ClinicalTrials.gg
Not yet recruitingNCT07793253Updated Nov 10, 2026

Phase 2 Study of Daraxonrasib in Recurrent KRAS-Mutant Biliary Tract Cancer

A Phase 2 interventional study of Daraxonrasib in Biliary Tract Cancers, Intrahepatic Cholangiocarcinoma (Icc) and Extrahepatic Cholangiocarcinoma, sponsored by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-10.

Sponsored by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins · Phase 2, Interventional, and Treatment

Updated Nov 10, 2026Study contact changedGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
55
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to evaluate the anti-tumor efficacy of daraxonrasib monotherapy in patients with unresectable or advanced/metastatic, KRAS-mutant BTC who have progressed on or are intolerant of 1st line systemic therapy.

02

Conditions studied

  • Biliary Tract Cancers
  • Intrahepatic Cholangiocarcinoma (Icc)
  • Extrahepatic Cholangiocarcinoma
  • Gallbladder Carcinoma
  • Ampulla of Vater Carcinoma
  • Ampullary Carcinoma

Keywords

  • Daraxonrasib (RMC-6236)
  • KRAS (Kirsten rat sarcoma virus) mutations
  • Immunotherapy
  • Biliary Tract Cancer
  • Liver Cancer
  • Carcinoma
  • Metastatic Cancer
  • Gastrointestinal Cancer
03

In context

Biliary Tract Neoplasms

519 studies on the registry are indexed under Biliary Tract Neoplasms; 199 are open to participants now.

This study's planned enrollment of 55 is close to the median of 58 across 427 interventional studies indexed under Biliary Tract Neoplasms.

Browse Biliary Tract Neoplasms studies →

Lead sponsor

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins is the lead sponsor of 582 studies on the registry; 71 are open to participants now.

Of its 114 completed or terminated interventional studies of FDA-regulated products, 68 (60%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Unresectable locally advanced or or cytologically confirmed biliary tract cancer
  • Must have documented disease progression or intolerance of one prior systemic chemotherapy regimen (with or without immunotherapy) for unresectable and/or advanced stage disease.
  • Age ≥ 18 years
  • (ECOG) performance status 0 - 1.
  • Have based on 1.1.
  • Documented KRAS mutation
  • Adequate organ and marrow function defined by study-specified laboratory tests and procedures.
  • Willingness to provide serial tissue and blood samples for mandatory translational research.
  • Evidence of status or a negative pregnancy test in women of (WOCBP).
  • All participants must agree to use acceptable form of while on study.
  • Ability to take oral medications and willingness to keep daily adherence record in a medication diary.
  • Must understand the study regimen, its requirements, risks and discomforts and is able and willing to sign the form in accordance with regulatory and institutional guidelines.

Exclusion criteria

Exclusion Criteria:

  • Any systemic anti-cancer therapy for advanced BTC within 3 weeks of enrollment or 5 half-lives of the drug, whichever is shorter.
  • Prior treatment with any KRAS, RTK, or MEK inhibitor or other RAS-pathway targeting signal transduction inhibitor agents
  • Major surgery, extended field radiotherapy, or local regional therapy within 4 weeks from first dose of study drug, limited field radiotherapy within 2 weeks of first dose, or failure to recover from side effects of these prior therapies
  • Known additional that is progressing and requires active treatment.
  • Receiving concomitant medications that interfere with Daraxonrasib.
  • Significant cardiovascular disease.
  • Significant cardiac conduction abnormalities.
  • Impaired gastrointestinal function.
  • Active disease
  • Clinically active ascites.
  • Active uncontrolled infection requiring systemic therapy within 72 hours prior to C1D1.
  • Known history of (HIV).
  • Active or chronic or .
  • Known history of central nervous system (CNS) and/or history of uncontrolled seizures.
  • Any uncontrolled acute or chronic medical illness.
  • History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
  • Pregnant or breastfeeding
  • Patient is unwilling or unable to follow the study schedule for any reason.
  • Has known psychiatric or substance use disorder that would interfere with cooperation with the requirements of the trial.
Terms in these criteria, in plain language(14)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
55 participants (estimated)

Study arms

  • Experimental
    Daraxonrasib

    Drug: Daraxonrasib

Interventions

  • Daraxonrasib will be taken at a dose of 300 mg orally once daily in 28-day cycles.

    Also known as: RMC-6236

06

What researchers measure

Primary outcomes

  1. Objective Response (ORR)

    ORR is defined as the proportion of patients who achieved a complete response (CR) or partial response (PR) based on the Response Evaluation Criteria in Solid Tumors (RECIST v1.1). Subjects who discontinue due to toxicity or clinical progression prior to post-baseline tumor assessments will be considered as non-responders.

    Time frame: 4 years

Secondary outcomes

  1. Overall Survival (OS)

    OS is defined as the number of months from the date of treatment initiation until death from any cause or end of follow-up. OS will be censored on the date the participant was last known to be alive for participants without documentation of death at the time of analysis. Estimation based on the Kaplan-Meier curve.

    Time frame: 4 years

  2. Progression free survival (PFS)

    PFS is defined as the number of months from the date of treatment initiation to radiographic disease progression using RECIST v1.1 criteria or death due to any cause, whichever occurs first. Progression of disease (PD) will be censored at the date of the last scan for participants without documentation of disease progression at the time of analysis. Progression will be censored at the time of treatment initiation for participants that do not have a follow up scan. Estimation based on the Kaplan-Meier curve.

    Time frame: 4 years

  3. Duration of response (DOR)

    DOR, defined as the number of months from the date of response to the date of clinically determined disease progression or death from any cause, in participants achieving CR or PR.

    Time frame: 4 years

  4. Disease control rate (DCR)

    DCR is defined as the proportion of participants who achieved CR, PR and stable disease (SD). Stable disease is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.

    Time frame: 4 years

  5. Unacceptable Toxicities

    Number of participants experiencing treatment-related adverse events requiring treatment discontinuation. Defined using NCI CTCAE version 6.0

    Time frame: 4 years

07

Study locations

1 site
08

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Nov 2026; primary completion for Nov 2030, 48 months later.

Of 99 non-industry phase 2 interventional studies under Biliary Tract Neoplasms, half reached primary completion within 39 months of starting (the median), counting those still running; a quarter within 29 and three quarters within 60. This study's planned 48 months is above that.

Counting every sponsor, half of 129 studies reached it within 39 months; a quarter within 29 and three quarters within 68.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 25, 2026
First posted
Aug 28, 2026
StartEst.
Nov 2026
Primary completionEst.
Nov 2030
CompletionEst.
Nov 2030
Last update
Nov 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Contact
Study contact changed: removed n•••@jh.edu · •••9169. See the current contact
Nov 10, 2026
Show all 1 update
  1. Nov 10, 2026
    Contact Study contact changed: removed n•••@jh.edu · •••9169. See the current contact
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT07793253
Collaborators
Revolution Medicines, Inc., Cholangiocarcinoma Foundation
Responsible party
Sponsor
First posted
Aug 28, 2026
Start date
Nov 2026 (estimated)
Primary completion
Nov 2030 (estimated)
Completion
Nov 2030 (estimated)
Last update
Nov 10, 2026

Study contacts

Colleen Apostal, RN
Contact
GIClinicalTrials@jhmi.edu
410-614-3644
Nilo Azad, MD
principal investigator · Johns Hopkins University

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Nov 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Daraxonrasib

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