A glimmer of hope may be on the horizon for a ruthless cancer that former Sen. Ben Sasse (R-Neb.) once called a “definite death sentence.”
An experimental treatment from Revolution Medicines helped patients with an aggressive form of pancreatic cancer live twice as long as those on chemotherapy alone in a late-stage trial.
But for Sasse, 54, taking the “nasty drug” hasn’t always been easy.
“It causes crazy stuff like my body can’t grow skin and so I bleed all out of a whole bunch of parts of me that shouldn’t be bleeding,” the ex-Nebraska lawmaker said in a recent interview with the New York Times, describing the sensation as “nuclear.”
Still, the cutting-edge drug behind Sasse’s “bubbling” skin — daraxonrasib — is giving him something invaluable: more time with his wife and three children, ages 24, 22 and 14.
When Sasse was diagnosed with Stage 4 pancreatic cancer last year, doctors said his torso was “chock-full” of tumors and that the disease had spread throughout his body, estimating he had just three to four months to live. He then became a participant in a clinical trial for the new drug, which does not yet have FDA approval.
This week, Sasse told Stat News that daraxonrasib has reduced his tumor volume by about 60%, while his pain levels are “way, way down.”
“Given what the prognosis was,” he said, “and given what the tables say about pancreatic cancer, this experience has seemingly extended both quantity and quality of life.”
In a Phase 3 clinical trial — not the one Sasse is in — RevMed enrolled more than 500 patients with metastatic pancreatic ductal adenocarcinoma (PDAC), a highly aggressive, usually incurable form of pancreatic cancer, whose previous treatments had failed.
Half of the participants received a daily oral dose of 300 mg daraxonrasib, while the other half were given standard-of-care intravenous chemotherapy.
Patients taking daraxonrasib had a median overall survival of 13.2 months compared to 6.7 months for the chemotherapy group — a difference Dr. Nicholas Hornstein, a medical oncologist at Northwell’s Lenox Hill Hospital, called “remarkable.”
“Pancreatic cancer is notorious for being nearly impossible to treat — most patients survive less than a year after diagnosis,” said Hornstein, who wasn’t involved in the trial.
In the body, the drug targets a mutated protein called KRAS, which Hornstein said acts like a “stuck accelerator” in cancer cells, telling them to keep growing when they should stop.
“Scientists have been trying to block KRAS for decades with little success,” Hornstein said.
“Recent drugs have managed to target one specific faulty version of KRAS, but daraxonrasib appears to work across multiple versions, which means it could potentially apply to far more patients — and far more cancer types, including colorectal and lung cancer.”
Hornstein said skin toxicity, like what Sasse is experiencing, is a relatively common side effect with cancer drugs designed to block KRAS activity.
“Luckily, the toxicity is generally far less than what Mr. Sasse reported,” he said. “Additionally, involving onco-dermatology early and using some newer agents, we are having significant success in mitigating these side effects.”
In the late-stage trial, RevMed said daraxonrasib was “generally well tolerated” and had a “manageable” safety profile, with no new issues observed.
RevMed plans to submit the trial results to the FDA, seeking approval for daraxonrasib as a second-line treatment for patients whose cancer has already spread after prior therapy.
It might not take long. The company was the first cancer drug developer to receive a Commissioner’s National Priority Voucher for a cancer therapy, placing its application on an expedited review track.
RevMed is also testing daraxonrasib on its own and in combination with chemotherapy in patients receiving first-line treatment for PDAC.
Because the disease often produces no early symptoms and there are few effective screening tools, roughly 80% of patients are diagnosed with PDAC at an advanced or metastatic stage.
In those cases, about 90% of patients have RAS mutations targeted by daraxonrasib.
Metastatic PDAC remains one of the leading causes of cancer-related deaths in the US, with a five-year survival rate of 3%.
“For patients with metastatic pancreatic cancer, new treatment options are urgently needed to increase survival time and improve quality of life,” said Dr. Brian M. Wolpin, professor of medicine at Harvard Medical School and lead researcher for the Phase 3 daraxonrasib trial.
“The widely anticipated results of this study indicate that daraxonrasib provides a clear and highly meaningful step forward for [these] patients.”
In 2026, an estimated 67,530 Americans will be diagnosed with pancreatic cancer, and 52,740 are expected to die from the disease.
