Elisabeth Stragier

[Nicholas Hornstein @GIMedOnc]

#ASCO26

This one is special.

This is the hottest paper of 2026 and potentially in the history of pancreatic cancer.

Let’s dive in.

RASolute 302: Daraxonrasib vs investigator’s choice chemotherapy in previously treated metastatic pancreatic cancer
Abstract LBA5 (soon!)
Presentation: May 31, 2026, 3:21-3:33 PM CDT

For decades, pancreatic cancer has been where good ideas go to die.

We have optimized chemotherapy. We have sequenced chemotherapy. We have celebrated modest gains.

But the central driver of PDAC has always been sitting there in plain sight:

RAS.

More than 90% of pancreatic cancers have oncogenic RAS mutations, and until recently, we had essentially nothing direct to do about it.

Daraxonrasib is an oral RAS(ON) multiselective inhibitor targeting the active GTP-bound state of mutant and wild-type RAS.

And in RASolute 302, it delivered.

Quick hits:

📌 Phase 3 international randomized trial 500 patients with previously treated mPDAC Daraxonrasib vs investigator’s choice chemotherapy

🧬 RAS G12 population
91.8% of patients had RAS G12 mutations

📈 OS in RAS G12 population
13.2 vs 6.6 months
HR 0.40
P<0.001

📈 OS in overall population
13.2 vs 6.7 months
HR 0.40
P<0.001

📊 PFS in RAS G12 population
7.3 vs 3.5 months
HR 0.45
P<0.001

📊 PFS in overall population
7.2 vs 3.6 months
HR 0.49
P<0.001

🔥 12-month OS
Overall population: 53.2% vs 17.3%

⚠️ Toxicity matters, but this was not just more efficacy for more toxicity
Grade ≥3 AEs: 61.8% vs 69.6%
TRAEs leading to discontinuation: 1.2% vs 11.2%

This is the kind of survival curve we almost never get to see in pancreatic cancer.

This validates RAS(ON) inhibition in the most RAS-addicted major cancer. It takes a target we have talked about for decades and turns it into a clinically meaningful survival benefit in a randomized phase 3 trial.

The next questions come fast: 1L combinations, maintenance, perioperative disease, sequencing, resistance, toxicity management, and whether this becomes a new backbone.

RAS is here, and it couldn’t have come sooner.

https://t.co/Y4WJRlRRTk

@TheGutonclab @UGrewalMD @TimothyJBrownMD @OncoAlert @Onco_Nexus @ASCO
@NazliDizman @LauraAlderMD @DVAraujoMD @DrBarbiOnc @LauraEsfeller @FunchainMD @YGaritaonaindia @DrSAHaddad @jgong15 @iandresmeraz @SakditadMD @RamilaShilpakar @RohitBanwar @lungoncdoc

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@my_ueg
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Check out our short Bulletin featuring GI Oncology papers from 01/2024! 📢 Stay up-to-date with the latest publications.

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For more details see: https://t.co/WtzYMbUteQ

[Giovanni Marchegiani @Gio_Marchegiani]

Neoadjuvant FOLFIRINOX 🤜🤛upfront surgery for resectable pancreatic cancer

NORPACT-1 out 🔥 now @LancetGastroHep

📈 Median OS 25 vs. 38 months and resection rate did not differ

💉 60% neoadjuvant group had severe adverse event 🚨

🫵Comments?🧐

👉 https://t.co/zhikhG8XQN

[Elisabeth Stragier @elsbiethastrag]

https://t.co/jsLJ58oydb

[ESDO @ESDO_tweets]

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[ESDO @ESDO_tweets]

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[Jeroen Dekervel @JDekervel]

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[Jeroen Dekervel @JDekervel]

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In #KN585, the addition of pembrolizumab to periop chemo in locally advanced #GastricCancer did not improve EFS.

Check out the interpretation of the results by key expert @KoheiShitara!

Link👇 @Medi_Mix

https://t.co/0Ko5qqIXN6

[Arndt Vogel @ArndtVogel]

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✅ CodeBreak 300 phase III
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👉ORR 26.4 vs 5.7 vs 0
👉DCR 71.7 vs 67.9 vs 46.3
👉mPFS 5.6 vs 3.9 vs 2.2
👉OS: hmm…
🧐met 1° EP, definitely an option, but maybe earlier &amp; w/ CTx
@myESMO

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