Georgia hospitals test ‘game-changer’ pancreatic cancer drugs

Cancer of the pancreas, a gland that helps with digestion, remains one of the most aggressive and treatment-resistant cancers. Up until now, the primary treatment has been chemotherapy with survival estimated in months and patients with the most advanced stages not surviving past a year.

The drug is doubling the survival rate of patients with the most advanced form of pancreatic cancer — stage 4 metastatic, cancer that has spread to other parts of the body — from about 6 ½ to 13 months. The progression-free survival rate also rose from about 3 ½ months for chemotherapy to about 7 months.

Hope for patients

For the 70-year-old Vinings resident, the drug hasn’t felt like a miracle cure because it eventually stopped working, albeit at the top of the expected survival range. Still, he considers it a major breakthrough that offers hope for future medical treatments.

“Everybody knew it would not last forever and so the fact that I got 13 months progression-free is phenomenal,” Stockton said. “A lot of people don’t live for 13 months.”

Credit: Thatcher Townsend.

Credit: Thatcher Townsend.

Stockton began treatment with the drug as part of the clinical trial at Sarah Cannon Research Institute in Nashville that led to the FDA early access approval. He is now under the care of a Piedmont Atlanta Hospital oncologist leading clinical trials involving two patients with stage 4 metastatic pancreatic cancer.

Only 13% of all pancreatic cancer cases reach the five-year survival rate, according to the American Cancer Society. Nearly half of all patients with the disease don’t learn they have it until it reaches the more advanced stages because of its vague warning signs, which can be easily mistaken for other conditions. In Georgia, incidence rates exceed the national average, the National Cancer Institute reports.

The trajectory is starting to change as Piedmont and Emory University study alternatives to chemotherapy that target mutations in the KRAS gene, which are found in more than 90% of pancreatic tumors.

KRAS genes make a protein “that is involved in cell signaling pathways that control cell growth, cell maturation and cell death,“ according to the cancer institute.

Drugs that treat KRAS mutations have the potential to benefit the vast majority of pancreatic cancer patients, oncologists involved in the clinical trials told The Atlanta Journal-Constitution. That’s why preliminary clinical trial results are such a strong sign of hope and a potential turning point for a disease long considered one of the more difficult cancers to treat effectively.

Credit: Winship Cancer Institute at Emory University

Credit: Winship Cancer Institute at Emory University

“The truth is that we’ve run so many clinical trials for pancreatic cancer over decades and the vast majority unfortunately have been negative,” said Dr. Olatunji Alese, director of gastrointestinal oncology at Emory’s Winship Cancer Institute.

More time, fewer side effects

Unlike most approved chemotherapy, received through intravenous infusion, the oral KRAS inhibitor daraxonrasib is a daily pill designed to target the genetic cause of the disease.

New treatment options are urgently needed. About 80% of pancreatic cancer patients are diagnosed at a stage too advanced for treatment that usually includes surgery, said Dr. Andrew Page, a surgical oncologist and medical director of Piedmont’s new early detection pancreatic cancer clinic.

Credit: Piedmont Atlanta Hospital

Credit: Piedmont Atlanta Hospital

In April, drugmaker Revolution Medicines reported that daraxonrasib doubled median survival in patients with previously treated metastatic stage 4 pancreatic cancer. Stockton was one of those patients.

“While the survival improvement findings were remarkable, the side effects of this new medication, combined with being able to take it orally, are a game-changer,” said Page. “The most common and debilitating side effect from the drug is skin rashes.”

Stockton’s cancer was diagnosed after he experienced slight, but persistent abdominal pain in 2022. Medical scans later revealed he had a blockage in his pancreas. A biopsy later confirmed the cancer.

After chemotherapy, radiation, and surgery to remove a part of his pancreas with the tumor, followed by more chemo, the disease stayed at bay for about 7 months. In November 2024, the scans and blood tests showed the cancer had spread into his liver.

It took several months before Stockton found and was accepted into the daraxonrasib clinical trial. Now, he’s back on chemo and, like other pancreatic cancer patients, actively searching with family and doctors for the next big breakthrough medication or treatment.

Targeting KRAS

Research into KRAS-targeting treatments is expanding beyond a simple drug. Piedmont is now one of 21 sites testing the new drug in a spinoff phase 3 Revolution Medicines study. Meanwhile, Emory University’s Winship Cancer Institute is testing different KRAS inhibitors similar to daraxonrasib in combination with chemotherapy in a clinical trial sponsored by Eli Lilly and Company conducted at 52 sides nationwide.

The new generation of KRAS inhibitors have the potential to extend lives beyond the median survival of 13 months achieved by the new drug, said Alese. “We need to do better than that.”

He said daraxonasib “is in a class of its own in terms of a remarkable improvement over existing chemotherapy options and the other ones that are being studied could be even more powerful and safer to use in terms of fewer side effects.”

That’s why he finds his patient Sarah Menning’s response to a recent KRAS drug trial so encouraging. The 77-year-old Buckhead resident was diagnosed with stage 4 pancreatic cancer when she enrolled in the clinical trial last year.

Six months later, Menning still receives chemotherapy every other week and takes five KRAS-targeting pills each day. The treatment can leave her fatigued, but she said it has given her something she never expected.

“I know that with pancreatic cancer, just from what I read, that we can’t eliminate it, but this trial has given me a quality of life that I didn’t expect I would ever have,” she shared. “When you get that diagnosis, you know, it’s a shock. I just take one day at a time. As bad as it is, I think I’ve been very lucky to still be going, and a lot of people when they meet me don’t even realize I have cancer.”

For oncologists, stories like Menning’s help illustrate why the excitement surrounding KRAS-targeting drugs extends beyond a single clinical trial. Researchers believe the treatments could fundamentally change how pancreatic cancer is treated.

“This new approach to pancreatic cancer brings hope to those diagnosed with pancreatic cancer. The toolbox of treatment options is broadened like it never has been before,” Page said. “This is as big as it gets in the pancreatic cancer community in 30 years.”

Roni Robbins has been a journalist for nearly four decades. This is her second stint as a freelance reporter for the AJC. She also freelances for Medscape, where she was an editor. Her writing has appeared in WebMD, HuffPost, Forbes, the New York Daily News, BioPharma Dive, MNN, Adweek, Healthline and others. She’s also the author of the award-winning novel, “Hands of Gold: One Man’s Quest to Find the Silver Lining in Misfortune.”