• By Natalia Gurevich | Examiner staff writer
• Sep 4, 2026 (SFExaminer.com)

UCSF researchers are celebrating the approval by the U.S. Food and Drug Administration of a groundbreaking new drug — the research roots of which can be traced back to the university — to treat pancreatic cancer.

Daraxonrasib — also known by the brand name Rasonque — is a pill-based drug treatment for metastatic pancreatic cancer that presents a new option for patients with advanced forms of the disease. It targets a protein called RAS, which is found in 90% of patients with pancreatic cancer and drives tumor growth.

The drug is in some ways a “RAS inhibitor,” said Dr. Andrew Ko, a specialist in digestive cancers who has long been researching the protein and ran the clinical trial in partnership with Revolution Medicines, which developed the drug.

Kevan Shokat, one of the co-founders of the Redwood City-based biotech company, is a professor of cellular and molecular pharmacology at UCSF.

Last week’s approval is a milestone years in the making.

“The biology — in terms of this RAS molecule, understanding how it functions, understanding the different aspects of its structure — has been ongoing for the past 10 to 20 years,” Ko said. “This has long been called the holy grail in terms of trying to develop drugs that target this mutation because it’s so common, because it’s what drives the pancreatic cancer to grow and survive.”

Pancreatic cancer is one of the most lethal cancers, with a five-year survival rate of 13%, according to the American Cancer Society. About 67,000 new cases are diagnosed every year, and it’s often detected late, according to the FDA’s announcement last week.

The clinical trial for Rasonque, which involved 500 adults, took place at multiple clinics, including UCSF. It found that the drug improved patients’ median overall survival time to 13.2 months, compared with 6.7 months for standard chemotherapy.

The typical treatment up until this point has been traditional chemotherapy, which uses strong, intense drugs that can have serious side effects, including fatigue, hair loss, nausea, numbness and tingling, and suppression of the immune system, while only providing “moderate efficacy,” Ko said.

“This is a completely different drug,” he said of Rasonque. “This drug compared to traditional chemotherapy really significantly improved survival for patients … this will be huge for our patient population.”

To qualify for the new drug, patients must have already tried chemotherapy or not be eligible for combined chemotherapies — but the FDA’s language on those restrictions is “liberal,” Ko said.

“You may see the drug even being used as a frontline treatment for patients with a new diagnosis of metastatic pancreatic cancer,” he said.

The drug could also potentially be applied to other types of cancers that also have the RAS protein mutation, although to lower degrees than pancreatic cancer, such as lung cancer, colon cancer, and bile-duct cancer. Those types of applications are being studied at UCSF and elsewhere, Ko said.

Ko said it’s a little premature to say that this drug treatment should become the “gold standard,” Ko said, but it opens up possibilities to shift cancer patients away from the harsher intravenous drugs used for chemotherapy.

“That would be a wholesale shift if that happens,” he said.

Patients could have more agency by taking the pill at home, instead of having to go into a facility to receive chemotherapy, Ko said.

“I don’t want to imply it’s totally benign,” he said of the drug — which does have side effects that include nausea and edema — but it still could “hearken a wholesale transformation in how we treat patients.”

The drug might have other possibilities as well, including use at earlier stages in patients who have operable cancers, and to prevent recurrence of the cancer in patients who have undergone surgery.

The drug does have a hefty price tag, as reported Monday by The New York Times — about $480,000 a year, or $663 per dose, which Ko said has become common with molecularly targeted therapies in recent years.

“It’s a bigger issue in terms of our health system and how these drugs are priced,” he said. “You absolutely can make an argument that it’s super expensive and that contributes to why our health-care costs are what they are.”

But he said that even with the high cost, it’s likely to be covered by Medicare, and he said he anticipates that other insurers will follow suit.

Because chemotherapy also includes the cost of intravenous time and other factors, comparing the two would be “apples and oranges,” Ko said.