Daraxonrasib for Pancreatic Cancer: What to Know

Key takeaways

• FDA approves daraxonrasib, a new pancreatic cancer drug. This oral medication treats stage 4 pancreatic cancer that hasn’t responded to other treatments.
• Improved pancreatic cancer survival rate. A recent study found that patients taking daraxonrasib lived nearly twice as long compared to those on chemotherapy.
• Mass General Brigham Cancer Institute offered early access to daraxonrasib. We’re one of few health systems that treated patients with the drug before its FDA approval, and we continue to offer daraxonrasib and other emerging therapies for pancreatic cancer.
• Talk to your care team to see if daraxonrasib is an option for you.
• Mass General Brigham Cancer Institute continues to research pancreatic cancer and offer access to clinical trials for eligible patients. Advancements like daraxonrasib could lead to better therapies in the future.

One of the biggest breakthroughs in pancreatic cancer treatment was recently approved by the U.S. Food and Drug Administration (FDA).

Daraxonrasib is an oral medication that may be an alternative to chemotherapy in some patients with stage 4 pancreatic cancer. A recent study found that the drug nearly doubled the survival rate in patients compared to those on chemotherapy.

“Oncologists around the world—myself included—are very much celebrating this new treatment. It’s been rewarding to see it give patients and their families hope,” says Harsh Singh, MD, an oncologist and program director of Hepatobiliary and Pancreas Cancers at Mass General Brigham Cancer Institute.

Dr. Singh has been treating patients with daraxonrasib since July 2026, when the Cancer Institute was one of few places offering the drug ahead of its FDA approval.

In this article, Dr. Singh explains what you need to know about this new treatment option for pancreatic cancer, including how it works, who is eligible to take it, possible side effects, and more.

What is daraxonrasib (RMC-6236)?

Daraxonrasib (RMC-6236) is a daily oral medication, which means patients take it by swallowing a pill.

It’s not chemotherapy — it’s a type of cancer treatment called targeted therapy. The drug targets proteins in the body called RAS, which help control cell growth.

RAS proteins are created by a family of genes, which are like instruction manuals for cells in the body. The RAS gene family, which includes the gene KRAS, can mutate (change) over time. This can cause RAS proteins to turn on when they’re not needed and cause cells to grow out of control. This creates cancer cells that can form tumors and eventually spread to other parts of the body.

Changes to RAS proteins happen in 9 out of 10 pancreatic cancers, as well as in other cancers like lung and colorectal cancer.

How does daraxonrasib work?

Daraxonrasib works by blocking those RAS proteins. It prevents them from sending signals to grow more cells, which slows down the cancer. Unlike previous targeted therapies, daraxonrasib can block multiple types of RAS protein. This wider range makes it more effective at slowing cell growth in pancreatic cancer.

Dr. Singh notes that this also makes daraxonrasib more promising for treating other types of cancer linked to the RAS protein in the future.

Study shows daraxonrasib improves pancreatic cancer survival rate

Pancreatic cancer is a relatively rare but challenging cancer. The overall 5-year survival rate is 13%, according to the American Cancer Society. However, the survival rate changes depending on the patient’s age, if the cancer has spread, and other factors.

The recent clinical trial for daraxonrasib, published in the New England Journal of Medicine, found the drug improved survival rates in patients with pancreatic cancer compared to those on chemotherapy.

Results of the daraxonrasib clinical trial

The investigators wanted to understand if daraxonrasib improved overall survival and progression-free survival in patients with pancreatic cancer. Progression-free means the cancer didn’t continue to grow or spread.

In a trial of 500 patients, about half took daraxonrasib and the others received standard chemotherapy. The results were groundbreaking:

• Overall survival: Patients taking daraxonrasib lived for about 13.2 months, while patients on chemotherapy lived for about 6.7 months. The new drug nearly doubled how long those patients lived.
• Progression-free survival: These rates also improved with the drug, with 7.2 months on daraxonrasib compared to 3.6 months on chemotherapy.

“When the researchers presented this at the American Society of Clinical Oncology conference, there was a standing ovation,” reflects Dr. Singh. “That kind of improvement in survival is life-changing for patients and their loved ones.”

Why is pancreatic cancer so deadly?

Unfortunately, providers often don’t catch pancreatic cancer until it’s grown or spread to other parts of the body (metastasized). The symptoms of pancreatic cancer can be hard to notice, or patients might not experience any symptoms at all. There’s also no standard health screening for pancreatic cancer.

Providers use stages to explain if the cancer has spread, and if so, how far. Stage 4 pancreatic cancer means the cancer has spread from the pancreas to a distant part of the body, like the liver, lungs, or bones.

A later stage means the cancer is harder for providers to treat. But after the recent clinical trial, the FDA approved daraxonrasib for treating certain patients with stage 4 pancreatic cancer. This gives patients with advanced cancer a new option that may help them live longer.

Daraxonrasib for stage 4 pancreatic cancer

Who is eligible to take daraxonrasib? The FDA approved daraxonrasib for patients with all of the following:

• Pancreatic adenocarcinoma, a type of cancer that usually starts in the ducts of the pancreas. This makes up the majority of pancreatic cancer cases.
• Metastatic cancer (stage 4), where the cancer has spread to distant parts of the body, like the liver or lungs.
• Disease progression after trying another type of treatment. This means the cancer continued to grow even after trying chemotherapy or another treatment. Patients who aren’t able to take multiagent (two or more) chemotherapy drugs are also eligible.

The recommended dose for daraxonrasib is 300mg, taken by pill once a day.

Talk to your care team to see if you might be eligible for daraxonrasib. If so, your oncologist prescribes it for you. If not, there are many other treatment options for pancreatic cancer.

These include:

• Chemotherapy
• Targeted therapy
• Immunotherapy
• Radiation therapy
• Surgery, such as the Whipple procedure

Daraxonrasib side effects

Like many cancer treatments, some patients may experience side effects from daraxonrasib. These may include:

• Rash
• Mouth sores
• Diarrhea
• Nausea
• Vomiting

The side effects are mostly manageable. Your provider prescribes anti-nausea medication with daraxonrasib, and they have different methods to manage mouth sores or diarrhea if needed. Skin creams and an antibiotic can help prevent the rash, and providers also partner with dermatologists to help manage this side effect.

During the study, more patients stopped chemotherapy due to side effects compared to patients taking daraxonrasib.

Dr. Singh notes that in his experience, patients have overall found an improvement in living with the side effects compared to chemo.

“We’ve been treating patients with daraxonrasib for a few months now, and we have more learnings about the side effects and how to manage them.”

Pancreatic cancer research at Mass General Brigham Cancer Institute

Mass General Brigham Cancer Institute wasn’t directly involved in the recent clinical trial for daraxonrasib, but it was involved in several earlier studies that helped lead to the drug’s development and similar therapies. It also offered early access to daraxonrasib for certain patients before the FDA approval.

Mass General Brigham researchers continue to study pancreatic cancer to improve diagnosis and patient outcomes. A recent study found that patients with low-risk pancreatic cysts have about 14 times higher risk of developing pancreatic cancer than the general population. This could help providers detect pancreatic cancer earlier, when it’s easier to treat.

Dr. Singh plans to study how a targeted therapy like daraxonrasib might help patients with cancer that hasn’t spread beyond the pancreas, when it’s not stage 4.

“Daraxonrasib’s FDA approval could set the stage for a new era of pancreatic cancer treatment,” says Dr. Singh. “The research around targeting RAS will continue to expand, and we may see treatments that become even more targeted and effective, not just for pancreatic but other cancers as well.”