New treatment for 2nd line treatment of pancreatic cancer

Pancreatic cancer: image from Wikipedia

Pancreatic cancers patients have worse prognosis than most other common cancers. The cancer research UK states only “25 out of every 100 (25%) survive their cancer for 1 year or more”.

Chemotherapy is the main treatment for advanced pancreatic cancer.

While immunotherapy and targeted therapy options have made great inroads into successfully prolong lives of patients with various other cancers, pancreatic cancer patients were left behind.

Only a small minority of pancreatic cancer patients benefited from targeted therapy so far.

Now there is a breakthrough !

Daraxonrasib is the name of the promising new drug.

Trial results were presented and discussed at the ASCO 2026 Annual Meeting in Chicago ( ASCO- American Society of Clinical Oncology).

The study author’s presentation of trial results of Daraxonrasib in pancreatic cancer received a standing ovation!

Daraxonrasib (“darax”) doubled the survival pancreatic cancer patients in the second line setting .

Results are extraordinary and are now published in the prestigious New England Journal of Medicine.

The drug will be the standard of care now in 2nd line setting.

A word of caution about availability!

American FDA has given the green light but it might take many months before it becomes available in European Hospitals for pancreatic cancer patients.

References

Lay public summary. ASCO. Oral targeted therapy slows pancreatic cancer growth, improves overall survival. Published 31 May 2026.

ASCO 2026: Daraxonrasib, a RAS(ON) multi-selective inhibitor vs chemotherapy in previously treated metastatic pancreatic adenocarcinoma (mPDAC): Primary and final analysis from the phase 3 RASolute 302 study. Abstract LBA5

Guardian newspaper. Daily pill can double survival time for world’s deadliest cancer, trial shows: Experts hail daraxonrasib as ‘gamechanger’ for patients with advanced pancreatic cancer

BBC News. Daily pill doubles survival time for pancreatic cancer patients

MHRA UK

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. But the author cannot vouch for scientific integrity of the sources cited and author is not responsible for any information in any advert on those cited pages. Please DO consult your own doctor to discuss concerns and options, which are directly relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting this blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Can applying some electric current make chemotherapy work better in pancreatic cancer ?

Yes !

Applying electricity to tumours can help to improve control of pancreatic cancer.

The procedure is called TTfFields.

The procedure is not invasive.

The procedure uses low-energy electricity which impedes cancer cells’ ability to grow and divide.

The procedure is done alongside standard chemotherapy .

The TTFields electric treatments has already been tested and has shown promise in brain tumours and lung cancers.

A study presented at the Chicago ASCO meeting shows better survival in patients who had TTFields electricity in addition to their usual chemotherapy regimen of gemcitabine and abraxane (nab-paclitaxel) for pancreatic cancer.

The study data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) at Chicago.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

  1. Tumour treating fields therapy for glioblastoma: current advances and future directions. British Journal of Cancer volume 124, pages 697–709 (2021)
  2. Weinberg U, Farber O, Giladi M, Bomzon Z, Kirson ED. Tumor treating field concurrent with standard of care for stage 4 non-small cell lung cancer (NSCLC) following platinum failure: Phase III LUNAR study. [abstract]. ESMO, October 2018. Ann Oncol. 2018;29:viii543. doi: 10.1093/annonc/mdy292.120.
  3. Lancet oncology. Tumor Treating Fields therapy with standard systemic therapy versus standard systemic therapy alone in metastatic non-small-cell lung cancer following progression on or after platinum-based therapy (LUNAR): a randomised, open-label, pivotal phase 3 study.
  4. Wiki. Alternating electric field therapy.
  5. PANOVA-3: Phase 3 study of tumor treating fields (TTFields) with gemcitabine and nab-paclitaxel for locally advanced pancreatic ductal adenocarcinoma (LA-PAC) .

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

More pancreatic cancer patients may benefit from immunotherapy

Immunotherapy has revolutionised cancer treatment over the last few years . But, sadly, not all cancer patients derive benefit from the costly immunotherapy drugs

For instance, almost, all advanced kidney or skin melanoma cancer patients are eligible to try immunotherapy. But only about 1% of patients with pancreatic cancer are at present eligible for immunotherapy .

A new study suggests more people with pancreatic cancer may be eligible for immunotherapy. 

The preliminary data from a good quality early study (randomized phase II trial) is interesting.

The study compared treatment with gemcitabine (G) and nab-paclitaxel (N) with and without dual immunotherapy treatment with durvalumab (D) and tremelimumab (T) as 1st-line therapy in patients with advanced pancreatic cancer. 

In this study, only a subset of patients derived benefit from the dual combination therapy. 

Subsequent molecular and genetic analysis showed that the presence of certain gene mutations (≥2 DDR) was strongly associated with benefit from the combination of chemotherapy with dual immune checkpoint inhibitor therapy. 

These intriguing exploratory data analysis needs confirmatory data before the combination therapy become the standard of care for advanced pancreatic cancer patients.

The study data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) hosted at Chicago.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

American Society of Clinical Oncology (ASCO) 2025: Concurrent mutations in DNA damage repair genes BRCA1, POLE, ATM and FANCA to predict overall and progression-free survival for patients (pts) with metastatic pancreatic ductal adenocarcinoma (mPDAC) treated with chemotherapy in combination with dual checkpoint inhibition in the CCTG randomized PA.7 trial.

Evaluating Mismatch Repair Deficiency in Pancreatic Adenocarcinoma: Challenges and Recommendations. Clin Cancer Res (2018) 24 (6): 1326–1336.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

How to overcome resistance to Olaparib and other similar PARP inhibitors ?

Olaparib and similar drugs have revolutionised the treatment of a sub-set of patients with BRCA gene mutations ( eg Ovarian, Prostate, Breast cancers).

But patients can develop resistance to these drugs.

At the ESMO European Society of Medical Oncology Congress-2024, Barcelona), ways to overcome this resistance was discussed.

Targeting the Enzymes USP-1 and POLQ seems to overcome resistance.

The future looks promising!

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Milder chemotherapy for older patients with pancreatic cancer

Older adults with newly diagnosed advanced pancreatic cancer are often frail and vulnerable.

The standard chemotherapy regimens such as the FOLFIRINOX regimen are quite toxic and not suitable for frail patients.

At the recent ASCO meeting in Chicago, a study which utilised gentler versions of the existing chemotherapy regimens was presented.

These gentler versions were found to have reasonable efficacy and toxicity.

References

1. ASCO post. Efrat Dotan, MD, on Pancreatic Cancer in Older Adults: Defining the Optimal Treatment Approach.

2. ASCO 2024 Abstract. A randomized phase II study of gemcitabine and nab-paclitaxel compared with 5-fluorouracil, leucovorin, and liposomal irinotecan in older patients with treatment-naïve metastatic pancreatic cancer (GIANT): ECOG-ACRIN EA2186.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.