PFS / OS: mPFS 9.6 mo (2L) vs 7.6 mo (3L+); 2L mOS not yet estimable (89% 6-mo OS), 3L+ mOS 10.5 mo (82% 6-mo OS).
Biomarker: RAS G12D mutation (most common KRAS alteration in PDAC, ~40% of cases).
Regulatory: Investigational; not FDA-approved. Daraxonrasib holds FDA Breakthrough Therapy + Orphan Drug Designation for previously treated PDAC with G12 mutations.
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[Slide 1 - Study design]
RMC-9805-001 Phase 1 Study (NCT06040541): Zoldonrasib + Daraxonrasib.
Key Eligibility Criteria: Advanced solid tumors with KRAS G12D mutations; received prior standard therapy appropriate for tumor type and stage; ECOG PS 0-1; no active brain metastases; no prior treatment with a RAS-targeted therapy.
Key Endpoints: Safety and tolerability; Pharmacokinetics; Antitumor activity.
Part 1: Dose Escalation - zoldonrasib and daraxonrasib co-administered orally QD, 21-day treatment cycle. Dose levels tested: Zoldonrasib 600mg/Daraxonrasib 100mg; 900mg/100mg; 1200mg/100mg; 1200mg/200mg; 1200mg/300mg. No DLTs observed at any dose level. No clinically meaningful exposure changes compared with monotherapy. Zoldonrasib 1200mg QD + daraxonrasib 300mg QD was the maximum administered dose and selected as the RP2D in PDAC. PDAC expansion cohorts enrolled at RP2D.
Part 2: Dose Expansion and Dose Optimization.
[Slide 2 - ORR/DCR waterfall]
ORR and DCR of Zoldonrasib + Daraxonrasib in 2L and 3L+ KRAS G12D PDAC (Zoldonrasib 1200mg QD + Daraxonrasib 300mg QD):
2L PDAC (N=30): ORR 50% (95% CI 31-69), DCR 97% (95% CI 83-100).
3L+ PDAC (N=30): ORR 47% (95% CI 23-66), DCR 90% (95% CI 74-98).
Waterfall plot shows best % change from baseline in target tumor burden per patient, both cohorts, with confirmed and unconfirmed (*) responses and ongoing-treatment markers.
KPCY (KrasG12D; Trp53R172H - PDAC) mouse model - Durable antitumor responses.
% Tumors Progression-Free vs Days on Treatment: Control (n=27, median 6 days); Zoldonrasib (n=27, median 28 days); Daraxonrasib (n=26, median 32 days); Combination (n=27, median not reached).
Statistical comparisons marked **** (combination vs control, and vs each monotherapy) and * (zoldonrasib vs daraxonrasib monotherapy).
Preclinical rationale slide, not human clinical trial data - included for mechanistic context on the combination's synergy.
Phase I trial (NCT06040541) evaluating zoldonrasib 1200 mg once daily plus daraxonrasib 300 mg once daily, the recommended Phase II dose, in advanced solid tumors with RAS G12D mutations. This analysis focuses on the RAS G12D metastatic PDAC cohort. Abstract 341O, presented by Nilofer Azad, MD (Johns Hopkins Sidney Kimmel Comprehensive Cancer Center), ESMO GI 2026, July 2, 2026.
Population
60 patients with RAS G12D metastatic pancreatic ductal adenocarcinoma (PDAC) who had received one or more prior lines of therapy - 30 in the second-line (2L) cohort and 30 in the third-line-or-later (3L+) cohort. Median follow-up was 12.0 months (2L) and 12.6 months (3L+).
Interventions
Zoldonrasib (RMC-9805), an oral RAS(ON) G12D-selective covalent tri-complex inhibitor, combined with daraxonrasib (RMC-6236), an oral RAS(ON) multi-selective non-covalent tri-complex inhibitor - a chemotherapy-free doublet designed to deepen RAS pathway inhibition and delay resistance.
The zoldonrasib plus daraxonrasib combination demonstrated antitumor activity in both cohorts. In the 2L cohort (n=30): ORR 50% (95% CI 31-69%), DCR 97% (95% CI 83-100%). In the 3L+ cohort (n=30): ORR 47% (95% CI 28-66%), DCR 90% (95% CI 74-98%). This is an early-phase, single-arm study; results should be interpreted cautiously until confirmed in larger randomized trials.
