A Landmark Moment in Pancreatic Cancer: A New Pill Nearly Doubles Survival
At the world’s largest cancer conference, a treatment aimed at pancreatic cancer’s most stubborn driver drew a standing ovation. Here’s what happened - and why it matters.
For almost forty years, one fault has sat at the heart of pancreatic cancer and resisted every attempt to switch it off. More than nine in ten pancreatic cancers are driven by a mutation in a gene called KRAS - and for decades, that target was considered “undruggable,” its surface too smooth and slippery for any medicine to grip.
In late May 2026, at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago - the world’s largest cancer conference - that label finally began to come apart. As the results of a trial called RASolute 302 appeared on screen, the packed auditorium rose to its feet, cheering and applauding. ASCO's Chief Medical Officer and Executive Vice President, Dr. Julie Gralow, did not reach for caution. She called it “a grand slam.”
For a disease where good news has been rare, that reaction tells you how much this moment means.
What the trial found
RASolute 302 tested a new once-a-day tablet, daraxonrasib, against standard chemotherapy in around 500 people across six countries whose pancreatic cancer had spread and had kept growing despite earlier treatment - a group with very few good options left. The findings were published the same day in the New England Journal of Medicine, one of the most respected journals in medicine.
The headline: people taking daraxonrasib typically lived about 13.2 months, compared with around 6.7 months on chemotherapy - close to double. The time before the cancer started growing again roughly doubled too. Put another way, the drug reduced the risk of dying during the trial by around 60%.
Just as striking, patients tolerated it better. Serious side effects were less common than with chemotherapy, and far fewer people had to stop treatment because of them - about 1 in 100, compared with roughly 1 in 9 on chemotherapy. People on daraxonrasib also went longer before their pain worsened and before their quality of life declined - which matters enormously when treatment is about living well, not just living longer.
Dr Eileen O’Reilly of Memorial Sloan Kettering Cancer Center, the study’s lead author, put it simply: in her whole career she had never seen this level of benefit from a single drug in this disease. “People live better for longer,” she said.
Why “second-line” makes this even more remarkable
One detail is worth focusing on. When advanced pancreatic cancer is diagnosed, the first treatment offered - usually chemotherapy - is called first-line. It often helps for a while, but the cancer tends to return. Doctors then move to second-line treatment - and historically this has been a bleak place. Second-line chemotherapy has typically added only three to four months, and for decades almost nothing improved on it.
Daraxonrasib achieved its results precisely here, in this second-line setting - in people whose cancer had already outlasted first-line treatment. To nearly double survival in the hardest group of all is what brought that auditorium to its feet.
How rare is a breakthrough like this?
To understand the enormity of this, we need to look back. The chemotherapy drug gemcitabine became the standard in 1997, but its benefit was modest, and for fifteen years nothing improved on it. The next real leap came in 2011 with a chemotherapy combination called FOLFIRINOX, then another in 2013 - both, crucially, in first-line treatment, and both still chemotherapy. Daraxonrasib is different on two counts: it is the first targeted therapy - a drug aimed at the cancer’s genetic fault rather than at dividing cells in general - to demonstrate this magnitude of survival benefit in a large Phase III trial, and it did so in the tougher second-line setting. The last advances of this magnitude were well over a decade ago.
Why this drug is different
For years, KRAS was the target everyone wanted and no one could hit. One of the trial’s investigators described the faulty protein as a shiny ball - nothing will stick to it; it just slides off. Daraxonrasib gets around that with a clever trick: it acts like a molecular glue, latching onto the protein and switching off the relentless “grow and divide” signal that drives the cancer. Because KRAS alterations drive most pancreatic cancers, this approach has the potential to benefit a large proportion of patients.
It is the first medicine of its kind to prove itself in a large, rigorous pancreatic cancer trial. Researchers are calling it the start of a “RAS revolution.”
What happens next
It’s important to be clear-eyed and honest. This is not a cure, and the results describe extra months, not years. Daraxonrasib is still moving through the approval process. But the direction has changed. In the United States, regulators have fast-tracked it and opened an early-access pathway so that some previously treated patients can reach it ahead of full approval, and the maker has begun supplying it to doctors there. Fresh trials are now testing it even earlier - as a first treatment, and after surgery - where the benefit could be greater still.
