New pancreatic cancer drug offers hope

For people facing advanced pancreatic cancer, treatment options have long been limited to standard chemotherapy. But what happens if chemo stops working? A newly approved targeted therapy called daraxonrasib is offering hope.

Approved by the U.S. Food and Drug Administration (FDA) last month, daraxonrasib (Rasonque) is the first drug in its class for adults with metastatic pancreatic adenocarcinoma. The drug is approved for adults with metastatic pancreatic cancer whose disease has continued to spread after initial chemotherapy or who are unable to receive combination chemotherapy.

Unlike chemotherapy, which affects many healthy and cancerous cells, daraxonrasib is a targeted therapy taken as a once-daily tablet. It targets a specific protein, called RAS, the driver of pancreatic cell growth.

“Daraxonrasib targets the main driver of the cancer cells and selectively suppresses continued cancer cell growth, allowing for improved patient survival compared to our standard second-line chemotherapies,” explains Dr. Heather Tracy, an oncologist with Sharp Community Medical Group and affiliated with Sharp Memorial Hospital.

Why is pancreatic cancer so challenging to treat?

Pancreatic cancer remains one of the most difficult cancers — and one of the deadliest, according to the National Cancer Institute. In fact, approximately 67,000 people in the U.S. are diagnosed with pancreatic cancer each year, and about 90% to 95% of those cases are pancreatic adenocarcinoma.

“It is a very deadly cancer,” Dr. Tracy says. “Unfortunately, it's usually discovered in the more advanced stages because of the location of the pancreas. It can ‘hide’ and spread before a person develops symptoms.”

Because pancreatic cancer often develops silently, symptoms may not appear until the disease is advanced. But Dr. Tracy says several warning signs require attention:

• Jaundice (yellowing of the skin or eyes)

• Abdominal pain

• Difficulty digesting food

• Bloating

• Unexplained increase in abdominal girth

• Unexplained weight loss

• Changes in appetite

Risk factors for pancreatic cancer include smoking, heavy alcohol use, obesity and certain inherited genetic mutations. People with a family history of pancreatic cancer should talk with their doctor to see if they may be a candidate for genetic testing.

How effective is daraxonrasib?

According to the FDA, daraxonrasib improved patient survival up to 13.2 months compared with 6.7 months for standard chemotherapy in a clinical trial of 500 adults with previously treated metastatic pancreatic adenocarcinoma. Dr. Tracy calls daraxonrasib “a huge breakthrough.”

“We haven't had a great second-line regimen, and unfortunately, the survival timeline after ineffective first-line chemotherapy is very short,” she says. “So this is a massive breakthrough with the chance to prolong survival.”

However, like most cancer treatments, daraxonrasib can cause side effects. According to the FDA, the most common side effects include:

• Rash

• Diarrhea

• Stomatitis (inflammation of the mouth lining)

• Nausea and vomiting

• Fatigue

• Abdominal pain

• Edema (swelling)

• Decreased appetite

• Hemorrhage (bleeding)

Still, experts are hopeful that daraxonrasib represents the beginning of a new chapter for pancreatic cancer treatment.

“Eventually this drug will likely get pushed into the earlier-line settings,” says Dr. Tracy. “It offers a lot of exciting hope for patients with advanced pancreatic cancer.”

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