Median PFS was 9.6 months (95% CI 7.1-NE) in the 2L cohort, with a 6-month PFS rate of 71%, and 7.6 months (95% CI 4.6-10.5) in the 3L+ cohort, with a 6-month PFS rate of 59%. Median OS was not yet estimable in the 2L cohort (6-month OS rate 89%); in the 3L+ cohort, median OS was 10.5 months (95% CI 6.7-NE; 6-month OS rate 82%).
mPFS 9.6 mo (2L) vs 7.6 mo (3L+)
Safety
Any-grade treatment-related adverse events (TRAEs) occurred in 97% of patients (58/60); Grade 3 or higher TRAEs occurred in 35%. Most common any-grade TRAEs: rash (90%), diarrhea (63%), nausea (57%), stomatitis/mucositis (53%), fatigue (28%), vomiting (28%), anemia (20%). Most common Grade 3+ events: rash (12%), anemia (10%), stomatitis/mucositis (7%). No Grade 4 TRAEs were reported; one Grade 5 TRAE (intestinal perforation) occurred. Discontinuation due to TRAEs was low: 2% (n=1) for zoldonrasib, 5% (n=3) for daraxonrasib. Mean dose intensity was 88% (zoldonrasib) and 76% (daraxonrasib). The safety profile was broadly consistent with established daraxonrasib monotherapy safety.
INVESTIGATIONALNo approved targeted therapy for RAS G12D PDAC
Both zoldonrasib and daraxonrasib are investigational agents. No targeted therapy is currently FDA-approved for patients with RAS G12D-mutant cancers. Daraxonrasib holds FDA Breakthrough Therapy Designation and Orphan Drug Designation for previously treated metastatic PDAC harboring G12 mutations, and was selected for the FDA Commissioner's National Priority Voucher pilot program to accelerate development and review. These designations do not constitute approval.
RMC-9805-001 is a chemotherapy-free proof-of-concept study supporting the planned Phase III RASolute 309 trial (zoldonrasib + daraxonrasib vs. gemcitabine/nab-paclitaxel, untreated RAS G12D PDAC). It is separate from the already-published Phase III RASolute 302 (daraxonrasib monotherapy/combo vs. chemotherapy, 2L PDAC, NEJM May 2026) and the ongoing Phase III RASolute 305 (zoldonrasib + chemotherapy, 1L PDAC).
No. RMC-9805-001 is an early-phase (Phase I) investigational trial. No targeted therapy is currently FDA-approved for RAS G12D-mutant pancreatic cancer. Daraxonrasib holds FDA Breakthrough Therapy and Orphan Drug Designations for previously treated metastatic PDAC with G12 mutations, and was selected for the FDA Commissioner's National Priority Voucher pilot program, but neither drug is approved.
What did RMC-9805-001 show in second-line (2L) pancreatic cancer?
In the 2L cohort (n=30), zoldonrasib plus daraxonrasib produced an objective response rate (ORR) of 50% (95% CI 31-69%), disease control rate (DCR) of 97% (95% CI 83-100%), and median progression-free survival (mPFS) of 9.6 months (95% CI 7.1-NE), with a 6-month PFS rate of 71% (ESMO GI 2026, Abstract 341O; data cutoff Feb 9, 2026).
What did RMC-9805-001 show in third-line-plus (3L+) pancreatic cancer?
In the 3L+ cohort (n=30), ORR was 47% (95% CI 28-66%), DCR was 90% (95% CI 74-98%), and mPFS was 7.6 months (95% CI 4.6-10.5), with a 6-month PFS rate of 59% and median OS of 10.5 months (ESMO GI 2026, Abstract 341O).
What is the safety profile of zoldonrasib plus daraxonrasib?
Any-grade treatment-related adverse events occurred in 97% of patients (58/60); Grade 3+ TRAEs occurred in 35%. The most common any-grade TRAEs were rash (90%), diarrhea (63%), nausea (57%), and stomatitis/mucositis (53%). The most common Grade 3+ events were rash (12%) and anemia (10%). There were no Grade 4 TRAEs and one Grade 5 TRAE (intestinal perforation). Discontinuation due to TRAEs was low: 2% for zoldonrasib, 5% for daraxonrasib.
How does RMC-9805-001 relate to the Phase III RASolute trials?
RMC-9805-001 is a chemotherapy-free proof-of-concept doublet study supporting the planned Phase III RASolute 309 trial (zoldonrasib + daraxonrasib vs. gemcitabine/nab-paclitaxel in untreated RAS G12D PDAC). It is distinct from RASolute 302 (Phase III daraxonrasib monotherapy/combo vs. chemotherapy, 2L PDAC, published in NEJM May 2026) and RASolute 305 (Phase III zoldonrasib + chemotherapy, 1L PDAC, ongoing).
Compiled and reviewed by the KOL Pulse research team, led by Brian Shields, Founder, KOL Pulse. Last updated 2026-07-05.