Pancreatic cancer has long been one of the most difficult diseases to treat. It is typically diagnosed late, progresses rapidly, and has seen only incremental improvements in patient outcomes over the last few decades. Today, the five-year survival rate for patients with pancreatic adenocarcinoma is roughly 14% and is even lower in metastatic disease.1
Recent advances in cancer research suggest this is beginning to change. One of the key drivers of this shift is a class of cancers defined by mutations in a gene called RAS.
RAS: Why It Matters and Why It Has Been So Hard to Drug
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RAS-addicted cancers are a class of tumors in which a mutation in the RAS gene produces a protein that continuously signals the cancer to grow (i.e., like a car accelerator getting stuck). These tumors rely on this always-on signal to survive.
RAS mutations are among the most common drivers of cancer, present in approximately 90% of pancreatic cancers, ~40% of colorectal cancers, and ~30% of non-small cell lung cancers. 5, 6, 7
With 9 out of 10 pancreatic cancers driven by RAS mutations, the potential patient impact of durable RAS-targeted therapies could be substantial.
RAS proteins have a smooth surface with few binding sites—like trying to stick a piece of paper to a balloon. They also bind tightly to a natural “fuel” inside the cell (GTP) that keeps them switched on, making the signal difficult to turn off.
A Game-Changing Advance with Broad Implications
“Conservatively, we think the RAS inhibitor class should be able to do north of $10 billion in revenue per year.”
In April 2026, Revolution Medicines (market cap > $30 billion) announced that its experimental drug, daraxonrasib, doubled overall survival (OS) in pancreatic cancer patients (13.2 months vs 6.7 months)8. This unprecedented breakthrough moves beyond early signs of activity, such as tumor shrinkage or slowing disease progression, toward what matters most for patients: longer survival.
Novel combinations with the potential for even greater efficacy, such as the partnership between Revolution Medicines and Tango Therapeutics (market cap ~$3 billion), along with fast-follower RAS competitors like Erasca, reflect growing confidence that this is becoming a meaningful area of oncology development.
“Conservatively, we think the RAS inhibitor class should be able to do north of $10 billion in revenue per year,” said Rod Wong, M.D., Chief Investment Officer at RTW Investments. “Financially it’s one of the more significant opportunities in cancer.”
Revolution Medicines’ presentation of final Phase 3 survival analysis at ASCO is expected to make RAS-targeted therapies one of the most closely watched themes at this year’s meeting.
Pancreatic cancer is not just another indication—it is one of the clearest tests of whether a new therapeutic approach can work under the most challenging conditions. If a drug can improve outcomes here, it provides a strong signal that the underlying approach may be applicable more broadly across multiple tumor types.
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What Has Changed—and What Hasn’t
In 2021-2022, a class of drugs called KRAS inhibitors (Lumakras®, Krazati®) targeting a specific RAS mutation (G12C) demonstrated that direct targeting of RAS was possible. However, cancers often develop resistance, meaning they adapt and find ways to continue growing despite treatment. Even when patients initially respond, those responses may not last.
Now, the focus is shifting from targeting one RAS mutation at a time to broader approaches, including pan-RAS strategies that aim to target multiple RAS mutations at once to improve durability of response. For both investors and society, that matters because broader coverage could expand the number of patients who may benefit and may help address resistance over time. This evolution is reflected in development efforts ranging from Eli Lilly & Co. (market cap ~$700 billion) to emerging biotechnology companies such as Erasca, both of which are pursuing broader RAS-focused strategies.
The Takeaway: Pan-RAS and Durable Outcomes
A breakthrough in pancreatic cancer may signal something much larger. The next phase of RAS-addicted cancers will not be defined by whether they can be targeted, but by whether those growth signals can be durably controlled. For investors, the key will be identifying which approaches can translate early activity into sustained outcomes and long-term value.
RTW's Chris Liu discusses what this means for the broader oncology investment landscape in this podcast episode.
Statements reflect RTW's views and opinions as of the date hereof and not as of any future date. All expressions of opinion are subject to change without notice and are not intended to be a forecast of future events or results.
1 Pancreatic Cancer — Cancer Stat Facts, National Cancer Institute, Surveillance, Epidemiology and End Results Program
2 National Cancer Institute. Pancreatic Cancer — Cancer Stat Facts. Surveillance, Epidemiology, and End Results (SEER) Program.
3 National Cancer Institute. Colorectal Cancer — Cancer Stat Facts, National Cancer Institute, Surveillance, Epidemiology, and End Results (SEER) Program.
4 National Cancer Institute. Lung and Bronchus Cancer — Cancer Stat Facts, National Cancer Institute, Surveillance, Epidemiology, and End Results (SEER) Program
5 Abidoye, O., Hoyek, C., & Bekaii-Saab, T. (2025). Targeting RAS in gastrointestinal malignancies. Clinical Advances in Hematology & Oncology, 23(2), 111-122.
6 Pun, M., et al. (2024). RAS mutations in advanced colorectal cancer: Mechanisms, clinical implications, and novel therapeutic approaches. Medicina, 61(7), Article 1202.
7 Wang, X., et al. (2024). Emerging landscape of KRAS inhibitors in cancer treatment. Cancer Cell
8 Revolution Medicines. “Daraxonrasib Demonstrates Unprecedented Overall Survival Benefit in Phase 3 RASolute 302 Trial in Previously Treated Metastatic Pancreatic Cancer.” April 2026
