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The purpose of this study is to evaluate the safety and efficacy of a novel RAS(ON) inhibitor compared to standard(s) of care (SOC) treatment.
This is a global, randomized, open-label, Phase 3 study designed to evaluate whether treatment with RMC-6236 will improve progression free survival (PFS) or overall survival (OS) compared to Investigator's choice of standard of care chemotherapy in patients with metastatic PDAC who were previously treated with one prior line of therapy with 5-fluorouracil (5-FU) based or gemcitabine-based regimen.
Patients will be randomized in a 1:1 ratio to receive RMC-6236 (Arm A) or Investigator's choice of standard of care chemotherapy (Arm B).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| RMC-6236 | Experimental | Study drug |
|
| Investigator's choice of standard of care therapy | Active Comparator | Patients randomized to Investigator's choice of standard of care chemotherapy will receive one of the following four treatments:
|
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| RMC-6236 | Drug | Oral Tablets |
| |
| Gemcitabine |
| Measure | Description | Time Frame |
|---|---|---|
| Progression free survival (PFS) in the RAS G12-mutant population | PFS is defined as the time from randomization until disease progression or death from any cause, whichever occurs first. Progression is per response evaluation criteria in solid tumors (RECIST) v1.1 and as assessed by blinded independent central review (BICR) | Up to approximately 3 years |
| Overall survival (OS) in the RAS G12-mutant population | OS is defined as the time from randomization until death from any cause. | Up to approximately 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| PFS in the all-patient population | PFS is defined as the time from randomization until disease progression or death from any cause, whichever occurs first. Progression is per RECIST v1.1 and as assessed by BICR. | Up to approximately 3 years |
| OS in the all-patient population |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Study Director | Revolution Medicines | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Banner MD Anderson Cancer Center | Gilbert | Arizona | 85234 | United States | ||
| Mayo Clinic Cancer Center - Phoenix |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42223072 | Derived | O'Reilly EM, Wainberg ZA, Hendifar AE, Borad MJ, Pietrantonio F, Pant S, Hammel P, Cremolini C, Manji GA, Oberstein PE, Garrido-Laguna I, Springfeld C, Azad NS, Ueno M, Chui SY, Zhang Y, Patel H, Lee Y, Salman Z, Wolpin BM; RASolute 302 Trial Investigators. Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer. N Engl J Med. 2026 May 31. doi: 10.1056/NEJMoa2605555. Online ahead of print. |
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| Drug |
intravenous (IV) infusion |
|
| nab-paclitaxel | Drug | IV infusion |
|
| Irinotecan | Drug | IV infusion |
|
| Liposomal irinotecan | Drug | IV infusion |
|
| 5-fluorouracil | Drug | IV infusion |
|
| leucovorin | Drug | IV infusion |
|
| Oxaliplatin | Drug | IV infusion |
|
OS is defined as the time from randomization until death from any cause. |
| Up to approximately 3 years |
| Objective response in the RAS G12 and all-patient populations | Objective response is defined as partial response (PR) or completed response (CR) per RECIST v1.1, assessed by BICR. | Up to approximately 3 years |
| Time to deterioration (TTD) in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Pancreatic Cancer Module (EORTC QLQ-PAN26) in the RAS G12 and all-patient populations | TTD is defined as the time from randomization to the first occurrence of deterioration as defined by a change of at least 10 points, or death, whichever occurs first, in each subscale in EORTC QLQ-PAN26. | Up to approximately 3 years |
| Time to deterioration (TTD) in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) in the RAS G12 and all-patient populations | TTD is defined as the time from randomization to the first occurrence of deterioration as defined by a change of at least 10 points, or death, whichever occurs first, in each subscale and global QoL score in EORTC QLQ-C30. | Up to approximately 3 years |
| Objective response per investigator in RAS G12 and all- patient populations | Objective response is defined as PR or CR per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, as assessed by the investigator. | Up to approximately 3 years |
| Duration of response (DOR) in RAS G12 and all-patient populations | DOR is defined as time from first evidence of objective response (PR or CR) to disease progression or death due to any cause, whichever occurs first, as assessed by BICR and by the investigator. | Up to approximately 3 years |
| Time to response (TTR) in RAS G12 and all-patient populations | TTR is defined as time from randomization to first evidence of objective response (PR or CR), as assessed by BICR and by the investigator. | Up to approximately 3 years |
| Percentage of patients with adverse events (AEs) | Up to approximately 3 years |
| Pharmacokinetics of RMC-6236 in RAS G12 and all-patient populations | Pharmacokinetics are defined by blood concentrations of RMC-6236 over time. | Up to approximately 3 years |
