For many years, doctors have struggled because pancreatic cancer usually causes few symptoms in its early stages.
By the time many people learn they have the disease, it has already spread to other parts of the body.
When this happens, surgery is often no longer possible, and chemotherapy becomes the main treatment.
Unfortunately, chemotherapy alone often cannot keep the disease under control for long, and the five-year survival rate for metastatic pancreatic cancer remains only about 3%.
Scientists have spent decades searching for better treatments.
One of the biggest discoveries was that around 90% of pancreatic cancers contain changes in a gene called KRAS. About 40% carry the KRAS G12D mutation, the most common form.
This mutation acts like a broken switch that keeps telling cancer cells to grow. For years researchers believed this mutation could not be targeted with medicines, leading many experts to call it “undruggable.”
That idea is beginning to change. Researchers from Dana-Farber Cancer Institute recently reported encouraging early results from a phase I/II clinical trial presented at the ESMO Gastrointestinal Cancers Congress 2026.
The study tested an experimental targeted medicine called zoldonrasib together with standard chemotherapy in people whose metastatic pancreatic cancer carried the KRAS G12D mutation.
Unlike chemotherapy, which attacks many fast-growing cells throughout the body, zoldonrasib is designed to block the faulty KRAS G12D protein directly. Researchers hoped that attacking the cancer in two different ways would produce better results.
The trial enrolled 81 patients at several cancer centres across the United States. Forty-one received zoldonrasib with modified FOLFIRINOX, while forty received the drug with gemcitabine and nab-paclitaxel.
Among patients who had enough follow-up, tumour shrinkage was seen in 82% of those receiving modified FOLFIRINOX and 61% of those receiving gemcitabine and nab-paclitaxel. Disease control reached 96% and 90% respectively.
Researchers also measured circulating tumour DNA, tiny pieces of cancer DNA found in blood. Every patient who could be evaluated showed at least a 50% drop in KRAS G12D tumour DNA. Nearly half of one treatment group and over seventy percent of the other group had no detectable mutant tumour DNA remaining in their blood.
The treatment did cause side effects such as nausea, diarrhoea, fatigue and low white blood cell counts. However, these were generally similar to those already expected from chemotherapy, and no new safety concerns or treatment-related deaths were reported.
Experts who were not involved in the study described these findings as an important milestone because they show that directly targeting KRAS G12D may finally be possible. The encouraging results have already led to the launch of a much larger international phase III study called RASolute 305, which will compare zoldonrasib plus chemotherapy against chemotherapy alone.
Although these findings are exciting, they should be viewed carefully. This was an early-stage study involving a relatively small number of patients, and it was not designed to prove that the new treatment helps people live longer.
Larger trials must confirm whether the impressive tumour responses translate into longer survival and better quality of life. Even so, this research represents one of the most hopeful developments in pancreatic cancer treatment in many years and may open the door to more personalised therapies based on a patient’s genetic mutation.
The research was presented at the ESMO Gastrointestinal Cancers Congress 2026.
The study provides strong early evidence that combining a KRAS G12D-targeted drug with chemotherapy may greatly improve tumour control without creating unexpected safety problems.
However, response rates are not the same as cure rates, and longer follow-up is needed to know whether patients live significantly longer. If the ongoing phase III trial confirms these results, this treatment could become a major advance for a cancer that has seen very few breakthroughs over the past several decades.
If you care about cancer, please read studies that artificial sweeteners are linked to higher cancer risk, and how drinking milk affects risks of heart disease and cancer.
For more health information, please see recent studies about the best time to take vitamins to prevent heart disease, and results showing vitamin D supplements strongly reduces cancer death.
