What Is Happening with the Promise Against Pancreatic Cancer?

Pancreatic cancer is notoriously difficult to treat. For one thing, there are no simple screening procedures that would alert a person to its presence until it is fairly well advanced. According to the American Cancer Society, about 67, 530 Americans will be diagnosed with pancreatic cancer this year. Three out of four of them are likely to die from this malignancy within a year of diagnosis. That’s around 50,000 people and roughly 8% of all deaths due to cancer. Doctors have seen no improvements in pancreatic cancer mortality for twenty years (Journal of Gastrointestinal Oncology, Aug. 31, 2024). No wonder a recent announcement of treatments that may offer promise against pancreatic cancer has caused a stir.

Promise Against Pancreatic Cancer

In a tiny phase I trial conducted at Memorial Sloan Kettering Cancer Center, an mRNA vaccine showed promise against pancreatic cancer. Researchers had already been investigating the possibility of using mRNA to treat cancer even before the COVID pandemic started. That is partly why the vaccines could be developed so quickly.

Now, investigators at MSK have utilized mRNA technology to activate the immune system against pancreatic cancer. BioNTech and Roche’s Genentech division are developing the treatment, which is personalized to each patient. A tiny bit of the patient’s tumor is used to encourage the immune system to attack the malignancy. Phase 1 trials are designed to determine safety. Phase 2 and phase 3 trials will be needed to see if this approach can deliver on its promise against pancreatic cancer. Findings from this trial were presented at the annual meeting of the American Association for Cancer Research.

A New Drug Results in Better Survival

Another study presented at that meeting demonstrated a survival advantage for people taking the drug daraxonrasib. People who got this revolutionary medicine lived six months longer than those who got standard treatment. That is to say, they lived about twice as long. Daraxonrasib works by inhibiting a gene called RAS that contributes to pancreatic cancer.

An update on daraxonrasib was presented at the ASCO (American Society of Clinical Oncology) annual meeting in Chicago. The researchers presented data from 500 patients whose cancer had spread widely despite previous treatment. Those receiving daraxonrasib survived an average of 13 months. Those on chemotherapy got 6.6 months. Progression-free survival also improved. The oncologists in attendance gave a standing ovation.

The FDA Approved Daraxonrasib

The FDA had already indicated interest in a drug that could inhibit RAS. Consequently, it reviewed daraxonrasib surprisingly quickly and approved it in August. The company named this new medicine Rasonque. Because daraxonrasib is in pills rather than injections or infusions, it may be more convenient for patients. Doctors could prescribe it along with chemotherapy.

Patients have pleaded for early access because they felt they could not afford to wait for final approval. Even before approval, the FDA authorized early access for people with metastatic pancreatic cancer that has already been treated. Former Nebraska Senator Ben Sasse told a 60 Minutes interviewer that the drug helped him live with less pain, and he is hoping to live longer than originally projected when he was diagnosed in December. His testimony has boosted strong interest in the medication. Drug developer Revolution Health has said it will provide daraxonrasib to eligible patients at no cost.

Will the Promise Against Pancreatic Cancer Be Fulfilled?

Despite the excitement about daraxonrasib, now we are reading about the limits of this new cancer drug. Ben Sasse got good results with Rasonque treating his metastatic pancreatic cancer. Now, however, he has announced that his cancer has become resistant to the medicine. This, unfortunately, is a common outcome. Scientists are now working hard to discover how resistance develops and how to overcome it.

In the future, doctors might prescribe a combination of daraxonrasib and mRNA treatment. There is a possibility that the research reported at the AACR and ASCO offer great promise for pancreatic cancer. To accomplish that, doctors may need to prescribe multiple treatments, including chemotherapy and a variety of RAS inhibitors rather than a single one.