International Patients — RAS-Mutant Cancer Clinic

Your cancer has a mutation with a name.
Your treatment can be designed around it.

For patients worldwide with KRAS/RAS-mutant pancreatic, lung, colorectal and other cancers — including those receiving daraxonrasib (RASONQUE) in their home country. At Precision Clinic in Tokyo, Nagoya and Kobe, we design KRAS-targeted and neoantigen dendritic cell vaccine therapy around your mutation type, HLA type and treatment history, drawing on more than 6,500 patients treated with dendritic cell vaccine therapy.

Physician consultations, including second opinions, are fee-based.

Key facts (as of October 2026)

Daraxonrasib (RASONQUE) is approved in the United States (August 26, 2026) for adults with metastatic pancreatic adenocarcinoma who have received at least one prior systemic therapy or who are not candidates for multi-agent systemic therapy. In the EU, the CHMP recommended authorisation on October 15, 2026 (European Commission decision pending). It is not approved in Japan.
What we provide in Japan is dendritic cell (DC) vaccine therapy: KRAS-targeted DC vaccine or neoantigen DC vaccine, as self-pay treatment.
We have treated patients who were receiving daraxonrasib at overseas medical institutions with KRAS-targeted DC vaccine therapy at our clinic. The clinical efficacy and safety of this combination have not been established, and results are not guaranteed.

Who this page is for

You have a KRAS, NRAS or HRAS mutation (for example KRAS G12D, G12V or G12R) in pancreatic, lung, colorectal or another cancer
You are receiving daraxonrasib in your country and want to know what can be added in Japan
You have completed standard treatment and are looking for what to consider next
You are a physician or family member gathering options on behalf of a patient

Why patients come to us from abroad

Mutation-first planning. We start from your genomic report and HLA type, not from a fixed menu.
Two ways to target the mutation. KRAS-targeted DC vaccine when the mutation type is known; neoantigen DC vaccine designed from your own tumor.
Experience. More than 6,500 patients treated with dendritic cell vaccine therapy; a pioneer in the clinical use of WT1 dendritic cell vaccine therapy.
English-language coordination from first inquiry to follow-up after you return home, with multilingual support arranged as needed.

Two dendritic cell vaccine options

KRAS-targeted DC vaccine

For patients whose KRAS mutation type is known from a genomic test. Peptides derived from the mutant KRAS protein are used as the antigen, selected according to your mutation type and HLA type.

Neoantigen DC vaccine

Designed from the genomic analysis of your own tumor, using antigens specific to your cancer. Genomic analysis and vaccine preparation generally take about 2–3 months before the first administration.

Which option fits depends on your test results, treatment history and condition. Our physicians explain the options after reviewing your records. Dendritic cell vaccine therapy is part of our SynerTri Immunotherapy program, which may also combine immune checkpoint inhibitors and local tumor-directed therapy.

Daraxonrasib and dendritic cell vaccine: what is known

Daraxonrasib is an oral RAS(ON) inhibitor that blocks RAS signaling. In the phase 3 RASolute 302 trial (previously treated metastatic pancreatic cancer), median overall survival was 13.2 months with daraxonrasib versus 6.7 months with chemotherapy (overall population; N Engl J Med 2026;395(4):325-337). Common side effects include rash, diarrhea, stomatitis, nausea and vomiting; rare but serious risks include gastrointestinal perforation and interstitial lung disease (US prescribing information).

Preclinical studies in mice reported that KRAS inhibition can increase T-cell infiltration into tumors, which provides a theoretical rationale for combining RAS inhibitors with immunotherapy. These are preclinical findings; no clinical trial has tested daraxonrasib together with dendritic cell vaccine therapy, and the efficacy, safety, timing and sequence of such a combination are unknown.

At Precision Clinic, we provide treatment with the overseas-approved RAS inhibitor described on this page, imported by our physicians under their own responsibility, as self-pay care. It is not suitable for everyone: after hearing your wishes, our physicians decide carefully based on your cancer type, mutation type, treatment history and general condition. This medicine is not approved in Japan, no drug with the same active ingredient is approved in Japan, and it is not covered by Japan's Relief System for Sufferers from Adverse Drug Reactions. The US prescribing information lists side effects such as rash, diarrhea and stomatitis, and serious risks such as gastrointestinal perforation and interstitial lung disease. Costs, risks and the time needed to obtain the drug are explained individually at consultation. If you are already receiving daraxonrasib, please keep your prescribing physician informed.

Treatment journey for international patients

Inquiry and record review — send your genomic test report, treatment history and recent imaging through our English inquiry form. We reply by email, normally within 24 hours. Physician consultations are fee-based.
Consultation and planning — we propose a plan based on your mutation type, HLA type and condition, and explain the schedule, costs and risks.
Apheresis — immune cells are collected from your blood for vaccine manufacturing.
Manufacturing — your dendritic cell vaccine is prepared (neoantigen vaccines: about 2–3 months including genomic analysis).
Administration — typically once every 1–3 weeks; the initial course is about 7 vaccinations over about 4 months. Continuation after the 8th vaccination is decided with your physician based on your condition.

Most international patients come to Japan for several short visits rather than one long stay: typically a visit for consultation and apheresis, and further visits for vaccinations, with the schedule planned around your home treatment. English- and Chinese-speaking physicians are available at our Tokyo clinic, and multilingual support can be arranged as needed.

Costs and risks

Costs: Dendritic cell vaccine therapy is self-pay treatment and is not covered by Japanese national health insurance. Fees for international patients differ from domestic fees and are provided as an individual quotation after we review your records.

Main risks: during apheresis — dizziness, nausea, anemia, decreased blood cell counts, numbness of the lips or limbs; during cell culture — bacterial contamination or unknown infections; after vaccination — redness at the injection site, rash and fever. Unknown side effects cannot be ruled out.

Frequently asked questions

Can I receive daraxonrasib in Japan?

Daraxonrasib is not approved in Japan (as of October 2026), and the timing of approval in Japan is undetermined. If you are considering treatment with a RAS inhibitor, please contact us; sourcing, costs, risks and the time needed are explained individually.

Can I continue daraxonrasib while receiving dendritic cell vaccine therapy?

Please discuss this with your prescribing physician. The efficacy and safety of the combination have not been established; we explain our approach after reviewing your records.

Which mutations can be considered for the KRAS-targeted vaccine?

It depends on your KRAS mutation type (such as G12D, G12V or G12R) and your HLA type. Please send your genomic test report.

How long do I need to stay in Japan?

You do not need to stay in Japan for the whole course. Most international patients come for several short visits: consultation and apheresis first, then visits for vaccinations (about 7 over about 4 months). Your schedule is planned individually around your treatment at home.

Is dendritic cell vaccine therapy approved in Japan?

It is not an approved drug. It is provided as self-pay treatment under Japan's Act on the Safety of Regenerative Medicine.

Contact us in English

Send your genomic test report and treatment history through our English inquiry form. We reply by email, normally within 24 hours (Japan time, excluding clinic holidays). Physician consultations, including second opinions, are fee-based.

Sources: US FDA approval announcement (Aug 26, 2026); RASONQUE US Prescribing Information (Revised 08/2026); European Medicines Agency (Oct 15, 2026); O'Reilly EM et al., N Engl J Med 2026;395(4):325-337; Canon J et al., Nature 2019;575:217-223; Mahadevan KK et al., Nat Commun 2026;17. Japanese page: RAS変異がん専門外来.

Your cancer has a mutation with a name.Your treatment can be designed around it.