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The race to drug KRAS in pancreatic cancer

The race to drug KRAS in pancreatic cancer

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First KRAS Drug Beats Chemotherapy in Phase 3 as CNIO Paper Retraction Clouds Triple-Therapy Path

May 6th, 2026: NEJM Publishes Phase 1/2 Daraxonrasib Data

Overview

In April 2026, daraxonrasib became the first drug to beat chemotherapy in a Phase 3 pancreatic cancer trial, cutting death risk by 60% and extending median survival from 6.7 to 13.2 months. The FDA authorized expanded access May 1; Revolution Medicines plans to file a New Drug Application and present full Phase 3 data at the ASCO Annual Meeting on May 31, 2026.

In April 2026, PNAS retracted the CNIO triple-therapy study after finding that Barbacid, Carmen Guerra, and Vasiliki Liaki hadn't disclosed financial stakes in Vega Oncotargets, a spin-off they co-founded in 2024 to commercialize the therapy. PNAS said no errors were found in the science. Barbacid divested from Vega Oncotargets on May 5, returning shares and patent rights, and the team resubmitted the paper through standard peer review.

Why it matters

Daraxonrasib is the first drug to beat chemotherapy in a Phase 3 trial for pancreatic cancer, where five-year survival sits at 13%.

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Key Indicators

90%
KRAS Mutation Rate
Share of pancreatic ductal adenocarcinomas driven by KRAS mutations
13%
5-Year Survival
Current survival rate for pancreatic cancer—the lowest of any major cancer
13.2 months
Phase 3 Median Survival
Daraxonrasib median overall survival in the RASolute 302 trial, versus 6.7 months on standard chemotherapy
60%
Death Risk Reduction
Reduction in mortality risk with daraxonrasib versus chemotherapy in the Phase 3 trial (hazard ratio 0.40)

Voices

Curated perspectives — historical figures and your fellow readers.

Oscar Wilde

Oscar Wilde

(1854-1900) · Victorian · wit

Fictional AI pastiche — not real quote.

"How delightful that Science, having spent forty years declaring something impossible, has finally succeeded by the simple expedient of trying three times as hard—a strategy that would have saved many a Victorian marriage, had anyone thought to apply it. One does hope the mice appreciate being cured of their mortality, though I suspect they would have preferred never to have been given cancer in the first place."

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People Involved

Organizations Involved

Timeline

January 1982 May 2026

18 events Latest: May 6th, 2026 · 3 weeks ago Showing 8 of 18
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  1. NEJM Publishes Phase 1/2 Daraxonrasib Data

    Latest Research

    The New England Journal of Medicine publishes Phase 1/2 trial results for daraxonrasib in 168 patients with previously treated RAS-mutated pancreatic cancer, detailing the efficacy and safety data that supported the Phase 3 design.

  2. Revolution Medicines Raises $2.225 Billion

    Business

    Revolution Medicines reports Q1 2026 results and discloses $2.225 billion raised in April capital offerings—$1.725 billion in common stock and $500 million in convertible notes—to fund the daraxonrasib NDA and an expanded Phase 3 pipeline across pancreatic, lung, and colorectal cancers.

  3. Barbacid Divests from Vega Oncotargets

    Research

    Barbacid returns his shares (valued at 750 euros) and two patent applications to Vega Oncotargets, severing commercial ties with the spin-off to prevent the conflict-of-interest dispute from affecting the resubmitted triple-therapy paper.

  4. FDA Authorizes Expanded Access for Daraxonrasib

    Regulatory

    The FDA issues a safe-to-proceed letter for a daraxonrasib expanded access program, allowing patients with previously treated metastatic pancreatic cancer to receive the drug outside a clinical trial while the NDA is prepared.

  5. PNAS Retracts CNIO Triple-Therapy Paper

    Research

    PNAS retracts the January 2026 Barbacid study, citing an undisclosed competing interest: Barbacid, Carmen Guerra, and Vasiliki Liaki held financial stakes in Vega Oncotargets, a spin-off they co-founded in 2024 to commercialize the therapy. Editors stated no errors were found in the underlying science; the authors plan to resubmit through standard peer review with full disclosure.

  6. Phase 3 Data Selected for ASCO Plenary Session

    Research

    Revolution Medicines announces the RASolute 302 results will be presented in a Plenary Session at the ASCO Annual Meeting in Chicago on May 31, 2026—a slot reserved for the most significant oncology trial findings of the year.

  7. Phase 3 RASolute 302 Trial Confirms Survival Benefit

    Research

    Revolution Medicines announces positive topline results from the Phase 3 RASolute 302 trial: daraxonrasib extended median overall survival to 13.2 months versus 6.7 months on chemotherapy, with a hazard ratio of 0.40 (p<0.0001), cutting death risk by 60%.

  8. Triple Therapy Achieves Complete Tumor Elimination

    Research

    CNIO publishes PNAS study showing complete and lasting pancreatic tumor elimination in mice using daraxonrasib plus afatinib plus SD-36. Nine of 12 genetically modified mice achieved full regression; implanted tumor models remained cancer-free for 250+ days.

