Mandinov is among the first people in the country to receive the drug, called daraxonrasib<\/a>, outside of a clinical trial. The medication is awaiting approval from the Food and Drug Administration but is being made available for free to more patients who qualify through an expanded access program<\/a>.<\/p>\n \u201cThe results have been nothing short of historic, landmark, you pick your biggest word,\u201d said Dr. Harsh Singh, an oncologist at Mass General Brigham Cancer Institute who is part of Mandinov\u2019s care team and has been involved in the development of daraxonrasib. \u201cWe have never had a treatment like this for pancreatic cancer.\u201d<\/p>\n A breakthrough decades in the making<\/p>\n While pancreatic cancer is considered rare, with roughly 70,000 people diagnosed each year<\/a>, it often isn\u2019t caught until it has reached an advanced stage, which is what can make it so deadly. Once the cancer has spread, its five-year relative survival rate is about 3 percent, according to the American Cancer Society<\/a>. <\/p>\n \u201cWhat we\u2019ve had to treat pancreatic cancer for many years is mostly just chemotherapy,\u201d said Dr. Brian Wolpin, director of the Hale Family Center for Pancreatic Cancer Research at Dana-Farber Cancer Institute and a principal investigator of the daraxonrasib trial.<\/p>\n For nearly 50 years, scientists and doctors have known about one of the disease\u2019s main drivers: mutations to a group of genes that fuel the growth of tumors.<\/p>\n One of those mutations, known as KRAS, is found in more than 90 percent of pancreatic cancers as well as some lung and colorectal cancers.<\/p>\n \u201cWhen it\u2019s mutated, it can\u2019t really turn itself off,\u201d Wolpin said. \u201cIt just keeps signaling to the cell to grow, even when it should not.\u201d<\/p>\n Researchers knew they needed to target the protein created by the mutated gene. But the smooth-surfaced molecule, which has been described as a \u201cgreasy ball,\u201d<\/a> seemed impossible to attack.<\/p>\n That didn\u2019t stop them from trying.<\/p>\n Over decades, scientists \u2014 with support from the National Institutes of Health and the Howard Hughes Medical Institute, a nonprofit research organization \u2014 chipped away at the challenge.<\/p>\n A major break came in 2013<\/a> when Kevan Shokat, a researcher at the University of California San Francisco, found a chink in the protein\u2019s armor where another molecule could wedge itself.<\/p>\n Meanwhile, Harvard scientist Greg Verdine discovered that molecular glues found in nature could bind drugs to the protein, revealing another way to effectively target it<\/a>.<\/p>\n Daraxonrasib, which is being developed by the California-based Revolution Medicines, uses the molecular glue approach to help attach to the mutated proteins and block the signals that tell cancer cells to grow. In a trial of 500 patients<\/a> with pancreatic cancer who had been treated with chemotherapy but saw their disease progress, people who took the pill lived a median of 13.2 months, compared with 6.7 months for those who continued receiving chemotherapy alone. The drug also kept tumors in check for a median of 7.2 months, compared with 3.6 months for the group that did not receive it.<\/p>\n When Wolpin presented the latest clinical trial results at a major cancer conference earlier this year, he received a standing ovation.<\/p>\n Mandinov\u2019s back started hurting in October.<\/p>\n At the time, Mandinov, a cardiologist, thought his frequent workouts were to blame. But then he started to notice the pain, deep in his body, when he would recline or lie on his back. <\/p>\n \u201cThis was the first sign that kind of rung a bell in my brain that there might be something with the pancreas,\u201d he said.<\/p>\n The big \u201cred flag,\u201d he said, came a few weeks later.<\/p>\n One night, shortly after falling asleep, Mandinov said he woke up drenched in sweat with intense upper abdominal pain. He was nauseous and salivating so much that saliva was running out of his mouth. <\/p>\n \u201cThis was the very first time when I said this must be cancer, nothing else,\u201d he said.