Anyone else on Daraxonrasib (RMC-6236)?

@joeseah

I had a distal pancreatectomy/splenectomy as my primary tumor was on the tail of my pancreas, followed by folfirinox. I went 9 months with NED and than had recurrence with tumors in my liver and abdomen.

Hubby is on day 9 of daraxonrasib for his stage 4 pancreatic cancer/ lung matast. First 2 days of pills had nausia and diarrhea but they were easily controlled and for the past 6 days he has had no side effects at all no nausia or diarrhea. Only the face rash that they say 90% of paitents get in some degree. he is now on a topical cordizone cream and and antibiotic for that. So far so good, but of course a CT is not due for another 2 months so knowing if the pill is effective will be some time to come. But I have to say we still go to the casino twice a week and visit our 4 grandchildren and play cards, so quality of life has been good. He is 80 by the way, and still is able to drive and does not need a walker.
As to history, diagnosed at 80 yrs old, in Oct 2024, with stage 4 pan/lung involvement, , and been on Chemo of Gemc and Paclitaxel, since March, 2025 with a modified schedule of just every other week. He has had 30 chemo treatments, and outside of fatigue he has had NO side effects. He did have a stent inserted in his bile duct called ERCP to avoid pain and jaundace way back at diagnosis in Oct 2024, and I believe that early proceedure has cause him to live much better than expected. No Whipple as you cannot have a Whipple if you are stage 4. CT scans show slsow or no advancement, but his CA 19 has gone from 7000 to about 15000 in that time, so we know that the cancer is slowed but still on the move.

Now Daraxonrasib, made available on Early Release and OK'b by FDA on May 1, 2026 check google and Revolution Medicine Inc's web site for the press releases. I researched and saw this and asked our Oncologist immediately if my Husband qualified. We set about to fill out all the necessary paperwork for approval from Revolution Medicines, Inc. They have a strict protocol for who will get the pill on Early Release...You have to be stage 4, you have to have tried the normal treatment protocols such as chemo, and you have to at this time after months of treatment, be losing the battle. you must also be in fairly good health otherwise with restrictions on your need for other meds like diabetes, as the "pill" won't mix with certains other meds. They don't take folks close to death, as "the pill" only increases your life expectancy by 50%, It does not cure you. Hospice patients don't qualify. Revolution Medicine INC takes your app and evaluates it, then lets your doctor know if you qualify. My husband's application took 6 weeks to be processed, but he did finally get the OK. He stayed on his chemo treatments right up to the day he took his first pill, then stopped the chemo. There is no way of knowing what my husbands life expectancy is since he was doing so well and defying the odds already, but the Doctor gave him 3 to 5 years. And since he had no side effects from chemo, we can't really expect "quality" of life to improve when we are already at the top of the scale so to speak. But we decided we would try the pill for 3 mos and see a CT scan. We can always go back on our chemo regemend if we want. We are in Pittsburgh so lucky to have one of the Country's leading Cancer centers here near by, Hillman Cancer Center out of University of Pittsburgh, But frankly, most of what my husband has experienced has come from MY own research and question to the doc, about chemo schedules, stents, and the "pill". You must stay active and on to of things. And most important of all ATTITUDE......you must keep a good attitude about what life you have left and make the best of it, and not dwell on the future, take day by day and have FUN.

It is my understand Daraxonrasib will be fully OK'd by the FDA by Jan 2027 when at that time, everyone will qualify for it depending on your doctors recommendation. But now, on Revolution Medicine Inc can say who gets it based on their protocol. Chemo is still considered the first line of defense, so if you haven't taken chemo, then forget thepill, at least until it is fullly approved in 1/2027. The pills go to your clinic or hospital where your doctor works with your name on them alone, which is why it takes so long. They are NOT going to outside pharmacies at this time. So if you think you qualify, get your doctor to submit your name, and then begin the waiting game, and good luc.

Please visit Revolution Medicine Inc web site and look under early release program to see who qualifies and how to go about it..I can't put their web site in here, the forum won't let me.
Love to all,
Marlene

For decades, KRAS/RAS was considered essentially “undruggable.” Daraxonrasib is a RAS(ON) multi-selective inhibitor, meaning it targets active RAS signaling across several common RAS mutations rather than being limited to one mutation. Its Phase 3 results showed significant improvements in both progression-free and overall survival compared with chemotherapy in previously treated metastatic pancreatic cancer.

And the researcher was absolutely right that more drugs are coming behind it. Revolution Medicines already has several next-generation RAS drugs in development:

Zoldonrasib (RMC-9805) specifically targets KRAS G12D, the most common KRAS mutation in pancreatic cancer, and has moved into late-stage development.
RMC-5127 specifically targets KRAS G12V.
Elironrasib (RMC-6291) targets KRAS G12C.
RM-055 represents another newer class of RAS(ON) inhibitors and is expected to enter human trials later in 2026.

They're also studying combinations of RAS inhibitors. For example, a Phase 3 program is planned combining zoldonrasib with daraxonrasib in pancreatic cancer.

@mimimmx oh really ok thanks. Do the nasty side effects stay with you the whole time? Hoping to start this pill soon.

@mimimmx sorry to hear about that.

@valerina30

My side effects have shifted over time with the exception of one that I have had the whole time. I have a blister on my lower lip that started just weeks after going on the drugs and has stayed the entire time. Annoying. I have never had a severe facial rash. Just iccasional flare up’s that go away when treated. I initially had diahrea that was easily treated with Imodium. It has now gone away. I have had two bouts with anemia caused by low iron/ hemoglobin. Very fatigued during those times. Treated twice with iron infusions. I also had mouth sores for awhile that also stopped. Now my challenge is a rash on scalp. All of this annoying but ok to live with. Much easier than folfirinox for me. Overall my quality of life is very good.

@ljojimo
I'm glad to hear your wife has access to the daraxonrasib! We meet this Friday with our oncologist and that new drug is on the table for discussion as her cancer has started to slowly regrow per the CT scan last week. I mentioned in a separate post on this thread that she has esophageal dysmotility which makes pill swallowing more difficult particularly for "hard" pills (versus capsules). Would it be possible to take a picture of a daraxonrasib pill next to a ruler so we could see the actual size of a pill (I understand they come in different dose levels but am not sure if the pill size changes per se). The posting mechanism for this forum does allow one to attach a photo. This info would help us be prepared better for our Friday meeting with the oncologist. Thanks in advance for whatever support you can provide.

@amiller7x7 I have attached photos of the measured width 1/4in, length 3/4in, and bottle label. These are 100mg pills, my wife takes three a day at one time (after breakfast). I am in a support group with a woman whose husband dropped from 300mg to 150mg because of terrible mouth sores. This implies to me that RevMed produces a 50mg size pill. Maybe you could inquire about that. Best of luck.

@amiller7x7 It doesn't appear the photos I attached went through. Sorry, best I can do.

@amiller7x7 OK, tried one more time with reduced file size..... nope that didn't work either. If you really need these photos, you could post your email address and I can email them to you outside of the Mayo list.