The FDA approved daraxonrasib (Rasonque) for pancreatic cancer on Wednesday, marking a breakthrough after decades of failed attempts to target the KRAS protein. Researchers view this as the first of many therapies targeting this elusive mutation. Large pharmaceutical companies including Eli Lilly, Pfizer, Amgen, and AstraZeneca are racing to develop similar medicines.

Daraxonrasib, developed by Revolution Medicines and taken as two daily pills, attacks mutated KRAS proteins found in pancreatic, lung, and colon cancers. Unlike earlier KRAS drugs from Amgen and Bristol Myers Squibb, which targeted only one mutant form, daraxonrasib can work on multiple mutations and block KRAS while it actively drives cancer growth. However, experts caution that tumors will eventually evolve to evade treatment. Dr. David S.

Hong of MD Anderson compared the approval to the advent of immunotherapy 15 years ago. Revolution Medicines, a small company near San Francisco, is widely seen as the field leader. The company has collaborations with Bristol Myers Squibb, Tango Therapeutics, and Summit Therapeutics to study drug combinations.

Studies are already underway testing KRAS-targeting drugs alongside other therapies to launch a multipronged attack. Researchers widely agree that the emerging class of drugs "will need combinations to advance their clinical response and durability," according to KRAS scientist Channing Der.