Pancreatic cancer Q&A

By Candace Gwaltney
June 22, 2026

Results for a new pancreatic cancer treatment elicited a rare reaction – a standing ovation – during the recent ASCO (American Association of Clinical Oncology) Annual Meeting, the world’s largest oncology conference. IU Simon Comprehensive Cancer Center physician-scientist Anita Turk, MD, answers questions about that new study, what’s bringing so much hope for pancreatic cancer research, and how IU clinicals trials are studying the next generation of treatment. Turk is an assistant professor of clinical medicine at the IU School of Medicine, medical director of the cancer center’s Clinical Trials Office, and an oncologist at IU Health.

Dr. Turk: The clinical trial that everyone's talking about is RASolute 302, which evaluated daraxonrasib, a targeted drug for patients with advanced pancreatic cancer whose cancer has progressed on chemotherapy. In the RASolute 302 trial, patients were randomized between chemotherapy versus daraxonrasib, which is delivered as a pill. Daraxonrasib significantly improved patient survival to over a year, which is unprecedented in pancreatic cancer compared to about six months, which is what we see in pancreatic cancer. This is clearly a landmark new standard of care option for patients.

Daraxonrasib is a RAS(ON) inhibitor, meaning it targets the active form of the RAS protein, which is almost always overactivated in pancreatic cancer due to activating mutations. More than 90% of pancreatic cancers have RAS mutations, most commonly KRAS mutations. The holy grail in pancreatic cancer has always been: How can we target this alteration, shut down this signal causing cancer cells to continuously grow, while offering something that doesn't involve chemotherapy?

Turk: Not yet as it is not FDA-approved. IU plans to offer it through the compassionate use program in partnership with Revolution Medicines [the clinical oncology company that developed the therapy]. Because each patient must go through an application and review process, access takes longer than a standard prescription. We hope to begin treating eligible patients in the coming months.

Learn more: FDA Permits Expanded Access for Investigational Pancreatic Cancer Drug

Turk: Every single one. Since the first press release and the announcement of the compassionate use program, we initially received 10 to 20 calls a day. I wish I could get the medication quickly, but the reality is that we must follow regulatory guidelines and safety, ensuring we are doing everything properly with the FDA. With the compassion use program rolling out soon, I'm hoping we can help our patients sooner rather than later.

Turk: It’s hard to know exactly how quickly. Doubling overall survival is unheard of in pancreatic cancer, which is a benefit the FDA will certainly consider. While daraxonrasib is a targeted pill, it can cause side effects, including rash, mouth sores, diarrhea, nausea and vomiting, requiring very close monitoring. We'll see how things pan out in the real world compared to what was published in the clinical trial. The company continues to track the side effects for their own database for the FDA to review as they continue the compassionate use program.

Turk: We have several ongoing clinical trials through our GI [gastrointestinal] program and our Phase I program using the next generation of RAS inhibitors and combination therapies.

One trial currently open being sponsored by Tango Therapeutics is looking at PRMT5 inhibitor, called Vopimetostat. This agent shows promising activity in cancers with a unique alteration called an MTAP deletion that affects cancer metabolism. That study now is accruing, and they just shared new data in a press release showing the combination of their drug with daraxonrasib had a response of 92% in a small, early-phase group of pancreatic cancer patients. So again, we're rapidly seeing some unprecedented responses and improvements in pancreatic cancer that we haven't seen in decades.

Turk: Absolutely. The AACR data came from an earlier Phase I study led by Memorial Sloan Kettering. IMCODE003 is a randomized Phase II trial is testing that approach in a larger group. This study recently completed accrual which means there are no longer spots open for patients at this time.

Essentially, the study creates a personalized mRNA vaccine after pancreatic cancer surgery, using the removed tumor. The vaccine is based off the proteins that the cancer is making and tries to train your immune system to fight the cancer. The COVID vaccine uses mRNA technology, and a lot of this cancer vaccine technology has blossomed since COVID, which is very exciting. Patients on the trial received the vaccine, immunotherapy, and chemotherapy after surgery to see if we can harness the immune system to stop cancer recurrence.

The early-phase study showed that patients who developed an immune response after the vaccine went much longer without recurrence. At about three years of follow-up, no recurrences were seen in the vaccine responders. Non-responders unfortunately had recurrences on average at just over a year. The latest follow up showed that 7 of the 8 responders were still alive four to six years after surgery.

Turk: Now that we kind of have the building blocks of new technologies of going into pancreatic cancer with mRNA vaccine and RAS inhibitors, I think the field is going to explode very quickly. There are many ongoing clinical trials across the country now looking at second-generation RAS(ON/OFF) inhibitors. In the lab, there could be more potent inhibitors of KRAS, which may show better activity than daraxonrasib. We have yet to see that. I think it's going to be exciting to see how the realm of non-chemotherapy regimens develop as we're seeing combination inhibitors based on the biology of the cancer.

I think the next step, especially for our Stage IV patients, is figuring out how to incorporate immune therapy. The unfortunate reality is that targeted therapies only work until the cancer develops resistance. But is there a combination of KRAS inhibitors and new types of immune therapies, maybe very well involving vaccines, that offer us more durable control of Stage IV pancreatic cancer? For example, the mRNA vaccine we just discussed, unfortunately, does not work in Stage IV cancer. And that's why they're focusing on moving it forward in the curative intense staging. The reality is that 75% of patients present as Stage IV disease. I think we still have a long way to go on how to incorporate that technology for those patients who need it most.