
A daily pill can double survival time in patients with the world’s deadliest cancer, according to the results of a clinical trial that experts are saying is a gamechanger and one of the biggest breakthroughs in decades. To find out more about how daraxonrasib works and how life-changing it could be for patients, Madeleine Finlay speaks to Prof Naureen Starling, consultant medical oncologist at the Royal Marsden hospital
Loading summary
Professor Noreen Starling
This is the Guardian.
Chase Sapphire Lounge Advertiser
The day begins at the Chase Sapphire Lounge by the club at Boston Logan Airport. You get the clam chowder in San Diego, it's Tostadas New York Espresso Martini. It's 10:00am why not? It's the quiet before your next flight. The shower that resets your day. The menu that lets you know where you are. This is access to over 1300 airport lounges and every Sapphire Lounge by the club. And one card that gets you in Chase Sapphire Reserve now even more rewarding.
Quo Business Phone System Advertiser / Andrew
Learn more@chase.com Sapphire Reserve cards issued by JP Morgan, Chase bank and a member FDIC subject to credit approval Running a business means juggling a lot of moving parts. And when your communication tools can't keep up, things start to slip. Missed calls, slow replies, scattered conversations. They're not just frustrating, they're lost opportunities and revenue left on the table. That's where Quo comes in. Spelled Q U O. Quo is the number one rated business phone system on G2, trusted by over 90,000 businesses. One shared business number for calls and texts so every conversation stays visible, organized and accountable. It works from an app or computer. You can keep your existing number, add teammates and sync your CRM, letting you scale without adding complexity. And with built in AI, Quo logs, calls, summarizes conversations and flags next steps even after hours Stop missing customers. Stop leaving revenue on the table. Try quo free and get 20% off your first six months at quo.comtech that's quasho.com tech quo no missed calls, no missed customers.
Madeline Findlay
Each May, the American Society of Clinical Oncology annual meeting is held in Chicago. Cancer researchers from around the world gather together to share the latest advances. And 2026 was a bit of a blockbuster year. One study pointed the finger at poor sleep in fuelling the global rise in cancer diagnoses in the under 50s. Another shared a groundbreaking genomic test that could spare millions of breast cancer patients Chemotherapy. Then there was a cancer jab that eradicated entire tumors. But there was one presentation with results so striking that the audience got to their feet and cheered. A clinical trial of a daily pill for the world's deadliest cancer found it doubled survival times. To date, pancreatic cancer has proved extremely hard to treat. But this drug could herald a new era for patients. So today, a game changing moment for pancreatic cancer. From the Guardian I'm Madeline Findlay and this is Science Weekly. Professor Noreen Starling. You're a consultant medical oncologist and director of the Royal Marsden Clinical Trials Unit and one of Your specialisms is pancreatic cancer. So what kind of treatment options are available right now for pancreatic cancer? And how effective effective are they?
Professor Noreen Starling
So, currently, the majority of patients we see in the UK and worldwide with pancreatic cancer present with advanced pancreas, cancer that has already spread, where surgery doesn't really have a role. Maybe we see 1 in 10 or slightly more patients who present with operable pancreatic cancer. So for the majority of patients with advanced disease today, and for really the last couple of decades, chemotherapy drug treatment has been the mainstay of our treatment approach. But these aren't curative treatments. They help us to help patients live longer and better with pancreatic cancer. But this is one of the most challenging cancers to treat. The average survival for patients with advanced pancreatic cancer is about a year, sometimes more, sometimes less.
Madeline Findlay
And why is pancreatic cancer so hard to treat?
Professor Noreen Starling
It presents often late at an advanced stage. And even for the patients who have operable disease, at a microscopic level, the cancer's already managed to break off, which is why we see so much relapse, even after surgery and chemotherapy.
Madeline Findlay
But there's another factor that makes pancreatic cancer so difficult to treat, and it's to do with mutations in a gene called Krasnohe.
Professor Noreen Starling
So 90% of patients with pancreatic cancer, so 9 out of 10 patients have a mutation in Kras, and this mutation really is the dominant driver of pancreatic cancer. This gene that drives the cancer to grow and develop has been considered undruggable.
Madeline Findlay
The KRAS gene is part of the RAS family of genes. These provide the instructions to make RAS proteins, which act as on and off switches for cell growth and division. Genetic mutations can mean RAS proteins get stuck in the on mode, leading to overactive cell growth and division, and ultimately cancer. Scientists spent decades trying to develop drugs to switch off RAS proteins. But there's something about them that makes them difficult to target.
