Jeff Geschwind, MD, is a physician scientist and interventional oncologist whose work has focused on liver cancer and other gastrointestinal malignancies. He currently serves as medical director of oncology, image-guided therapy, and imaging core lab at NAMSA, where he oversees imaging protocols used for clinical trial endpoints. His advisory and consulting work includes roles with HistoSonics, Philips Healthcare, Cage Pharma, and New Phase. Previously, Dr. Geschwind held faculty positions at the Johns Hopkins University School of Medicine and the Yale University School of Medicine, where he served as chairman of radiology and biomedical imaging. With experience across clinical research, imaging, interventional oncology, and cancer drug development, his background provides relevant context for evaluating emerging targeted therapies such as daraxonrasib and their potential significance for patients with pancreatic cancer.
Daraxonrasib Represents Major Breakthrough for Patients with Pancreatic Cancer
A new drug for pancreatic cancer is providing patients with hope following promising results from a clinical trial where the drug, daraxonrasib, almost doubled patient survival. Lead investigator Dr. Brian Wolpin presented his findings at the recently concluded 2026 American Society of Clinical Oncology annual meeting in Chicago to a standing ovation.
During the last couple of decades, oncologists and cancer researchers have made great strides improving treatments and patient outcomes across various cancer types. However, pancreatic cancer has proven to be especially resistant to new therapies and it remains one of the most highly lethal cancers with very poor overal 5-year survival rates. In the United States, pancreatic cancer ranks as the third leading cause of cancer death, accounting for almost 53,000 deaths each year. In most cases, the disease develops in pancreatic exocrine cells, which are critical to digestive processes. Pancreatic cancer typically causes minimal symptoms, growing imperceptibly and insidiously until it has spread widely throughout the body, at which point patients have an average survival rate of less than 12 months.
The development of daraxonrasib may change those outcomes significantly. Daraxonrasib which is still an investigational drug not yet approved by the FDA, targets RAS mutations including those affecting the KRAS gene, itself a key hallmark of pancreatic adenocarcinoma. Such RAS mutations were previously thought to be “undruggable”, yet are present in over 90% of all pancreatic ductal adenocarcinomas. Dr. Wells Messersmith, a pancreatic and gastrointestinal cancer specialist at UCHealth University of Colorado Hospital, described daraxonrasib as a “game changer” because it is the first effective targeted therapy against most cases of pancreatic cancer.
Dr. Messersmith had the opportunity to personally observe the effect of the drug on patients he treated with the experimental drug, as the University of Colorado Hospital served as one of the trial sites. During the study conducted in patients with advanced pancreatic cancer, daraxonrasib was administered orally once daily. The resulting overall patient survival at 15 months was more than twice that of the current standard of care therapy.
As is the case with most cancers, pancreatic cancer involves a cellular malfunction that results in unchecked cellular growth. In pancreatic cancer, specifically, the mutation occurs in KRAS protein cells in over 90 percent of cases. Although the KRAS mutation present in pancreatic cancers has been known for several years, developing a drug that effectively binds to the protein and blocks its harmful effects was a monumental achievement.
Dr. Wolpin’s team took an alternative approach. Instead of focusing on KRAS proteins, they took a step back and targeted the associated RAS cellular-growth pathway and introduced a chaperone protein. This new protein had a widespread effect on the pathway, which included KRAS proteins and each of the seven possible mutations that can lead to pancreatic cancer. In this way, daraxonrasib represents not just a new cancer drug, but a completely new class of cancer treatments. As more information about the drug and pre-clinical studies become available, others will build on Dr. Wolpin’s success and are likely to develop even more effective therapies with fewer side effects. “That’s part of the reason why it’s so exciting,” Messersmith explained.
The US Food and Drug Administration greenlit expanded access to daraxonrasib in May 2026. The drug is on schedule to receive full approval before the end of the year. The drug is not the only reason for optimism when it comes to effective pancreatic cancer treatments. In addition, artificial intelligence has demonstrated the ability to improve early detection and enhance pancreatic cell studies. Meanwhile, additional research suggests that doctors might soon be able to treat pancreatic cancer using immunotherapies. As a result, one can hope that such emerging treatments will be able to finally improve outcomes of patients with pancreatic cancer.
About Jeff Geschwind
Dr. Geschwind is medical director of oncology, image-guided therapy, and imaging core lab at NAMSA. He also serves as a medical advisor for HistoSonics and consults for Philips Healthcare and Cage Pharma. Previously, he was a professor at Johns Hopkins University School of Medicine and Yale University School of Medicine. His work includes nearly 300 scientific articles, multiple clinical trials, patents, and recognized contributions to interventional oncology and liver cancer research.
