PDAC at ASCO 2026 / Pancreatic Cancer 06/16/2026

Managing Toxicity and Expanding RAS Therapy in Pancreatic Cancer

Close-up of a smiling male scientist in a checkered shirt and tie, outdoors, representing cancer research and medical innovation. Andrew H. Ko, MD Eileen O'Reilly, MD 1. Professional oncologist in a suit with a pink tie, focused on cancer research, healthcare, or medical leadership, representing expertise in oncology. Shubham Pant, MD, MBBS OncUpdates healthcare professional, expert in cancer research and treatment, providing latest updates on oncology therapies, clinical trials, and cancer patient care. Rachna Shroff, MD, MS, FASCO Smiling man with beard wearing a white shirt, professional headshot, suitable for oncology or cancer research content, emphasizing healthcare and medical expertise. Rahul Gosain, MD, MBA Oncologist smiling in white coat, highlighting cancer research and treatment expertise, with a bow tie, in a bright medical setting. Rohit Gosain, MD

Key Points

  • Rash and gastrointestinal (GI) toxicity are most common but generally manageable.
  • Proactive supportive care is central to treatment success.
  • Discontinuation rates are low despite adverse events.
  • Ongoing trials are moving therapy into frontline and adjuvant settings.

As attention turned to implementation, the cohosts of the Clinical Insights session — Rahul Gosain, MD, MBA, and Rohit Gosain, MD — along with panelists Andrew H. Ko, MD, of the University of California, San Francisco; Eileen O’Reilly, MD, of Memorial Sloan Kettering Cancer Center; Shubham Pant, MD, MBBS, of The University of Texas MD Anderson Cancer Center; and Rachna Shroff, MD, MS, FASCO, of the University of Arizona, focused on the manageable safety profile of daraxonrasib. 

The most common adverse events included rash, stomatitis, diarrhea, and GI symptoms. Rash was generally low grade but required proactive management, including sun protection, doxycycline prophylaxis, and topical corticosteroids.

GI toxicity, including diarrhea and early-onset nausea, was emphasized as another key management area, with experts recommending early use of antidiarrheals, hydration strategies, and antiemetics. Mucositis and stomatitis were typically later events and responded to supportive oral care measures such as steroid mouth rinses and “magic mouthwash.”

Despite these toxicities, treatment discontinuation rates remained low, particularly in the setting of clinical benefit. Investigators noted that many patients reported improved appetite, reduced pain, and better overall quality of life, which often encouraged continued adherence even in the presence of manageable adverse effects.

Looking forward, multiple trials are evaluating daraxonrasib in earlier disease settings, including frontline therapy (RASolute 303) and adjuvant use (RASolute 304), along with combination strategies across additional RAS-targeted agents and tumor types. Experts concluded that RASolute 302 likely represents the beginning of a broader transformation in RAS-driven oncology, extending beyond pancreatic cancer into colorectal and lung malignancies.