Professor Noreen Starling
The RAS protein is tricky because the protein is pretty smooth. Now, you might think, why does that make it challenging to drug? Well, good drug targets often have these deep pockets that you can design a drug to fit and nestle into that pocket and by doing so, switch off the protein and switch off that signal. But these pockets are pretty shallow and smooth.
Madeline Findlay
Scientists had to look for other, more circuitous ways to get around these shallow, smooth pockets and bind their drugs to RAS proteins. But after decades of work, they did it and proved KRAS and the rest of the RAS proteins could be switched off. And last week, the next Big breakthrough was announced at the annual meeting of the American Society of Clinical Oncology in Chicago.
Professor Noreen Starling
Honestly, it was a spine tingling moment. I was in the room, thousands of listeners in the room as the data were presented. What we saw was a major breakthrough for the treatment of pancreatic cancer. And the results were so stunning that the presenter received a standing ovation as he was presenting the data, not even at the end of the presentation.
Madeline Findlay
This excitement was sparked by the results from a phase three randomised control trial of a drug called Daraxan Rasib, a tablet the patients take once a day.
Professor Noreen Starling
So half of the patients received another chemotherapy and half of the patients received the oral tablet therapy. And the results were just jaw dropping. So in this group of patients, survival was doubled, going for an average of about six months to over 13 months. We saw tumors shrink in the patients who had the Duraxon Rasib tablets. A good shrinkage of over 30% of patients compared to about 10% of patients with chemotherapy. And really importantly for patients, not only were they living longer, but they felt better. There was a reduction in pain and improvement in symptoms for a good amount of time.
Madeline Findlay
So this drug has had incredible results. But Noreen, how exactly does it work?
Professor Noreen Starling
The way it works is very clever and it's quite different to sort of the traditional drug inhibitor. So a drug interacts with the protein that you want and shuts it down. It does it in a more sneaky way. So it binds to a chaperone protein called cyclophenol A and forms a bond with that. And then that doublet, if you like, blocks the activated state of ras. It's forming a kind of molecular glue to shut ras down and stop it, providing the signal for the cancer cell to grow.
Madeline Findlay
So this drug uses another protein to form a molecular glue that grabs and shuts down Kras and and the other members of the Ras family. It's exciting science. And this clinical trial is just the beginning of exploring how it could be used to help patients.
Professor Noreen Starling
There are so many more important questions now for our patients with pancreatic cancer. So the trial is very specifically for the group of patients who have had chemotherapy previously and it has stopped working. One of the next important questions is, okay, what about the patients who've just been diagnosed with advanced stage 4 pancreatic cancer? Does Daraxon Rasib, this oral therapy, work for those patients? Does it improve survival and symptoms and how patients feel as the first line of treatment? But then going back to how do we actually prevent pancreatic cancer becoming advanced? What about those patients with operable pancreatic cancer. But it doesn't stop there. There are many other questions about what are the other combinations of this sort of drug, Duraxon, racib, but indeed other drugs that are also rapidly through clinical trials. For me, this is really the key that unlocks the transformative treatment potential for pancreatic cancer. So it's going to be a really busy clinical trials landscape. That is wonderful. We've been looking for that in pancreatic cancer for such a long time. I think it's a triumph for science and it's a triumph for patients.
Madeline Findlay
The fact that in this trial, patients saw a doubling of survival time, which is just, it's so huge when you're faced with having to think about how long you might have left. Others in similar situations, hearing about Diracs and Rasid now will no doubt be asking themselves, well, when am I going to be able to get hold of this? So in your mind, I know this is a little bit like asking how long is a piece of string, but when do you think this could become available to patients?
Professor Noreen Starling
There's two answers to that. One is the length of time it takes in terms of the regulator to review the data in order to allow the drug to be available. And within every jurisdiction, there will also need to be reimbursement considerations. And for the uk, that will be a nice appraisal which looks at benefit and resource and cost. That timeline can vary. You know, I would hope that we can see progress within this next year, or certainly with within the next couple of years. But it's such an important breakthrough. I would hope the system can move quickly. In regard to this.
Madeline Findlay
Coming up, could the approach behind this drug work for other cancers?
Max Rushton
33 days, 33 episodes, no off. Switch from the goals and the glory to the politics and the problems of the World Cup. If you want football analysis from a podcast that's been overanalyzing the game for more than 20 years, this is it. Join me, Max Rushton, and our expert team of football journalists every day of the tournament. Can England end 60 years of hurt? Probably not. Or will this be another year of falling just short? Probably. World Cup Daily Listen wherever you get your podcasts or watch the full episodes on YouTube.