What this means for Australians
We want to be honest. As things stand, daraxonrasib is not yet available in Australia.
But obviously we want it to be!
Every step forward so far has happened in the United States, where the drug has already begun reaching patients ahead of full approval.
The most important thing to understand is what has to happen next. Before daraxonrasib can be assessed for use here, its maker, Revolution Medicines, must lodge an application with our regulator, the Therapeutic Goods Administration (TGA). Once that happens, the TGA can assess it for safety and effectiveness, and it can then be considered for the Pharmaceutical Benefits Scheme (PBS) - the listing that would make it affordable for most families. No Australian application or timeline has been announced yet, and each stage takes time.
That first step - the company choosing to bring daraxonrasib to Australia - is not something any patient or charity can decide. But it is something we can influence. Across the Australian pancreatic cancer community, clinicians, researchers and patient organisations - Dare to Hope among them - are working to encourage that application, and to press for every available pathway to be used to speed it up once it comes. We will keep you updated as the situation here develops.
In the meantime, if this treatment may be relevant to you or someone you love, the right first step is always a conversation with your treating oncologist. They can advise on your situation and on whether a clinical trial might be an option. No Australian family affected by pancreatic cancer should be left behind when it comes to reaching treatments like this - and closing that gap is exactly the kind of work we exist to do.
A doctor’s perspective
For the specialists who treat pancreatic cancer, the wait is painful. Dr Michael Lee, a pancreatic cancer clinician at the Peter MacCallum Cancer Centre and one of the researchers Dare to Hope funds through the Paul Dear Postdoctoral Fellowship, describes what this moment means:
“What Herceptin is to breast cancer is what Daraxonrasib is to pancreatic cancer. This is a really major and exciting change to our patients with pancreatic cancer. Not only do they live longer, but patients also live better, in terms of quality of life.
It ticks all the boxes we want in a drug, and we hope this could be funded for all Australians to access, especially when drugs with a smaller benefit are already funded. My challenge is facing the tsunami of requests for access from my patients, and it breaks my heart to know it is many months away from reality at this stage, but it is encouraging to know that discussions are underway to bring it to Melbourne for clinical trial.”
- Dr Michael Lee, Peter MacCallum Cancer Centre, Paul Dear
A Message from CEO/ Co- Founder Cherie Dear
When my husband Paul was diagnosed with pancreatic cancer in 2020, we learned very quickly how few options exist for this disease, and how rarely the news is good. Like more than 90% of people with pancreatic cancer, Paul’s cancer was driven by a faulty KRAS gene. We knew this because he had undertaken genetic profiling of his tumour tissue. It was pessimistically described to us as being like having your foot jammed down on the accelerator - KRAS was speeding up the progress of his cancer and at that point, and until very recently - KRAS was considered undruggable.
We founded Dare to Hope because we believed that had to change - that with better research, the odds facing the next family could be different from the odds that faced ours.
News like this is exactly why we do this work. For the first time in well over a decade, there is a treatment that meaningfully extends life for people with advanced pancreatic cancer - and it works by targeting that very fault, the KRAS accelerator that drives so many of these cancers.
Dare to Hope exists to have the “Hard conversations” - and by doing so driving genuine HOPE based on reality. We can’t pretend it is a cure, or that it will arrive in time for everyone. For many families, including my own, progress like this comes too late. But it is an monumental change and it is an excellent signal regarding the future of pancreatic cancer. Every extra month of life it offers, and every door it opens for the research that follows, is precious.
This is what hope looks like when it is built on science. It is the product of years of painstaking work, funded by people who refused to accept that nothing could be done. We acknowledge and are grateful to those who have funded pancreatic cancer in the time before we were even aware of pancreatic cancer. That is the work Dare to Hope exists to support, and results like these only deepen our resolve.
This is an exciting time for pancreatic cancer – we are on the cusp of significant treatment breakthroughs – we can’t afford to lose the momentum. We must, and the Government must keep prioritising funding pancreatic cancer research.
Together, we are changing the numbers. Dare to Hope directs 93 cents in every dollar to medical research. Please support our work by donating today.
— Cherie Dear, Co-Founder, Dare to Hope
