When former U.S. Sen. Ben Sasse (R-Neb.) learned he had metastatic pancreatic cancer, he immediately chose action over comfort. Anything he could do to save his life, he wanted to try it. Doctors told him that perhaps his only option was to enroll in a clinical trial.
“If you had a significant chance of living longer than the three or four months they were giving you at that point, you would need to have an aggressive trial,” Sasse told STAT last month.
It turned out to be an early-stage clinical trial testing Revolution Medicine’s dalaxone lasib as a first-line therapy. The pancreatic cancer community has been buzzing about this drug ever since Revolution Medicines (many people refer to the company as Rev Med) announced the first early-stage data on this next-generation targeted therapy. Even before the company announced positive Phase 3 top-line results on Monday, pancreatic cancer experts were confident it would gain approval.
These top-line results confirm that prediction. The RASolute 302 trial showed that dalaxone lasib alone can significantly improve survival in patients with advanced pancreatic cancer to 13.2 months compared to 6.7 months in the second-line chemotherapy group. Administering daraxone lasib even earlier as a front-line treatment, as Sasse did, may have even greater benefits than chemotherapy.
Sasse said he may already be living longer than the few months he originally thought when he was diagnosed last December. “Given what the prognosis was and what was on the table regarding pancreatic cancer, this experience seems to have expanded both the quantity and quality of my life,” he said.
STAT Plus: Revolution Medicine touts ‘unprecedented’ data on pancreatic cancer drug
STAT spoke to Sass about his experience with daraxone lasib for an upcoming feature examining the breakthroughs behind the new drug. This interview has been edited for length and clarity.
How did you first find out you had pancreatic cancer?
I just started having two main symptoms in October. I have a lot of serious back pain. I’m not a very tough guy, but I grew up working on a farm. I’m used to some pain. But the pain was so great that I knew something was wrong. Pressure on my back would radiate and eventually cause weird stomach cramps. It was about 70% of my waking hours. The pain started in my back and went to my front, where I felt like my body was doubled over.
I thought I had pulled a significant muscle. I did a blood test. Nothing was displayed. My doctor said, “Okay, let’s schedule a test.” He called me on Friday morning. My child graduated from college the next day. He was stressed and worried but didn’t want to give me the big bad news over the phone. I said, tell me the hardest fact.
“You have a lot of tumors in your torso,” he said, “and a very significant mass in your pancreas.”
What was it like learning that?
I wanted to focus on my kids, so I said let’s schedule a biopsy for the following Monday. I obviously felt like this wasn’t going to work. Theology was number one. Christians have a saying: “To live is Christ, and to die is gain.” The second challenge was thinking about how to love all of my children and my wife in the time I had left. I didn’t want to reflect on it for 36 hours because I didn’t feel it was the right choice to have my child’s graduation party stolen. We weren’t good at that.
How did you hear about the trial? What was the process of making it happen?
I found that there were two places I could quickly figure out the genetic profile of my tumor: MD Anderson and Memorial Sloan Kettering. Over the next 6 days we went to both for a day and a half. No one told me I could live with what I got from conventional chemotherapy. It seemed obvious. Pancreatic survival rates are abysmal.
I heard this pitch from the MD Anderson team and headed to Memorial Sloan Kettering. Dr. Eileen O’Reilly, MSK, is defined by me as the number one pancreatic cancer doctor in the United States, and when I had the opportunity to meet with her, she agreed to meet with us. She basically said that if you had a chance to go to trial, I would take it too. It became clear that they were waiting for me to say yes.
What was it like being on drugs?
There were many clinical benefits. It is difficult to distinguish between the benefits of morphine and the early benefits of the trial. It was very painful. Second, they said that if we started this type of treatment, the tumor would fight back. After taking Dalasonelasib, my lower back pain returned and it was severe. I am also taking morphine at the same time. Bob Wolf, a medical oncologist at MD Anderson, told me that this is a good sign that the tumor is responding. He also started bleeding profusely from his face. I had to stop and get antibiotics and then take them again.
Now my CA 19-9 level has completely collapsed. (A common blood marker for pancreatic cancer. Declining levels can be a sign that the cancer is responding to treatment.) That’s great. When I started the trial it was 8,100 north of 8,000. This week (mid-March) it went down from 579 to 374. This is huge. This is a 60% reduction in tumor volume. My pain has decreased considerably.
When you think about this trial, it’s one of the first major advances in pancreatic cancer in recent decades. What does it mean to you to be a part of it?
First of all, I am extremely grateful to those who have dedicated their time and talent to this research. My team, Bob Wolf and Shubham Pant at MD Anderson, are amazing. The purpose of clinical trials is not the individualized care of a single patient, but the benefit of obtaining data to advance the next generation of clinical care. That was understandable.
However, we are extremely grateful to the entire team at MD Anderson and how they treated us. It was a wonderful consideration. The fact that you don’t have to be permanently hospitalized. You will be able to leave the hospital and spend more time with your family.
