Rasonque

Rasonque (daraxonrasib) is a targeted cancer treatment used in adults with metastatic pancreatic cancer who have received at least one prior systemic therapy or are not able to have multiagent systemic therapy.

Rasonque oral tablets are taken once daily, at the same time each day with or without food. Tablets should be swallowed whole; do not crush, chew, or split tablets.

Rasonque is designed to work by switching off RAS proteins, which drive tumor growth in most pancreatic cancers. By blocking RAS signaling, Rasonque suppresses tumor growth and induces cancer cell death (apoptosis) in laboratory studies.

Rasonque is taken on its own rather than as part of a chemotherapy combination. Treatment continues until the cancer starts growing again or until side effects become too difficult to manage.

Rasonque treats adults with a type of pancreatic cancer called pancreatic adenocarcinoma that has spread (metastatic). It is for people who either:

• have already tried at least one other treatment, or
• cannot have a combination of several cancer medicines at once.

Rasonque has not been studied in children, so it is not known whether it is safe or effective in people under 18.

Rasonque FDA approval was granted to Revolution Medicines, Inc. on August 26, 2026.

Rasonque is a RAS inhibitor, or more specifically an oral inhibitor of the RAS GTPase family. Rasonque works by attaching to a protein in the cell called cyclophilin A. Together they form a paired unit (a binary complex) that then locks onto the active, switched-on form of RAS. This three-part structure (tri-complex) blocks RAS from passing its signal to the next proteins in the chain and also helps flip RAS back into its inactive, switched-off state.

Because of how it works, Rasonque acts on both normal (wild-type) and mutated forms of the three main RAS proteins, known as KRAS, NRAS, and HRAS. In laboratory studies, this slowed tumor growth, caused cancer cells to die off (apoptosis), and shrank tumors in models of pancreatic adenocarcinoma. These studies also suggest the drug may help the immune system recognize and attack the tumor.

In its main clinical trial, people who took Rasonque lived a median of 13.2 months compared with 6.7 months for people given standard chemotherapy. Their cancer also took about twice as long to start growing again, and tumors shrank in close to three times as many people.

These results come from RASolute 302 (NCT06625320), a global study that randomly assigned 500 adults with metastatic pancreatic adenocarcinoma to one of two treatments. Everyone in the study had already had one prior round of treatment that stopped working, either a fluoropyrimidine-based or a gemcitabine-based regimen. Participants were split evenly:

• 248 people took Rasonque 300 mg once daily, on its own
• 252 people received a chemotherapy regimen chosen by their own doctor, from mFOLFIRINOX, gemcitabine with nab-paclitaxel, FOLFOX, or nal-IRI with fluorouracil and leucovorin

Rasonque clinical trial results

These are middle values. Some people did better, and some did worse. Rasonque is not a cure. In most cases, the cancer started growing again in time.

Take Rasonque once a day, at about the same time each day, exactly as your healthcare provider tells you. Key points to follow:

• Swallow the tablets whole. Do not chew, crush, or split them.
• You can take Rasonque with or without food. A high-fat, high-calorie meal does not meaningfully change how much of the drug your body absorbs.
• Do not change your dose or stop taking Rasonque unless your provider tells you to.
• Your provider will also prescribe medicines to take before and during treatment to lower your risk of skin reactions.

Rasonque has no contraindications. That means the label does not list any group of people who must never take it. Still, tell your doctor about your health problems and all the medicines you take before you start.

The most common side effects of Rasonque are rash (87%), diarrhea (67%), mouth sores (56%), nausea (52%), tiredness (47%), vomiting (42%), stomach pain (27%), swelling in the arms and legs (25%), decreased appetite (24%), and bleeding (22%).

Skin and digestive side effects are very common, and most people need at least one pause or dose change during treatment.

In the main clinical trial, 69% of people taking Rasonque had their treatment paused at some point because of a side effect, and 37% had their dose lowered. Only 2.9% stopped Rasonque permanently because of side effects. Serious side effects of any kind occurred in 30% of people, most often diarrhea (3.7%), fever (pyrexia, 3.3%), a severe bloodstream infection (sepsis, 2.9%), fatigue (2.1%), and bleeding (2.1%).

Certain abnormal blood tests are common during treatment with this medicine. Your healthcare provider will monitor you for abnormal blood tests and treat you if needed.

These are not all of the possible side effects of Rasonque. You may get side effects that are not listed here. Tell your doctor about any side effect that bothers you or does not go away. You can report side effects to the FDA at 1-800-FDA-1088.

Rasonque can cause serious problems with your skin, mouth, gut, and lungs. Tell your doctor right away if you notice any of these.

