One of my patients, a woman in her 60s with pancreatic cancer, came to me looking for a clinical trial. She received a new drug before its approval, through an expanded access program, and stayed on it when it reached the market. She still asks what comes next, hopeful that American innovation will give her more chances. In more than two decades as an oncologist, I have learned that time is never merely a number: it can mean celebrating your daughter’s wedding, spending another Thanksgiving with your family, or meeting a new grandchild for the first time.
Few diagnoses make that truth more urgent than pancreatic cancer. It is one of the deadliest forms of cancer, in part because it is often discovered only after it has spread. For years, patients with advanced pancreatic cancer have had too few options and little reason to hope for a cure. In the United States alone, it is estimated that 67,530 will face this terrible diagnosis in 2026, and 52,740 will die from it.
But it’s not like cancer researchers to accept anything as written in stone.
In late August, the FDA approved a powerful new treatment for pancreatic cancer, Revolution Medicines’ (RevMed) Rasonque, for patients with metastatic disease who have had prior treatment or cannot receive combination chemotherapy. This is the result of over a decade of tireless research into the possibility of deploying RAS(ON) inhibitors to shut off cancer-producing genes and proteins in certain tumors.
The results so far have been incredible. Previously treated patients on Rasonque have a 12-month survival rate of 53.2% compared to a mere 17.3% with chemotherapy-based approaches. Progress in this field is often slow and incremental, which makes this staggering accomplishment from RevMed and its partners all the more remarkable, offering a rare source of hope for pancreatic cancer patients.
But the approval should not be mistaken for the final word. FDA review materials released this month raised questions about how consistently daraxonrasib performs across different KRAS mutation subtypes, while cautioning that the available analyses were not designed to support formal comparisons among those groups. That is not a reason to retreat from this advance. It is a reason to learn faster: to identify which patients are most likely to benefit, understand how tumors evade treatment, and test rational combinations that can produce more durable responses.
Former U.S. Senator Ben Sasse accessed this promising drug before it was officially approved, and in April 2026 he described it as a “miracle drug,” saying he had much, much less pain…and a 76 percent reduction in tumor volume. In September 2026, Sasse shared on social media that he recently underwent major liver surgery that removed a significant amount of cancer, but that his tumors have developed a resistance to his former treatment.
Remarkable as this progress is, the greater promise lies ahead. A cure for pancreatic cancer may be possible, something we could not have dreamed up ten years ago, but only if we seize every opportunity available to us today.
New targeted therapies produce a remarkable initial benefit. But unfortunately, like in Sasse’s case, tumors can often find alternate survival routes, especially in aggressive forms like pancreatic cancer. To combat this, oncologists often deploy what is called a “combination therapy” of multiple treatment approaches to attack the disease from numerous directions, trapping the cancer with no back-up escape route.
Combination therapies have been transformative in the treatment of other cancers. In advanced melanoma, for instance, the combination of two drugs, Opdivo and Yervoy, has yielded a five-year survival rate of 52 percent, compared to 44 percent for Opdivo and 26 percent for Yervoy alone.
All of this is why I am encouraged that RevMed’s CEO, Mark Goldsmith, has expressed his interest in exploring new Rasonque-driven combination therapies with other cutting-edge therapies. Several other companies, including Bristol Myers Squibb and Tango Therapeutics, are also working on novel treatments for pancreatic cancer using a distinct method called a PRMT5 inhibitor, which targets tumors missing a gene called MTAP, a deletion common in pancreatic cancers. As Goldsmith said on an August earnings call, a combination therapy of these two treatments is a credible idea.
Ben Sasse was told in December 2025 that he had three to four months to live. He is still here today because of medical innovation and a willingness to pursue new therapies when conventional treatment alone was not enough. Though he has well surpassed his initial prognosis, Sasse isn’t cured and has had to turn to an aggressive chemotherapy regimen.
The first RAS-directed approval in pancreatic cancer should be the beginning of a broader effort, not the endpoint. Researchers, companies, cancer centers, and regulators should move urgently to test combinations that may make responses deeper, longer-lasting, and available to more patients.
That means designing biomarker-driven trials, sharing evidence quickly, and ensuring promising combination strategies are evaluated on their scientific merits. Patients with pancreatic cancer have too few options to let practical, commercial, or institutional barriers slow the search for better ones.
We do not yet know which RAS-directed combination will prove most effective. But we know enough to test the best ideas rigorously, and patients deserve nothing less.
Arturo Loaiza-Bonilla, MD, MSEd, is systemwide chief of hematology and oncology at St. Luke’s University Health Network and the co-founder and chief medical AI officer at Massive Bio, a company connecting patients to clinical trials using artificial intelligence.