  9. Merck Acquisition Talks Collapse

    Business

    Negotiations between Merck and Revolution Medicines over a potential $28-32 billion acquisition ended without agreement on price. Revolution Medicines stock dropped 20% following the announcement, erasing nearly $6 billion in market value.

  10. Merck Enters Acquisition Talks

    Business

    Financial Times reports Merck in talks to acquire Revolution Medicines for $28-32 billion, potentially making it the largest biotech deal since Pfizer's $43 billion Seagen acquisition in 2023. Stock surged 20% on the news.

  11. Daraxonrasib Monotherapy Shows Survival Gains

    Research

    Early reporting from Phase 1 trials shows daraxonrasib nearly doubles median survival to 15.6 months compared to 7 months with standard chemotherapy, with more than 90% of 83 patients experiencing disease stabilization and roughly 30% seeing tumor shrinkage.

  12. Daraxonrasib Receives Orphan Drug Status

    Regulatory

    FDA grants Orphan Drug Designation to daraxonrasib for pancreatic cancer treatment, providing additional development incentives.

  13. Daraxonrasib Gets Breakthrough Designation

    Regulatory

    FDA grants Breakthrough Therapy Designation to daraxonrasib (RMC-6236), a multi-selective KRAS inhibitor that targets mutations common in pancreatic cancer, based on promising Phase 1 data showing 8.8-month progression-free survival.

  14. Second KRAS Inhibitor Approved

    Regulatory

    FDA approves adagrasib (Krazati) for KRAS G12C-mutated lung cancer, providing a second option but still not addressing the G12D mutations dominant in pancreatic cancer.

  15. First KRAS Inhibitor Approved

    Regulatory

    FDA grants accelerated approval to sotorasib (Lumakras) for KRAS G12C-mutated lung cancer—the first approved drug targeting any KRAS mutation after 40 years of failed attempts. However, G12C mutations are rare in pancreatic cancer.

  16. SD-36 STAT3 Degrader Published

    Research

    University of Michigan researchers publish SD-36, a PROTAC degrader that selectively destroys STAT3 protein. The compound achieves complete tumor regression in mouse models of leukemia and lymphoma.

  17. Afatinib Approved for Lung Cancer

    Regulatory

    FDA approves afatinib (Gilotrif), an irreversible EGFR inhibitor, for metastatic non-small cell lung cancer. This drug would later become one of three components in the CNIO triple therapy.

  18. First Human Oncogene Isolated

    Discovery

    Three independent research groups, including Barbacid's, identify HRAS as the first human oncogene. The discovery establishes RAS proteins as central to cancer but also reveals how difficult they are to drug.

Historical Context

3 moments from history that rhyme with this story — and how they unfolded.

May 2001

Imatinib and Chronic Myeloid Leukemia (2001)

The FDA approved imatinib (Gleevec) for chronic myeloid leukemia, the first cancer drug designed to target a specific molecular defect—the BCR-ABL fusion protein. Patients who had months to live began achieving long-term remission. The drug transformed CML from a death sentence into a manageable chronic condition.

Then

Five-year survival for CML patients jumped from 30% to over 90%.

Now

Imatinib became the template for targeted cancer therapy, proving that attacking specific oncogenic drivers could succeed where chemotherapy failed.

Why this matters now

KRAS researchers explicitly cite imatinib as their model. Like BCR-ABL, KRAS drives cancer growth; unlike BCR-ABL, KRAS resisted drugging for 20 additional years. The CNIO triple therapy aims to achieve for pancreatic cancer what imatinib did for CML.

2003-2013

EGFR Inhibitors in Lung Cancer (2003-2013)

After early EGFR inhibitors showed mixed results in unselected lung cancer patients, researchers discovered that only tumors with specific EGFR mutations responded. Gefitinib (2003) and erlotinib (2004) were approved for mutation-positive patients, followed by afatinib (2013). However, resistance typically emerged within 12-18 months.

Then

EGFR-mutant lung cancer patients gained months to years of progression-free survival.

Now

The resistance problem drove development of next-generation inhibitors and combination strategies—the same approach now being applied to KRAS.

Why this matters now

Afatinib, one of the three drugs in the CNIO combination, was designed to overcome resistance to earlier EGFR inhibitors. The triple therapy strategy—blocking the primary driver plus escape routes—directly responds to lessons learned from EGFR resistance.

May 2021

KRAS G12C Breakthrough (2021)

After researchers discovered a previously unknown binding pocket on the KRAS G12C mutant protein, Amgen developed sotorasib—the first approved drug targeting any KRAS mutation. The FDA granted accelerated approval based on a 36% response rate in lung cancer patients who had failed other treatments.

Then

Patients with G12C mutations gained a new treatment option, though responses were often temporary.

Now

The approval proved KRAS was druggable after all, triggering massive investment in inhibitors targeting other KRAS mutations.

Why this matters now

Sotorasib's approval validated the KRAS-targeting approach but left pancreatic cancer patients behind—G12C mutations occur in only 1-2% of pancreatic tumors versus 40% for G12D. The CNIO study uses daraxonrasib, which targets the mutations actually common in pancreatic cancer.

Sources

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