Dr. Zev Wainberg, a leading figure at UCLA Health’s GI Oncology Program, experienced firsthand how patients with advanced pancreatic cancer preferred experimental treatments over another round of chemotherapy. Wainberg directed a clinical trial of daraxonrasib, a new drug under investigation. Many participants had previously received chemotherapy that was proving ineffective. Wainberg said, “Statistically, only half would receive the pill, and choice was not ours. Many patients were placed on the chemotherapy arm, and sadly, none survived.”
Breakthrough in Treatment
Daraxonrasib is generating significant enthusiasm. It was proven to double the survival time in a Phase 3 trial with 500 patients with advanced pancreatic cancer. Patients lived an average of 13.2 months compared to 6.7 months for those receiving chemotherapy. These results were presented at the American Society of Clinical Oncology’s annual meeting and published in the New England Journal of Medicine.
Dr. Rachna Shroff hailed these findings as unprecedented, stating the implications for pancreatic cancer treatment were enormous.
Beyond Pancreatic Cancer
Daraxonrasib targets a mutation in the KRAS gene, found in various cancers including lung, colorectal, and ovarian. Dr. Brian Wolpin, who led research on daraxonrasib at the Dana-Farber Cancer Institute, indicated that pancreatic cancer is the starting point for this drug, and its potential extends to other cancers.
The FDA has accelerated approval for daraxonrasib treatment of pancreatic cancer. Recently, they have allowed Revolution Medicines to offer access to patients outside clinical trials through an expanded program. Dr. Mark Goldsmith from Revolution Medicines noted that preparations for FDA approval are ongoing.
The Impact on Patients
Most pancreatic cancers are diagnosed late, limiting treatment options. Traditionally, even advanced chemotherapies offer only a brief survival extension. The American Cancer Society notes that only 3% of patients with metastatic pancreatic cancer live five years post-diagnosis.
“Even with our best chemotherapies, the average benefit is around 6 months, sometimes as little as weeks or months,” stated Dr. Sameek Roychowdhury.
One case is Debby Orcutt, diagnosed with stage 4 pancreatic cancer, who experienced dramatic results on the drug. Her liver lesions disappeared and her pancreatic tumor reduced significantly. Orcutt reported feeling well daily and not focusing on her diagnosis.
How Daraxonrasib Works
Daraxonrasib targets the KRAS gene mutation that causes unchecked cell growth in cancers. Previously, targeting this mutation was challenging. The drug acts by combining with cyclophilin A protein in cells to disrupt the mutated protein. Despite its effectiveness, daraxonrasib isn’t a cancer cure; tumors can eventually grow again. Other drugs targeting similar mutations are in development to create a comprehensive treatment approach.
Researcher Wolpin suggests daraxonrasib could benefit all patients with metastatic pancreatic cancer, regardless of the specific gene mutation. This drug could potentially reduce chemotherapy reliance for advanced cases.
Daraxonrasib usually causes fewer side effects than chemotherapy. Some experienced vomiting or diarrhea, mouth and throat sores, or rashes. Ben Sasse, who tried the drug, described a severe rash. Debby Orcutt, meanwhile, noted she had minor issues, viewing them as negligible compared to the potential life-saving benefits.
Family Support and Daily Life
Debby has the support of her husband, Ron Orcutt, who keeps track of her medication schedule. The couple has been married for 47 years. Ron ensures Debby takes her medication correctly due to the specific timing required. Debby, involved with her grandchildren and other activities, sees her treatment as a new opportunity to enjoy life. “You’ve just got to keep going and have faith,” she reflects. Her outlook is positive, believing she has a second chance.