Quo Business Phone System Advertiser / Andrew
Running a business means juggling a lot of moving parts. And when your communication tools can't keep up, things start to slip. Missed calls, slow replies, scattered conversations. They're not just frustrating, they're lost opportunities and revenue left on the table. That's where quo comes in. Spelled Q U O quo is the 1 rated business phone system on G2 trusted by over 90,000 businesses. One shared business number for calls and texts, so every conversation stays visible, organized and accountable. It works from an app or computer. You can keep your existing number, add teammates and sync your CRM, letting you scale without adding complexity. And with built in AI, Quo logs calls, summarizes conversations and flags next steps. Even after hours, stop missing customers. Stop leaving revenue on the table. Try Quo free and get 20% off your first six months@quo.com tech. That's quo.com tech quo. No missed calls, no missed customers.
Madeline Findlay
Noreen do mutations in RAS genes cause other kinds of cancer? And so could this drug or the principle behind it at least be developed for other cancers?
Professor Noreen Starling
Absolutely. So the two main other cancers where we can see RAS mutations include non small cell lung cancer and colorectal cancer. In fact, RAS mutations might be present in about 50 to 60% of tumours of patients with colorectal cancer. So there's definitely efforts and trial coming focused on both of these diseases. There may be additional challenges. RAAS is not the same in every disease, so it's very dominant and inhibition is powerful in pancreas cancer. Colorectal cancer could be a bit more challenging because the circuitry is somewhat difficult. What we sometimes see with these targeted drugs is it's a bit like whack a mole. You press one thing down and another thing pops up in terms of resistance. And that's again a challenge to the scientists in the field for how we manage that. So, again, very evolving field.
Madeline Findlay
So lots still to do. But after decades of research on this, it feels like a really exciting time, not just in the field of pancreatic cancer research, but cancer research generally. Do you see this as almost marking a moment where real progress is being made on finding new kinds of effective therapies?
Professor Noreen Starling
It's really exciting. And I wanted to see this in my career time, you know, when I started as a consultant 12 years ago. And I thought about what the challenges were and what I would love to see in terms of transformation, much like we saw in terms of melanoma and immunotherapy transformation. And I think this is it. Melanoma was a devastating condition when patients presented with stage four disease. You know, when I was in training, patients would survive less than a year. And now we're curing well over half of the patients with immunotherapy. It does mark a real shift in time. It's historic that the undruggable became druggable. So if RAS can be unlocked and druggable. I think that shifts our thinking. Is no target undruggable? Can we target every possible molecule that is important and a driver for cancers and across all cancers? So honestly, I think it's one of the most exciting times to be in clinical trials and cancer research and I think it gives me a lot and I'm hoping it gives our patients and their families a lot of hope.
Madeline Findlay
Well, Noori, we'll be looking forward to seeing the results from all these clinical trials coming down the road. Thank you so much.
Professor Noreen Starling
Thank you for having me.
Madeline Findlay
And that's all from us today. You can read more about the latest advances in cancer research from health editor Andrew gregory@theguardian.com and before you go. As the World cup kicks off, the Guardian's award winning football weekly podcast is turning into World Cup Daily. Join Max Rushton, Barry Glendenning and the team as they discuss every big match and every big moment every day of the World Cup. Listen now, wherever you get this podcast or watch on YouTube. This episode was produced by Elliot Sands. The sound design was by Ross Burns and the executive producer was Ellie Burey. We'll be back on Tuesday. See you then. This is the Guardian.
Professor Noreen Starling
Hannah, I just Venmoed you for dinner.
Venmo Advertiser
Obsessed. I'm spending it right now in the lip gloss that's been sitting in my cart.
Professor Noreen Starling
What do you mean spending it right now?
Venmo Advertiser
You can instantly spend your balance with the Venmo debit card or when you pay with Venmo at checkout.
Professor Noreen Starling
Stop. Say more.
Venmo Advertiser
More. Exactly. The more you do with Venmo, the more you get, like earning up to 5% cash back with Venmo stash. Get the Venmo debit card or checkout online. Venmo stash bundle Terms and Exclusions apply. Max $100 per month. See terms at Venmo Me Stash terms. Venmo checkout not available at all merchants. The Venmo MasterCard is issued by the Bancorp Bank N.A.