Skin reactions

Skin problems are the most common serious side effect. Most people get some kind of skin reaction, and about 1 in 10 have a severe one. They usually start in the first 2 weeks.

Call your doctor if you get a rash, itching, dry or cracked skin, or red, swollen, painful skin around your fingernails or toenails.

Mouth sores (stomatitis)

About half of people get mouth sores or a sore, swollen mouth. This usually starts in the first month.

Call your doctor right away if your mouth hurts, looks red or swollen, or has sores. Also call if you have trouble eating, talking, or swallowing. Your doctor can give you a special mouthwash to help.

Diarrhea

Diarrhea is common and can be severe. It often starts in the first few days.

Call your doctor right away if your diarrhea is new or getting worse. Also call if you have 6 or more extra bowel movements in a day. Your doctor can give you medicine for it.

A tear in the stomach or gut

Rarely, Rasonque can cause a hole or tear in the wall of the stomach or intestines. This is serious and can be deadly. It usually happens later in treatment.

Get help right away if you have bad stomach pain that will not go away, if you are sick or throwing up, if you throw up blood, if your stool has blood in it or looks black and tarry, or if you get a fever or chills.

Lung problems

Rarely, Rasonque can cause swelling in the lungs (pneumonitis). This is serious and can be deadly.

Tell your doctor right away about any new or worse breathing problems. These include a cough, being short of breath, trouble breathing, or wheezing.

Harm to an unborn baby

Rasonque can harm an unborn baby. See the pregnancy section below.

Your doctor will start you on skin medicines before your first dose. Keep using them during treatment. The usual plan is:

• a steroid cream on your face and chest
• moisturizer on your skin
• less time in the sun
• sunscreen with SPF 30 or higher
• clothes and a hat when you go outside
• an antibiotic tablet, in some cases

If a skin reaction does develop, your provider may add other treatments such as oral corticosteroids, and may refer you to a skin specialist (dermatologist).

The recommended dose of Rasonque is 300 mg taken by mouth once daily, continued until the cancer starts growing again or side effects become too difficult to manage. This is made up from tablets available in 100 mg and 150 mg strengths.

What should I do if I miss a dose of Rasonque?

If you miss a dose of Rasonque, take it as soon as you remember. If more than 4 hours have passed, skip the missed dose and take your next dose at the regular time. Do not take two doses at once to make up for a missed dose.

If you vomit after taking a dose, do not take a replacement dose. Wait and take your next dose at the usual time.

Some medicines change how much Rasonque gets into your blood. Too much can cause more side effects. Too little can make it work less well.

Tell your doctor if you take:

• antifungal medicines, such as itraconazole, voriconazole, or fluconazole
• heart or blood pressure medicines, such as verapamil or quinidine
• seizure medicines, such as phenytoin
• the antibiotic rifampin
• the HIV medicine efavirenz
• modafinil, used for sleepiness
• cyclosporine, used after a transplant
• the blood thinner dabigatran

Your doctor may avoid one of these, change your Rasonque dose, or ask you to take the two medicines a few hours apart.

Some common medicines do not cause problems with Rasonque. These include heartburn medicines like esomeprazole, and the cholesterol medicines rosuvastatin and pravastatin.

Tell your doctor about everything you take, including vitamins and herbal products. Check before starting anything new.

This is not a full list of the medicines that can interact with Rasonque. Other medicines can affect how well it works or raise your risk of side effects, so ask your doctor or pharmacist to review your full medicine list before you start treatment.

No, you should not take Rasonque when planning a pregnancy or pregnant, as it can harm an unborn baby.

If you are able to become pregnant, your provider will do a pregnancy test before you start Rasonque. Use effective birth control during treatment and for 1 week after your last dose, and tell your provider right away if you become pregnant.

Men with female partners who are able to become pregnant should also use effective contraception during treatment and for 1 week after the last dose.

It is not known whether the active ingredient daraxonrasib passes into breast milk. Do not breastfeed during treatment and for 1 week after your final dose.

Rasonque tablets are blue and oval. Each one has "R" on one side. The other side shows the strength:

• 100 mg tablets say "100 M"
• 150 mg tablets say "150 M"

They come in bottles of 30 tablets with a child-safe cap.

Store Rasonque at room temperature, between 68°F and 77°F (20°C to 25°C). Keep it out of the reach of children.

Active ingredient: daraxonrasib

Inactive ingredients: butylated hydroxytoluene, colloidal silicon dioxide, croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose acetate succinate, magnesium stearate, mannitol, and microcrystalline cellulose. The coating contains FD&C blue #2/indigo carmine aluminum lake, glyceryl mono and dicaprylocaprate, polyvinyl alcohol, sodium lauryl sulfate, talc, and titanium dioxide.