Understanding KRAS Inhibitors: A new direction in pancreatic cancer treatment 

Hi, my name is Nicci and I am a pancreatic cancer specialist nurse here at Pancreatic Cancer UK.

In this blog, we’ll take a closer look at a promising group of treatments known as KRAS inhibitors (pronounced K – ras). These aim to treat cancers with a mutation (change) in the KRAS gene. Daraxonrasib is a KRAS inhibitor treatment.

What is the KRAS gene?

Around 90% of people with pancreatic ductal adenocarcinoma (the most common form of pancreatic cancer) have a change (mutation) in a gene called KRAS, which is part of the RAS family of genes. These gene changes can cause cancer cells to keep receiving signals to grow and divide, even when they should not. This can lead to the cancer growing and spreading.

Read more about genes and mutations.

For many years, cancers with KRAS mutations have been particularly challenging to treat. This is because standard treatments like chemotherapy do not work as well for them, compared to other types of cancer.

How will you know if you have a KRAS mutation?

You may have heard your healthcare team talk about genomic profiling or genomic testing.

This testing looks at the genes in cancer cells to:

• identify specific mutations or changes (like KRAS)
• help guide more personalised treatment decisions
• work out whether you may be able to have clinical trials or targeted therapies.

Targeted therapies are treatments that target specific things in cancer cells, like genes or proteins.

You can ask your oncology team about genetic testing, and you can read more about genomics here

What are KRAS inhibitors?

KRAS inhibitors are part of an exciting new generation of targeted therapies. Rather than broadly attacking fast-growing cells (like chemotherapy does), these drugs are designed to:

• directly block the activity of KRAS genes

• interrupt the signals that tell cancer cells to grow.

By targeting the cause of the problem — the abnormal KRAS signal — these treatments offer a more focused approach to treatment.

What is Daraxonrasib?

Daraxonrasib is a KRAS inhibitor medication that has just completed phase 3 trials in the United States. This was a trial for people with advanced (metastatic) pancreatic cancer.  The phase 3 trial (called RASolute‑302) compared:

• Daraxonrasib (taken as a daily tablet)
  to
• standard chemotherapy.

The results were promising, showing an improvement in survival for people taking Daraxonrasib. The company developing the drug, Revolution Medicines, are now working towards making Daraxonrasib available to patients in the US, with plans for further clinical trials.

Are there any clinical trials for Daraxonrasib or KRAS inhibitors available in the UK?

Currently here in the UK, Daraxonrasib is only being used in a clinical trial for people who have had surgery and whose cancer has not come back. This is called the RASolute 304 trial. There may also be other KRAS trials available. You can find out more about these trials on our Clinical Trial Finder.

We would always encourage you to discuss clinical trials with the health professionals providing your care.

Will KRAS inhibitors be available on the NHS?

If clinical trials show positive results, they will be formally assessed to determine if they should be available on the NHS for eligible patients. This decision is made based on how well they work, cost and the other treatments currently available. At Pancreatic Cancer UK, we will do whatever we can to help make sure effective new treatments are approved for the NHS.

I hope this has been helpful to you. Thanks for reading.