Introduction: The pancreas is a gland that releases enzymes that aid in digestion and blood sugar level controls . When cells grow rapidly or in an unregulated fashion, it can cause a tumor to form. A tumor is a mass of cells that has beyond the cell division controls. A tumor could be benign and be a somewhat harmless mass or cancerous and spread metastatically (1). Pancreatic cancers account for roughly about 3% of all new cancer cases reported and about 8% of all cancer-related deaths (2). Pancreatic cancers can be of two main types: exocrine and neuroendocrine or endocrine tumors. Exocrine tumors account for almost 92% of all pancreatic cancers and are hence the more common variation of pancreatic cancer They occur in the exocrine cells which release enzymes that aid in digestion. One of the most common types of pancreatic exocrine cancer is Adenocarcinoma (3). Endocrine tumors of the Pancreas, also called PNETs (Pancreatic Neuroendocrine Tumors), occur in the islet cells. The islet cells produce endocrine hormones which regulate blood sugar levels
Symptoms of pancreatic cancers and prognosis: Some of the symptoms for pancreatic cancer include: nausea, abdominal or back pain, jaundice (yellowing of the eyes/skin), weight loss, a sudden onset of diabetes, fatigue and other symptoms such as fluid in the abdomen, blood clots or swollen pancreas in advanced cases (3, 4 and 5). Pancreatic cancers, in general have a poor prognosis. This is largely due to the location of the pancreas and difficulty in diagnosing the disease until it is at a fairly advanced stage. The current prognosis places a recovery from all pancreatic cancers in general, to a 13% chance of survival of a 5 year period from the time of diagnosis. For localized pancreatic cancers, there is a 44% chance of survival for 5 years. However, less than 20% of diagnosed pancreatic cancers are localized. About 80% of them are diagnosed when the cancer has already spread to other area sin the body, making treatment difficult and the prognosis bleak. However, when found at an early stage, there is a 15%-20% of surgical resection (removal) of a pancreatic tumor, if it has not spread to other areas and a much better chance of recovery (6).
Treatment options for pancreatic cancer:
The current treatment options for pancreatic cancer include various options.
One of the options is surgery. Surgery to treat pancreatic can involve the complete or partial removal of the pancreas. The ‘whipple’ procedure involves removal of the widest region of the pancreas in addition to a portion of the small intestine, the gall bladder, a part of the bile duck and some lymph nodes around the area. Other treatment options include, radiation therapy, chemotherapy and certain targeted drugs that affect cancer cells (7).
New treatment approved for pancreatic cancer
The US FDA approved a new drug called Rasonque (daraxonrasib ) to treat pancreatic cancer (8). The drug acts as an RAS inhibitor. The RAS protein is part of the cellular growth control mechanisms of the cell, which controls and stops cell proliferation. It is an oncogene, in that a mutation in this gene can allow for uncontrolled cell division. There can be various mutations to the RAS protein (9). The drug Rasonque, acts as an inhibitor of the RAS protein. It binds with the protein Cyclophilin A, which is overexpressed in cancer cells, thus targeting the drug to cancer cells (10). This binary complex, then binds to the active (GTP-bound) form of the RAS protein and prevents the downstream affects of RAS. This could lead to the suppression of tumor growth and induce cell death (apoptosis) (11).
Treatment outcomes
Since it is a new treatment drug, there are still unanswered questions on its efficacy. However, some of the early research on the drug showed promising results. The drug showed an almost a doubling in survival, from about 6-7 months to about 13 months in pancreatic cancer patients taking the drug. There was also an improvement in progression-free survival after the treatment (12). There have been some side effects reported with usage of the drug as well. These include, diarrhea, skin rashes, stomatitis (inflammation of the mucus membranes in the mouth), fatigue etc (13). There are also
There are some results that indicate that the drug might be more effective for patients with certain types of mutations in the Ras gene rather than others (14).
Despite that, the ovreall promise of treatment for pancreatic cancer through daraxonrasib drugs such as the Rasonque, is high and offers a hopeful promise to patients of pancreatic cancer, their families and loved ones.
References:
- 1. https://www.cancer.gov/about-cancer/understanding/what-is-cancer
- https://www.cancer.org/cancer/types/pancreatic-cancer/about/key-statistics.html
- https://pancan.org/facing-pancreatic-cancer/about-pancreatic-cancer/what-is-pancreatic-cancer/
- https://my.clevelandclinic.org/health/diseases/15806-pancreatic-cancer
- https://pancan.org/facing-pancreatic-cancer/symptoms/
- https://pancreatic.org/pancreatic-cancer/about-the-pancreas/prognosis/
- https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/diagnosis-treatment/drc-20355427
- https://www.uchealth.org/today/new-pancreatic-cancer-drug-daraxonrasib/
- https://blog.dana-farber.org/insight/2025/01/what-is-a-ras-mutation/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11552246/
- https://www.clinicaltrialsarena.com/projects/rasonque-daraxonrasib-for-the-treatment-of-metastatic-pdac-us/?cf-view
- https://hcp.rasonque.com/results/rasolute-302-efficacy
- https://www.fda.gov/news-events/press-announcements/fda-approves-first-class-targeted-therapy-metastatic-pancreatic-cancer
- https://www.fiercepharma.com/pharma/fda-rasonque-review-documents-pressure-revmed-investors-jitter-over-kras-subgroup-data