “And it reduces the amount of pain someone experiences, as pancreatic cancer comes with many symptoms – especially pain.”
Side effects of daraxonrasib include skin rashes, diarrhea, mouth sores, fatigue and nausea, which patients can work with their medical teams to manage.
It’s also easier to use than traditional chemotherapy: a daily pill means people don’t have to go to an infusion center and get hooked up to an IV to undergo chemotherapy.
“There are really very minimal downsides to this drug,” says Dr. Philip. “When the FDA-approval of daraxonrasib was announced at a recent American Society of Clinical Oncology conference, it received a standing ovation. Some people were crying. For people like me who have been treating pancreatic cancer for three or four decades, we haven’t seen anything like this before. It will open the door for many more advances in this disease. It isn’t an experimental drug anymore – it’s a definite drug.”
Reviewed by Philip A. Philip, M.D., Ph.D., F.R.C.P., an internationally renowned medical oncologist specializing in gastrointestinal cancers. He is the Interim Chief, Division of Hematology/Oncology in the Department of Internal Medicine at Henry Ford Health and a professor at Wayne State University School of Medicine. He has led numerous studies in the areas of gastrointestinal tumors focusing on pancreatic cancer. He sees patients at Henry Ford Cancer in Detroit and Henry Ford Medical Center – Columbus.
