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Nanoknife for pancreatic cancer

Posted by hopefulandpositive @hopefulandpositive, Apr 10 11:16am

Hi,
My husband was diagnosed with pancreatic adenocarcinoma 7 months ago. It is inoperable because it is wrapped tightly around superior mesenteric artery. He has done 12 cycles of chemo (oxaliplatin, irinotecan and floururacil) but tumor has not shrunk but it hasn't spread/grew either. We were told that continuing chemo after this many sessions is not good for his bone marrow and another chemo regimen is unlikely to going to help if 5FU didn't. We are given an option to go through Nanoknife procedure to "freeze" the tumor. The surgeon said he has done 200 procedures in the last 7 years and there are still some patients who haven't had any additional growth. Does anyone have experience with nanoknife? How was it? Any concerns? Just trying to get more information on this procedure as we were told to make a decision as soon as possible as the tumor hasn't spread to other organs yet and he will no longer be a candidate if it presents spread.

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

gracect | @gracect | Oct 7 7:20am
In reply to @stageivsurvivor "If an investigational new drug that was part of a trial showed evidence that it proved..." + (show)
@stageivsurvivor

If an investigational new drug that was part of a trial showed evidence that it proved efficacious as determined likely by the RECIST version 1.1 guidelines which is a common measurement standard for tumors and the trial ended or was terminated, the principal investigator of the trial can write an Individual Patient Investigational New Drug application and submit to the FDA for approval on compassionate need. This is what was done in my case when the trial was terminated and it was shown I had a complete response to the trial drug. The FDA acted on the application within 24 hours and I was allowed to continue receiving the drug under compassionate use. The manufacturer agreed to continue supplying the drug and I continue to be closely monitored 8.5 years after the trial was terminated.

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I remember reading your post before. My husbands oncologist did try to get it through proper channels but was denied.
When the gemabraxane stops working the plan is to go to another trial- for KRAS - and then to Fulforinox. If nothing else comes along. There are other drugs that target the storms around the cell in trials, as pamrevulab did. Maybe one of them will prove more successful.

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1 reply
gracect | @gracect | Oct 7 7:25am
In reply to @gracect "I remember reading your post before. My husbands oncologist did try to get it through proper..." + (show)
@gracect

I remember reading your post before. My husbands oncologist did try to get it through proper channels but was denied.
When the gemabraxane stops working the plan is to go to another trial- for KRAS - and then to Fulforinox. If nothing else comes along. There are other drugs that target the storms around the cell in trials, as pamrevulab did. Maybe one of them will prove more successful.

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Also, my husband’s tumor shrank by half, not a complete response as with stage4survivor. The results showed OS of 3 weeks less with the trial drug than standard of care and that OS was far less than he is at now.

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gracect | @gracect | Oct 7 7:28am
In reply to @gamaryanne "I continue on the Revolution Medicine trial for KRAS mutations. I am on the combo drugs..." + (show)
@gamaryanne

I continue on the Revolution Medicine trial for KRAS mutations. I am on the combo drugs 9805/6236. I am in a thread with people on 6236. So far I have heard of stable tumors /no progression/shrinkage. I have seen shrinkage and CA-9-9 declining significantly.

A drug to keep an eye on if you have KRAS mutations. Also MiratA has one but not connected to those results.

Cisplatin is the root cause of neuropathy when given with the chemo drugs we all take.

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I’m happy to hear that - we are hopeful to start the KRAS trial with the pills next at Stage 3 trial. We would like to try that before the Fulforinox, not wanting to exhaust both proven standards of care.

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gracect | @gracect | Oct 7 7:30am

Very helpful and hopeful.
How are the side effects?

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stageivsurvivor | @stageivsurvivor | Oct 7 8:59am
In reply to @gamaryanne "I continue on the Revolution Medicine trial for KRAS mutations. I am on the combo drugs..." + (show)
@gamaryanne

I continue on the Revolution Medicine trial for KRAS mutations. I am on the combo drugs 9805/6236. I am in a thread with people on 6236. So far I have heard of stable tumors /no progression/shrinkage. I have seen shrinkage and CA-9-9 declining significantly.

A drug to keep an eye on if you have KRAS mutations. Also MiratA has one but not connected to those results.

Cisplatin is the root cause of neuropathy when given with the chemo drugs we all take.

