Patients, Nurses Share What Daraxonrasib Means in Practice

Within 24 hours of his first dose of daraxonrasib (Rasonque), the pain and limp caused by Brad Dugai's recurrent pancreatic cancer were gone. In a new Oncology Nursing News video, Dugai, a caregiver, and clinicians describe what the first approved RAS-targeted therapy for metastatic pancreatic adenocarcinoma means for patients, and why proactive nursing care is central to keeping them on treatment.

What did the pivotal trial show?

The FDA approved daraxonrasib on August 26, 2026, for adults with metastatic pancreatic adenocarcinoma who have received at least one prior systemic therapy or who are not candidates for multiagent systemic therapy.^1,2 In the phase 3 RASolute 302 trial (NCT06625320) of 500 adults, median overall survival was 13.2 months with daraxonrasib vs 6.7 months with chemotherapy, and median progression-free survival was 7.2 vs 3.6 months.³

"It didn't cure people yet, right? So it prolonged survival, it helps improve quality of life, but it did not yet result in cures," said Paul E. Oberstein, MD, assistant director of the Pancreatic Cancer Center at NYU Langone Perlmutter Cancer Center.

How are nurses managing adverse effects at home?

Skin toxicity affected 86% of patients in clinical trials, diarrhea 63%, and stomatitis 57%.² "Prophylaxis should be prescribed and reviewed with the patient before they even take that first dose," said Yolanda Justal, APRN, of the University of Miami Sylvester Comprehensive Cancer Center. Adrienne Kolk, MSN, FNP-C, AOCNP, a nurse practitioner in the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute, described starting minocycline or doxycycline along with topical steroids. Dugai, who experienced a severe rash, shares before-and-after photos in the video. Additional protocols appear in ONN's nursing guide to daraxonrasib.⁴

Dose holds and reductions, from 300 mg to 200 mg to 150 mg daily, are planned strategies; 2.9% of patients stopped permanently because of adverse reactions.² "It's safer to hold the treatment than to force the patient or have the patient feel like they have to push through, because pushing through can lead to ultimately hospitalizations or permanent discontinuations," Justal said.

What should teams know about cost and trials?

With a market price of roughly $40,000 a month, financial navigation should begin when the decision to prescribe is made. Caregiver Marnie Reed said a specialty pharmacy, her husband's insurer, and the manufacturer's assistance program brought their cost to $0.

Christopher Graham, RN, BSN, OCN, a clinical research nurse at Dana-Farber, noted that now that daraxonrasib is approved, prior treatment with it "may exclude patients from enrolling in more next generation or future KRAS-directed therapies."

What are the key takeaways for oncology nurses?

• Start skin prophylaxis before the first dose.²
• Have loperamide on hand; median onset of diarrhea was 3 days.²
• Frame dose holds and reductions as planned strategies.
• Begin financial navigation early, and document prior RAS-directed therapy for future trial screening.

References

1. ONN Staff. FDA approves daraxonrasib for metastatic pancreatic adenocarcinoma. Oncology Nursing News. August 26, 2026. Accessed October 29, 2026. https://www.oncnursingnews.com/view/fda-approves-daraxonrasib-for-metastatic-pancreatic-adenocarcinoma

2. Rasonque. Prescribing information. Revolution Medicines Inc; 2026. Accessed October 29, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/220910Orig1s000lbl.pdf

3. O'Reilly EM, Wainberg ZA, Hendifar AE, et al; RASolute 302 Trial Investigators. Daraxonrasib or chemotherapy in previously treated metastatic pancreatic cancer. N Engl J Med. Published online May 31, 2026. doi:10.1056/NEJMoa2605555

4. Biese A. Daraxonrasib approved: what oncology nurses must know about Rasonque. Oncology Nursing News. August 27, 2026. Accessed October 29, 2026. https://www.oncnursingnews.com/view/daraxonrasib-approved-what-oncology-nurses-must-know-about-rasonque