<\/p>\n An MRI revealed he had pancreatic cancer that had spread to his liver. <\/p>\n He started chemotherapy, and the treatments were working, but after 10 cycles the drugs were taking too much of a toll. He joined an early trial of another experimental drug that also targets the cancer-causing protein, but the medication made him too sick to continue. <\/p>\n Then he heard about daraxonrasib. People from around the world were calling him about it.<\/p>\n \u201cOnce you see the data, you don\u2019t need to be expert in any particular field to understand that this is a game-changer,\u201d said Mandinov, who works for a global clinical research organization. <\/p>\n For Rob Martell, who runs a brewery in Searsport, Maine, access to the drug brings \u201cpeace of mind.\u201d <\/p>\n \u201cI feel like I\u2019m being extended,\u201d said Martell, 58. <\/p>\n Martell\u2019s symptoms began two years before he was diagnosed last summer.<\/p>\n \u201cI was going to the doctor, and I kept telling them something is wrong,\u201d he said. <\/p>\n He had pain near the top of his stomach that would travel down to his kidneys. Sometimes he felt dizzy. He completed a battery of tests and scans, but doctors still couldn\u2019t find a problem.<\/p>\n Then, a blood test showed he was diabetic. That didn\u2019t make sense, Martell said. He was active, not overweight, and maintained a healthy diet. <\/p>\n His doctor recommended he get another scan.<\/p>\n \u201cBoom, that\u2019s when they found the tumor,\u201d he said.<\/p>\n Martell figured he had about four months to live, based on how long his mother and a friend survived after also being diagnosed with pancreatic cancer.<\/p>\n He started receiving care at Dana-Farber, beginning with chemotherapy. But after his first round, he felt the treatment was \u201cunsurvivable.\u201d <\/p>\n Modifications to his chemotherapy regimen allowed him to tolerate more rounds. His tumor shrank and surgery seemed promising. But then doctors found cancer in his liver.<\/p>\n His doctors decided to try daraxonrasib and he started the daily three-pill regimen in July. <\/p>\n The night after his first dose, Martell said he didn\u2019t need opioids to sleep. The next day, he didn\u2019t feel any pain. <\/p>\n He has experienced some of the known <\/a>side effects<\/a> from the medication, including gastrointestinal symptoms and an acne-like rash on his head, neck, and shoulders, but, Martell said, \u201cI can feel it working.\u201d <\/p>\n Despite daraxonrasib\u2019s success, experts say research into pancreatic cancer treatments must continue.<\/p>\n \u201cThis is not a cure,\u201d said Dr. Ryan Holstead, a medical oncologist at UMass Memorial Medical Center. \u201cThis helps prolong survival.\u201d <\/p>\n People can develop resistance to daraxonrasib and other similar medications, meaning their cells will eventually learn to evade the drugs.<\/p>\n Research is ongoing to look at how these drugs could be combined with other cancer-fighting therapies, such as chemotherapy. Meanwhile, scientists are also studying other technologies such as vaccines and mRNA immunotherapies<\/a>. <\/p>\n But even if the drug doesn\u2019t cure cancer, having more time is critical for patients, Martell said. <\/p>\n \u201cThere\u2019s always something in the pipeline that they\u2019re working on next,\u201d he said. \u201cIf this can hold whatever off and they release something new, I can then jump onto that. I don\u2019t know how long I can ride it, but I\u2019m going to ride it as long as I can.\u201d <\/p>\n At MGB, Mandinov was eager to take his first dose. <\/p>\n \u201cIt\u2019s a great day,\u201d Singh, the oncologist, said with a smile as he handed over the bag of medication.<\/p>\n Mandinov shook three pale blue pills from the bottle into his hand, tossed them into his mouth, and gulped them down with a swallow of water. <\/p>\n Allyson Chiu can be reached at allyson.chiu@globe.com<\/a>. Follow her on X @_allysonchiu<\/a>. Emily Spatz can be reached at emily.spatz@globe.com<\/a>. Follow her on X @emilymspatz<\/a>.<\/p>\n![\"Bottles](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2026\/08\/XGEH7HMGCH5EDGWTXNJ5HNWEYE.JPG\")
Bottles of an investigational pancreatic cancer drug were held by Mandinov.Erin Clark\/Globe Staff<\/p>\n![\"Lazar](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2026\/08\/SUAPTY7KLPPGWZAI3ZYRCKSZEE.jpg\")
Lazar Mandinov, in the prayer room of his home in Newton. Mandinov, who is Eastern Orthodox, said he goes to this room to be alone and pray.Christian Kantosky for The Boston Globe<\/p>\n