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Cis-platin, oxaliplatin which is the platin agent used in (m)Folfirinox and taxanes such as Abraxane (nab-Paclitaxel) are all neurotoxic and can cause chemo induced peripheral neuropathy. More pancreatic oncologists are beginning to consider using cold therapy to improve quality of life and patient experience for patients on these neurotoxic agents

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1 reply
sheridanb | @sheridanb | Oct 7 9:39am
In reply to @stageivsurvivor "Cis-platin, oxaliplatin which is the platin agent used in (m)Folfirinox and taxanes such as Abraxane (nab-Paclitaxel)..." + (show)
@stageivsurvivor

Cis-platin, oxaliplatin which is the platin agent used in (m)Folfirinox and taxanes such as Abraxane (nab-Paclitaxel) are all neurotoxic and can cause chemo induced peripheral neuropathy. More pancreatic oncologists are beginning to consider using cold therapy to improve quality of life and patient experience for patients on these neurotoxic agents

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My husband did the 12 rounds folfirinox, then a maintenance for 4 months without the oxy which allowed him to regain some weight and strength and have a little more life this summer. Unfortunately his CA19-9 numbers started climbing again and scans showed growth while on the maintenance. So he has once again started the full dosage. This time they are trying the cold therapy while getting the chemo... cold booties and mittens, plus spooning ice chips in his mouth for the last two hours of infusion. Reasoning is to stop the neuropathy from getting worse. He's only had two sessions of it, so unknown if that will help. Though he felt for the first time an uncomfortable spot in his throat so he is wondering about continuing with the ice chips.

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kopkafam13 | @kopkafam13 | Oct 23 9:07am
In reply to @tiffboss "Hello hopefulandpositive, I had the Nanoknife procedure eleven months ago. Like your husband, I was not..." + (show)
@tiffboss

Hello hopefulandpositive,
I had the Nanoknife procedure eleven months ago. Like your husband, I was not a candidate for Whipple because of atrial involvement. My surgery was done at the University of Iowa Hospital by Dr. Carlos Chan. I had eight rounds of Folfirinox chemo and 25 rounds of chemo radiation prior to my surgery. The chemo and radiation shrank my tumor from about 3 cm to just under 2.

My surgery was an open procedure, and they also moved where my bowel connects to my stomach to avoid future blockages due to narrowing or scarring of the bowel (the tumor was very close to it). My surgery was on a Friday, and I went home the following Wednesday. I was definitely sore afterwards, but it wasn’t terrible. I used pain meds for maybe a week, mainly to help me sleep, then Tylenol was fine. My doctor did not recommend any chemo after the surgery, but some doctors do.

I’ve had PET and CT scans every three months. The most recent one was about a month ago. So far, so good! No signs of any active cancer cells and my CA 19-9 is at 18 (the lowest it’s ever been). I feel great, and dairy is the only food that gives me any minor issues.

I know not everyone is on board with this procedure, but I am very grateful that I was able to have it done. There is a Facebook page called Nanoknife Surgery Warriors. It is run by a doctor in Florida, Dr. Robert Donoway. He is a big proponent of Nanoknife and performs many of them. He thoroughly answers questions and in my opinion it’s worth checking out.

I’m more than happy to answer any questions you have. Best of luck!!

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We are waiting on biopsy results and meeting with doctors next week regarding my father’s unresectible pancreatic cancer. You have given us hope there are some other options. They too live in Iowa

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2 replies
tiffboss | @tiffboss | Oct 23 12:22pm
In reply to @kopkafam13 "We are waiting on biopsy results and meeting with doctors next week regarding my father’s unresectible..." + (show)
@kopkafam13

We are waiting on biopsy results and meeting with doctors next week regarding my father’s unresectible pancreatic cancer. You have given us hope there are some other options. They too live in Iowa

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Wishing you all the best!! My NanoKnife was in May, 2023 and I still have no signs of any active cancer cells. I’m incredibly thankful.

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1 reply
Moderator
Colleen Young, Connect Director | @colleenyoung | Oct 31 9:53am
In reply to @kopkafam13 "We are waiting on biopsy results and meeting with doctors next week regarding my father’s unresectible..." + (show)
@kopkafam13

We are waiting on biopsy results and meeting with doctors next week regarding my father’s unresectible pancreatic cancer. You have given us hope there are some other options. They too live in Iowa

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@kopkafam13, how are you and your father doing? What did you learn at the recent appointment?

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kopkafam13 | @kopkafam13 | Oct 31 10:54am

We are actually heading to Iowa city now for the second set of biopsies and ultra sound.
His has been said to be unresectible with celiac and SMA involvement. I am hoping to get the opinion of Dr. Chan if possible that did the Nonoknife procedure.

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