Chase Sapphire Lounge Advertiser
the day begins at the Chase Sapphire lounge by the club. At Boston Logan Airport, you get the clam chowder. In San Diego, it's Tostadas New York. Espresso martini. It's 10am why not? It's the quiet before your next flight. The shower that resets your day, the menu that lets you know where you are. This is access to over 1300 airport lounges and every Sapphire lounge by the club. And one card that gets you in Chase Sapphire Reserve. Now even more reward.
Quo Business Phone System Advertiser / Andrew
Learn more@chase.com Sapphire Reserve cards issued by JP Morgan Chase bank and a member FDIC, subject to credit approval. Many business leaders see AI's tremendous potential for the companies, but they're still struggling to turn their potential into measurable results and competitive advantage. I'm Andrew.
Madeline Findlay
And I'm Sarah Elk. And on our new podcast, Winning with
Quo Business Phone System Advertiser / Andrew
AI, we're talking to CEOs who are using AI to drive business transformation, delivering real wins and changing how their companies run. We'll hear how leaders empower and mobilize their people and make the use of AI part of how the whole organization thinks. Winning with AI.
Episode: ‘The undruggable became druggable’: a breakthrough cancer treatment
Date: June 11, 2026
Host: Madeline Findlay
Guest: Professor Noreen Starling, Consultant Medical Oncologist and Director of the Royal Marsden Clinical Trials Unit
This episode delves into a landmark breakthrough in the treatment of pancreatic cancer: the development of the drug Daraxon Rasib, an oral medication that has, for the first time, shown the ability to double survival in advanced pancreatic cancer. Host Madeline Findlay and guest Professor Noreen Starling discuss why pancreatic cancer has resisted progress for so long, what makes the new treatment so revolutionary, and its potential implications for cancer treatment as a whole.
“The majority of patients… present with advanced pancreatic cancer that has already spread, where surgery doesn't really have a role.” – Prof. Noreen Starling (03:51)
“This gene that drives the cancer to grow and develop has been considered undruggable.” – Prof. Noreen Starling (05:14)
“The protein is pretty smooth… good drug targets often have these deep pockets… but these pockets are pretty shallow and smooth.” – Prof. Noreen Starling (06:07)
"It was a spine tingling moment… the results were so stunning that the presenter received a standing ovation as he was presenting the data…” – Prof. Noreen Starling (07:08)
“The results were just jaw dropping… survival was doubled… Tumors shrink… and, really importantly… not only were they living longer, but they felt better.” – Prof. Noreen Starling (07:42)
“It binds to a chaperone protein… and then that doublet… blocks the activated state of RAS. It's forming a kind of molecular glue to shut RAS down…” – Prof. Noreen Starling (08:34)
Work Ahead in Pancreatic Cancer:
“For me, this is really the key that unlocks the transformative treatment potential… we’ve been looking for that in pancreatic cancer for such a long time. I think it's a triumph for science and it's a triumph for patients.” – Prof. Noreen Starling (09:30)
Regulatory Pathway & Patient Access:
“…I would hope that we can see progress within this next year, or certainly within the next couple of years. But it’s such an important breakthrough, I would hope the system can move quickly.” – Prof. Noreen Starling (11:16)
“RAS is not the same in every disease… what we sometimes see with these targeted drugs is it's a bit like whack a mole. You press one thing down and another thing pops up in terms of resistance.” – Prof. Noreen Starling (14:12)
“It’s historic—that the undruggable became druggable… If RAS can be unlocked and druggable, I think that shifts our thinking. Is no target undruggable?... I think it gives our patients and their families a lot of hope.” – Prof. Noreen Starling (15:34)
On patient impact:
“The fact that in this trial, patients saw a doubling of survival time, which is just, it's so huge when you’re faced with having to think about how long you might have left.” — Madeline Findlay (10:45)
On the atmosphere at ASCO:
“It was a spine-tingling moment… standing ovation as he was presenting the data…” — Prof. Noreen Starling (07:08)
On the future of cancer research:
“Honestly, I think it’s one of the most exciting times to be in clinical trials and cancer research, and I think it gives me a lot and I’m hoping it gives our patients and their families a lot of hope.” – Prof. Noreen Starling (15:34)
This episode of Science Weekly captures a momentous development—the first compelling evidence that a once “undruggable” cancer driver can be successfully targeted, marking the start of a potentially transformative era in cancer therapy. While challenges remain and full clinical rollout will take some time, the results for Daraxon Rasib offer genuine hope not only to pancreatic cancer patients but to the wider cancer research community.
As Professor Starling sums up:
“If RAS can be unlocked and druggable, I think that shifts our thinking. Is no target undruggable?” (15:34)