Living With Pancreatic Cancer: 5 Things to Know About KRAS

A Message from Dr. Borazanci

“The emergence of treatments targeting KRAS, which is the driving force of growth for most pancreatic cancers, is going to allow oncologists to provide more targeted therapies for individuals with pancreatic cancer. Additionally, combination therapies building upon the success of trials targeting KRASare now being offered.”

  1. KRAS is very common in pancreatic cancer

    About 9 out of 10 people diagnosed with pancreatic cancer have a change (mutation) in a gene called KRAS. While KRAS mutations can also occur in other cancers—such as lung or colorectal cancer—they are most common in pancreatic cancer. Because it is so common, KRAS plays an important role in understanding and treating this disease.

  2. KRAS is a main driver of pancreatic cancer

    Think of KRAS as a light switch inside your cells that tells them when to grow. In healthy cells, this switch turns on and off as needed. In pancreatic cancer, the KRAS switch can become stuck in the “on” position, causing cells to grow and divide uncontrollably. This makes KRAS important not only in starting the cancer, but also in keeping it growing.

  3. KRAS was once thought to be “undruggable”

    For many years—starting in the 1980s—scientists believed KRAS could not be targeted with medication. After many failed attempts, KRAS earned the label “undruggable.” That changed in 2013, when researchers successfully developed a drug that targets a specific KRAS mutation (KRAS G12C) in lung cancer. This breakthrough opened the door to new treatments for KRASdriven cancers, including pancreatic cancer.

  4. New KRAS-targeted treatments are showing promise

    Recent Phase 3 results from the RASolute 302 trial studied daraxonrasib, a targeted treatment that blocks active KRAS signaling. In patients with previously treated metastatic pancreatic cancer, daraxonrasib significantly improved outcomes. Patients who received daraxonrasib lived a median of 13.2 months, compared with 6.7 months for those receiving standard chemotherapy—almost doubling survival time. These results represent meaningful progress and new hope for patients.

  5. Genetic testing matters—because you can’t treat what you don’t test

    Everyone diagnosed with pancreatic cancer should discuss genetic testing with their care team. This typically includes:

    • Germline testing (inherited genes), and
    • Tumor testing (genetic changes in the cancer itself)
  • KRAS mutations are found through tumor sequencing, which may use a tissue biopsy or a blood test. Identifying these genetic changes can help guide treatment decisions and open the door to targeted therapies or clinical trials.

Sources:

  • Khan et al. Cancer Biology & Medicine Jul 2025, 22 (7) 762-788
  • Revolution Medicine
  • Singhal et al. Nature Medicine 2024; Jiang et al Cancer Discovery 2024:14:1-24