My HIPEC experience and pancreatic cancer

Signatera at .04 positive and tumor marker up at 207. Scans identified a penny-size anterior met on liver. Possible second (tik tac size) close to surgical site. John’s Hopkins and my doctors say GEMZAR now to target systemic attitude of the disease. 2nd round tomorrow and will discuss what is next if shrinkage shows. They are now saying two cycles (2 months) before discussing next steps. I have KRAS which does not seem to have solid trials available once one has had curative surgeries. If anyone knows of something different, pls post. Much interesting research underway at JH for BRCA mutations

@gamaryanne , sorry to hear that. It sounds a lot like my story -- NED for 3.5 months including Signatera negative with similar CA9-9 levels and trends, then a recurrence confirmed at original site plus mets. 🙁

I don't know if you could handle a treatment more aggressive than GEMZAR alone, or would want to. In my case, the immediate chemo recommendation was for biweekly Gemzar (Gemcitabine) plus Abraxane, with Cisplatin on top of that to target my ATM mutation. It has brought my CA19-9 down from about 677 to 55 over 5 months and Signatera down from 0.14 to 0.00 (negative), but still a little iffy on the MRI. I will know more in a week (new scans and new Signatera).

You might qualify for this trial https://classic.clinicaltrials.gov/ct2/show/NCT04605913 which adds Tumor Treatment Fields (TTF) equipment to my regimen above, but appears to only be available at Mayo in Jacksonville.

There's a new and exciting trial underway using CAR T cells called BASECAMP https://classic.clinicaltrials.gov/ct2/show/NCT04981119 which would check your blood to see if you're eligible for treatment in a follow-on study called EVEREST https://classic.clinicaltrials.gov/ct2/show/NCT05736731 .

Of course, you're reading the HIPEC thread, so depending on the location and extent of your mets, and your ability to tolerate the surgery, this might also be an option if you hook up with the right medical team. I appear to be ineligible for EVEREST, but similar cellular trials are said to be in the works. Until something like that comes through, I will continue barking up the other trees (TTF or HIPEC).

If your only other confirmed mets are in the liver, maybe they could be treated concurrently with radiation or Y-90... (?)

Wishing you the best, and hoping you'll keep us posted.

I see my surgeon this week. He is the “chief cook”on my case.
I will see if another Y90 is being considered or lap surgery. Of course, we would want to clear my system as much as possible before any surgery.

I am going to ask about the biweekly Gemzar with displaying. I think I could handle it!

Hi- thanks for sharing your experience. I was wondering how you’re doing post HIPEC/surgery? I hope you’re doing well!

My dad has pan can with probable Mets to peritoneal. His surgeon mentioned doing CRS/HIPEC and whipple. Any advice?

We were told it’s not for pancreatic cancer that’s moved to liver. But sounds like that not true ????

Thank you for this info 😊we asked oncologist about this (Canada) and we were told it’s not done for pancreatic cancer that moved to liver ???
My husband is has had his 1st treatment. Any further info is so appreciated about HIPEC

I had the HIPEC (closed, laparoscopic) in June at Mayo in Rochester as well. They forgot to warm me up so that was entertaining. My only problem is a constant pain in my upper right abdomen near one of the surgical sites. I start radiation on Monday and an open HIPEC is planned for September. My tumor markers are increasing so I’m not sure if the procedure did any good at this point. Otherwise, no issues.

So many approaches, my husband's metastasis 6 months after the 14 hour surgery wasn't responding well to the chemo. Due to the many mutations he qualified for immunotherapy Keytruda which zapped the visible 2 months metastasis on both of the adrenals . Unusual that Pan C. qualifies for that but after 2 years on it with .no recurrences and an improved quality of ife, he had to stop due to side effects. Now off of it for 1.5 years no visible recurrence . We just rejoice in one day at a time. but cancer is clearly an ongoing trip, especially P. C. Dealing with food absorption inadequacies is the big issue and fatigue is the daily issue.

Dealing with malabsorption. I eat alot and it seems to go through me. Have you found anything that works?

Foods that bind? Steel cut oatmeal, baked potato, rice then progress slowly to other solid food without much fat. Creon or zenpep for long term issue(speak to nurses/oncologist on which one and how much)