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FDA Approval of Daraxonrasib Marks Turning Point in Pancreatic Cancer Care

Sylvester Comprehensive Cancer Center researchers report an FDA approval for a pancreatic cancer pill that nearly doubled survival, alongside new findings on alcohol-related cancer deaths, ctDNA blood testing, AI-driven discovery and CAR T-cell resistance.

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For decades, a diagnosis of metastatic pancreatic cancer has been among the most devastating pronouncements in medicine. The disease is typically detected late, spreads early, and shrugs off most conventional therapies, leaving patients with few meaningful options and painfully little time.

That trajectory has now changed. The United States Food and Drug Administration has approved daraxonrasib, a targeted therapy pill tested in a global clinical trial in which the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine served as the only participating site in South Florida.

According to the trial results that underpinned the approval, patients who received daraxonrasib lived nearly twice as long as patients treated with standard chemotherapy, an outcome that researchers in the field describe as a genuine inflection point for one of oncology’s most stubborn challenges.

Peter Hosein, M.D., co-leader of Sylvester’s Gastrointestinal Cancer Site Disease Group, called the approval a monumental shift in the treatment of pancreas cancer. The significance lies not only in the survival benefit itself but in what it signals about the future of the disease: pancreatic cancer, long treated as a monolith to be attacked with blunt cytotoxic chemotherapy, is increasingly being understood at the molecular level, allowing drugs designed for specific biological vulnerabilities to be matched with the patients whose tumors carry them.

Targeted therapies of this kind have transformed outcomes in lung cancer, breast cancer and leukemia, and daraxonrasib’s success suggests that pancreatic oncology is finally entering that same era of precision medicine. Even as treatment advances, earlier detection remains the field’s most urgent unmet need, and a new grant from the Pancreatic Cancer Action Network aims to address it.

The organization has awarded Sylvester researchers 225,000 dollars over two years to help establish a blood test for pancreatic cancer based on circulating tumor DNA, or ctDNA. For patients with lung cancer, colon cancer and certain other solid tumors, liquid biopsies that detect fragments of tumor DNA shed into the bloodstream have become routine tools, helping oncologists identify molecular weaknesses in a tumor without invasive procedures and adjust treatment as the disease evolves.

Pancreatic cancer patients have not enjoyed that advantage; invasive tissue biopsies remain the standard, and the tumors’ biology has made reliable ctDNA detection difficult. The PanCAN-funded project seeks to change that by establishing ctDNA analysis as a dependable way to measure the molecular makeup of metastatic pancreatic cancer, one of the deadliest malignancies known.

If successful, the approach could allow clinicians to track tumor evolution in near real time through simple blood draws, matching patients to targeted agents as new mutations emerge and monitoring treatment response without repeated surgical intervention. The work complements the daraxonrasib story in an important way: targeted therapies are only as useful as the molecular diagnostics that identify eligible patients, and liquid biopsies could dramatically widen the funnel of patients who benefit from drugs like the newly approved pill.

Shifting from treatment to prevention, Sylvester investigators have published sobering new data on alcohol’s role in cancer mortality. A study by the center’s researchers, first presented at the annual meeting of the American Society of Clinical Oncology and now published in The Lancet Regional Health – Americas, found that alcohol-attributable cancer deaths in the United States doubled between 1990 and 2023.

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