Dana–Farber Cancer Institute building Credit ajay_suresh (CC BY 4.0) Wikimedia

Pancreatic cancer has long been a death sentence, and a rapid one at that, but a new two-a-day pill has seen patients live twice as long even after chemotherapy fails.

“Surviving” cancer refers to living more than 5 years post-diagnosis. Under that criteria, just 3% of patients survive pancreatic cancer, which usually requires particularly grueling chemotherapy.

For those whose cancer remains, there is now a simple option to extend lifespan that’s largely covered by insurance called daraxonrasib, manufactured by Revolution Medicine which received FDA approval for use in humans who have already tried chemotherapy after a review of just 35 days.

The phase 3 clinical trial which informed the FDA’s decision saw a doubling of lifespan in patients who’d tried chemo but whose cancer survived, from 7 months to more than 13.

Presented recently at the annual meeting of the American Society of Clinical Oncology in Chicago, in May, the attending physicians and scientists rose and applauded, some with tears in their eyes at the news, the New York Times reports. 

“I have not seen anything like that before in trials we have run in pancreatic cancer,” Dr. Brian Wolpin of the Dana-Farber Cancer Institute in Boston, and leader of the study, told the Times. “I just kept repeating, ‘Wow.’”

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The drug works by targeting a protein called KRAS which pancreatic cancer, as well as others, needs to live. For decades, it was thought KRAS was untargetable pharmaceutically because of its smooth surface, but daraxonrasib has been able to by gluing other molecules together in such a way as to allow the agglomeration to grab and stop KRAS from reaching the tumor.

It’s not just daraxonrasib, Revolution Medicine, and pancreatic cancer patients that will benefit from the drug’s success and approval, but a whole field of research into KRAS-inhibiting drugs. Colon and lung cancer, for example, also rely on KRAS for survival, and the Times claimed that “dozens” of KRAS-inhibiting medications are being tested—alone, with chemotherapy, and with immunotherapy—for their potential use.

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In some rare cases, daraxonrasib has curative effects in pancreatic cancer. One man in his 70s who was enrolled in the daraxonrasib clinical trial in 2022 had seen the cancer spread to his lymph nodes and assumed he was doomed. The pill shrunk the tumors such that he is not only still alive today, but that they can’t even be seen in scans.

Study and approval of the drug was made according to its use after chemotherapy had already failed, but the author of the Times story Gina Kolata said in reply to a commenter that the drug is now being evaluated for its potential efficacy at earlier stages.

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