| Phoenix |
| Arizona |
| 85054 |
| United States |
| City of Hope-Duarte | Duarte | California | 91010 | United States |
| Cedars-Sinai Medical Center | Los Angeles | California | 90048 | United States |
| UCLA | Los Angeles | California | 90095 | United States |
| UC San Diego Health Moores Cancer Center | San Diego | California | 92037 | United States |
| Mission Hall UCSF | San Francisco | California | 94158 | United States |
| Rocky Mountain Cancer | Aurora | Colorado | 80012 | United States |
| Mayo Clinic Cancer Center - Florida | Jacksonville | Florida | 32224 | United States |
| University of Miami Sylvester Comprehensive Cancer Center | Miami | Florida | 33136 | United States |
| Cancer Care Centers of Brevard Inc | Palm Bay | Florida | 32909 | United States |
| Moffitt Cancer Center | Tampa | Florida | 33612 | United States |
| The Queen's Medical Center | Honolulu | Hawaii | 96813 | United States |
| The University of Chicago Medical Center | Chicago | Illinois | 60637 | United States |
| Johns Hopkins | Baltimore | Maryland | 21287 | United States |
| Dana Farber Cancer Institute | Boston | Massachusetts | 02215 | United States |
| University of Michigan | Ann Arbor | Michigan | 48109 | United States |
| Karmanos Cancer Institute | Detroit | Michigan | 48201 | United States |
| Mayo Clinic Cancer Center - Rochester | Rochester | Minnesota | 55905 | United States |
| Washington University | St Louis | Missouri | 63110 | United States |
| Roswell Park Cancer Institute | Buffalo | New York | 14263 | United States |
| NYU Lagone Health | New York | New York | 10016 | United States |
| Memorial Sloan Kettering Cancer Center | New York | New York | 10022 | United States |
| Columbia University Medical Center | New York | New York | 10032 | United States |
| Duke University Medical Center | Durham | North Carolina | 27710 | United States |
| University of Cincinnati Medical Center | Cincinnati | Ohio | 45219 | United States |
| Stephenson Cancer Center | Oklahoma City | Oklahoma | 73104 | United States |
| Oregon Health and Science University | Portland | Oregon | 97239 | United States |
| Abramson Cancer Center Clinical Research Unit | Philadelphia | Pennsylvania | 19104 | United States |
| UPMC Hillman Cancer Center | Pittsburgh | Pennsylvania | 15232 | United States |
| Sarah Cannon Research Institute (Tennessee) | Nashville | Tennessee | 37203 | United States |
| Texas Oncology Sammons | Dallas | Texas | 75246 | United States |
| MD Anderson Cancer Center | Houston | Texas | 77030 | United States |
| Texas Oncology - Central South | Irving | Texas | 75063 | United States |
| Huntsman Cancer Institute | Salt Lake City | Utah | 84112 | United States |
| Virginia Cancer Specialists | Fairfax | Virginia | 22031 | United States |
| Fred Hutchinson Cancer Center | Seattle | Washington | 98109 | United States |
| Institut Paoli Calmettes | Marseille | 13009 | France |
| Centre Eugene Marquis | Rennes | 35042 | France |
| Hopital Paul Brousse | Villejuif | 94804 | France |
| Gustave Roussy | Villejuif | 94805 | France |
| Charité Universitätsmedizin, Campus Berlin Mitte | Berlin | 13353 | Germany |
| Nationales Centrum fur | Heidelberg | 69120 | Germany |
| Universitatsklinikum Ulm, Zentru | München | 81377 | Germany |
| Universitatsklinikum Ulm | Ulm | 89081 | Germany |
| Fondazione IRCCS Istituto Nazionale dei Tumori | Milan | Italy |
| IEO-Istituto Europeo di Oncologia | Milan | Italy |
| IOV-Istituto Oncologico | Padova | 35128 | Italy |
| Azienda Ospedaliera | Pisa | 56126 | Italy |
| National Cancer Center | Chiba | 277-8577 | Japan |
| Aichi Cancer Center | Nagoya | 4648681 | Japan |
| Osaka International Cancer | Osaka | 541-8567 | Japan |
| National Cancer Center Hospital | Tokyo | 104-0045 | Japan |
| Cancer Institute Hospital of JFCR | Tokyo | 135-8550 | Japan |
| Kanagawa Cancer Center | Yokohama | 241-8515 | Japan |
| Pan-American Center for Oncology Trials | San Juan | 00907 | Puerto Rico |
| Hospital Unversitari | Barcelona | 08035 | Spain |
| Hospital 12 de Octubre | Madrid | 28041 | Spain |
| Clinica Universidad de Navarra | Pamplona | 31008 | Spain |
| Hospital Clinico de Valencia | Valencia | 46010 | Spain |
| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
| D004066 | Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D000093542 | Gemcitabine |
| C520255 | 130-nm albumin-bound paclitaxel |
| D000077146 | Irinotecan |
| C584112 | irinotecan sucrosofate |
| D005472 | Fluorouracil |
| D002955 | Leucovorin |
| D000077150 | Oxaliplatin |
| ID | Term |
|---|---|
| D006571 | Heterocyclic Compounds |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D002166 | Camptothecin |
| D000470 | Alkaloids |
| D014498 | Uracil |
| D011744 | Pyrimidinones |
| D005575 | Formyltetrahydrofolates |
| D013763 | Tetrahydrofolates |
| D005492 | Folic Acid |
| D011622 | Pterins |
| D011621 | Pteridines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D003067 | Coenzymes |
| D045762 | Enzymes and Coenzymes |
| D056831 | Coordination Complexes |
| D009930 | Organic Chemicals |
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