New Drug Shows Promise in Treating Pancreatic Cancer

A recent drug targeting a gene linked to pancreatic cancer has given physicians and researchers a reason to feel cautiously hopeful about treatments for this often-fatal disease.

Revolution Medicines, the company developing this drug, plans to provide more comprehensive findings on the clinical trials for their pill soon.

Named daraxonrasib, this drug belongs to a class known as RAS inhibitors, specifically focusing on the KRAS gene. Notably, mutations of this gene are present in over 90% of the most common kind of pancreatic cancer and in a significant portion of patients with colorectal and non-small cell lung cancers.

Pancreatic cancer is notoriously difficult to detect early, contributing to a bleak five-year survival rate of only 3%. Most patients find out they have the disease when it’s already more advanced.

Experts who are not part of the drug’s development expressed to PBS News that the initial results from daraxonrasib trials are igniting some optimism regarding improved survival for these patients.

Initial Results from Clinical Trials

At the end of April, Revolution Medicines released encouraging data from their Phase 1 and 2 trials that showed an overall survival rate of 13.2 months for those on daraxonrasib. This is nearly double the 6.7 months typical with standard chemotherapy.

Patients received this drug as a secondary treatment after initial chemotherapy.

“For that to exceed one year is really extraordinary,” commented Dr. Emil Lou, a medical oncologist and professor at the University of Minnesota.

Among the 168 patients diagnosed with pancreatic ductal adenocarcinoma, the most common type, 26 had the prevalent RAS G12 gene mutation. Remarkably, over a third of those patients showed significant tumor reduction, with some maintaining cancer-free periods for more than eight months.

However, daraxonrasib has caused severe side effects in about 30% of patients, with common issues being rashes and gastrointestinal problems.

Breakthrough Discovery and Its Implications

The drug specifically targets the KRAS gene, found in many cancers. Researchers have noted that when KRAS malfunctions, it can lead to cancer by overstimulating the cell it’s in.

For years, the KRAS gene was deemed “undruggable,” mostly due to its complex structure and location within cells. But in 2013, scientists located a previously unknown binding pocket in the KRAS structure, kickstarting a collaboration between drug developers and researchers to create viable treatments.

According to Dr. Jaffee, with daraxonrasib capable of targeting various KRAS mutations, physicians can potentially avoid the necessity of screening each patient for specific mutations.

“For all the years that I’ve been treating and developing new therapies for pancreatic cancer, it’s still a death sentence,” she noted, highlighting the limitations of current chemotherapy, which can often be difficult to tolerate and provide only a few months of life extension.

Daraxonrasib, on the other hand, is noted for having more manageable side effects in comparison.

Challenges Ahead

Despite its potential, there are concerns. The FDA recently fast-tracked limited approval for daraxonrasib, allowing “expanded access” for eligible patients. Unfortunately, access remains an issue, particularly for those not treated in larger health facilities.

Cost is another significant factor; the price of the drug is still undetermined but is expected to be high, and insurance coverage could complicate matters further.

Oral drugs like this require patients to be able to swallow and digest medication, which isn’t always feasible in cancer care.

What’s Next?

Revolution Medicines is set to unveil extensive findings from their Phase 3 trial at an upcoming oncology conference in Chicago. Experts are hopeful that daraxonrasib could be incorporated earlier in treatment plans or alongside other therapies, potentially enhancing both longevity and quality of life for cancer patients.

Dr. Jaffee aspires for future treatments for pancreatic cancer to mirror the advancements made in HIV treatment, where researchers developed combination therapies to target multiple pathways effectively.

With daraxonrasib being just one piece of a larger puzzle, we’re still in the early stages of discovering the best approaches for treating pancreatic cancer, but there’s a sense of optimism in the air.