Wish Dhillon, Medical Oncologist at AZCCC/Honor Health, shared on LinkedIn:
“Treatment of Pancreatic Cancer: The Work Ahead
Three months ago RASolute 302 got a standing ovation at ASCO based on extraordinary data. On August 26 the FDA approved daraxonrasib for metastatic PDAC after prior therapy, or for patients who are not candidates for multiagent chemo.
The approval is done. We are at early stages of what will likely be a decade of RAS inhibition. 4 questions land in clinic this week.
- Access. How long from prescription to first dose in a community practice versus a trial site? How are you drawing the line for patients who cannot get multi-agent chemo, and is payer policy matching it?
- Toxicity. Rash, diarrhea, stomatitis, and nausea show up in the first weeks. The label also flags severe skin reactions, GI perforation, and pneumonitis. What are your protocols? Are you starting preventive skin care on day one?
- Resistance. Nature Medicine found new RAS-pathway changes in 59% of progressors, often extra copies of mutant KRAS. When it stops working, are you repeating molecular testing?
- Trials. RASolute 303 is first-line. RASolute 304 is adjuvant versus observation. If you have an eligible newly diagnosed or resected patient this week, are they going on one of those studies?
Rahul Gosain, Rohit Gosain, you have covered this topic very well and extensively.
What does clinic look like now that the drug is approved? This will be an ongoing conversation. Look forward to collaborating with expert colleagues Mitesh Borad, M.D. Tanios Bekaii-Saab, Erkut Borazanci, HonorHealth, Arizona Center for Cancer Care.
And finally, How do we help patients who may need manufacturer’s assistance? Looking forward to working with Revolution Medicines.”
You can also read ‘FDA Approves Daraxonrasib: First-in-Class RAS Inhibitor for Metastatic Pancreatic Cancer‘
