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Who else has had Gem-Abraxane chemo regimen and for how long?

Posted by joiedevivre @joiedevivre, 3 days ago

I am understanding this disease as I journey with my husband who had a distal pancreatectomy and splenectomy. No signs of active cancer activity anywhere other than pancreas; tumour ws stuck to a little wedge of the stomach and that wedge was removed. Jury is out on whether Stage 2B or Stage 4. He was on Folfirinox at first and that caused his CA-19 markers to rise post-surgery. He was switched to Gem-Abraxane and markers came down. It would be encouraging for us to know how many here is on that regime, how long it has been and how well everyone on it is doing. My husband has been on it 10 months and it is "long-term" until it no longer works.

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joiedevivre | @joiedevivre | 1 day ago
In reply to @sheridanb "can I ask how long he did the 3 on/1 off? I'm wondering about bringing this..." + (show)
@sheridanb

can I ask how long he did the 3 on/1 off? I'm wondering about bringing this up to the oncologist, but Dan has only had two months of the 3/1. He starts the third 3/1 on the 26th.
Prior to that he had nearly a year of folfirinox.

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My husband had the 3 on/1 off for 5 cycles (4weeks per cycle) before it got spaced out in August 2024 to fortnightly. Then end-Sept 2024, it was changed to one chemo every 3 weeks. Markers are low-ish and stable. The first month of Gem-Abraxane was the worst. 2 blood transfusions and white blood cell booster jabs. He could not walk 50 yards without sitting down to rest. It got better.

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gracect | @gracect | 1 day ago
In reply to @sheridanb "can I ask how long he did the 3 on/1 off? I'm wondering about bringing this..." + (show)
@sheridanb

can I ask how long he did the 3 on/1 off? I'm wondering about bringing this up to the oncologist, but Dan has only had two months of the 3/1. He starts the third 3/1 on the 26th.
Prior to that he had nearly a year of folfirinox.

Jump to this post

He did 3 weeks in a row for 15 months. It was trial protocol. But because of the platelets he kept having to delay treatment and we were running back and forth to the city so they allowed him to go to every other week. If not for the trial his oncologist would have switched him sooner.
So very much better quality of life with the every other.

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dalegantous | @dalegantous | 1 day ago

Hello all! I had Whipple in February 2024 with clear margins but some lymph node and nerve tissue involvement, then 6 months of Folfirinox from April to September. All the while on Folfirinox my CA19-9 was never higher than 11; but 2 weeks after my last infusion, on October 2nd, metastases was discovered - 2 lesions in my liver and 2 tumors in the soft tissue of my belly. I began Gemcitabene/Abraxane on November 1st, 3 weeks on and 1 week off. Tumors in my belly stopped hurting after the first infusion, and CA19-9 started to come down. Only side effect during the first cycle was diarrhea, controllable with loperamide. Second cycle was different, no diarrhea and I started getting fevers. After 2nd infusion I had a high fever and my liver ALT enzyme shot up to 519. Had an ultrasound, no sign of duct blockage, and my ALT came back down. Doc said it was likely chemo-induced hepatitis. Doctor cancelled my third infusion and darnit all my belly tumors are starting to hurt again. I'm actually looking forward to my next chemo on December 27th to hopefully knock this back again. Doc is going to reduce the dosage of both my Gem and Abrax. Oh and I do have peripheral neuropathy, it kicked in on my 11th round of Folfirinox. Doc said it would get worse in time and it certainly has, I am trying acupuncture but no improvements yet. And I do ice my fingers and feet during the Abraxane.
I so appreciate everyone's stories and contributions here! Gives me hope.

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mimimmx | @mimimmx | 1 day ago
In reply to @markymarkfl "I was on Folfirinox w/ so-so response before Whipple in 2022. After recurrence, I started Gemcitabine..." + (show)
@markymarkfl

I was on Folfirinox w/ so-so response before Whipple in 2022. After recurrence, I started Gemcitabine + Abraxane + Cisplatin in January 2023. I did that biweekly nonstop except for one treatment missed due to Covid in Feb 2024. Resumed 2 weeks later, continued until April 2024 when I took a 4-month break for a clinical trial.

The trial failed, my tumors grew, and my CA19-9 went from under 100 to almost 2400. I resumed the biweekly GAC in July 2024, and my CA19-9 went down quickly. I missed one round of chemo due to hospitalization in August, but have been going strong on the biweekly schedule since then.

I dropped the Cisplatin about 6 weeks ago, but my CA19-9 has continued downward, reaching 76 yesterday 🙂 on the G+A alone. Cisplatin can be hard on the kidneys and can cause nausea; I had some issue with the kidneys, less with nausea. I'm starting to worry about peripheral neuropathy from the Abraxane though...

My oncologist said most people on the GA alone do 2 or 3 consecutive weeks before a week off. I asked about going 3 weeks between treatments, but he strongly recommended against that, based on the cancer cell life cycle and the CA19-9 rises I saw when I missed a treatment due to Covid and when we tried a 20% reduction in Abraxane for two treatments.

The treatments are still hitting me harder than they used to. I feel like crap for 3-4 days after a GA infusion. We decided to keep the status quo (2 week intervals) so I'd have 10 "better" days between treatments, and give my hemoglobin a little more time to recover. Since my CA19-9 and scans are going in a good direction, we didn't see a need to change at this time.

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Cymbalta has helped my neuropathy.

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199 | @199 | 1 day ago

I have been on gemcitabine/abraxane since the end of July 2022. I had 4 months off but my CA19-9 rose & had to restart in May of 2024. I have now had a total of 59 treatments. At first, I was on 2 on with 1 week off. After several months we switched to every other week until my break Jan-April 2024 & restarted on every other week. My CA 19-9 had gone down to 24.9 but without treatment in Nov due to pneumonia, it started to elevate & is now to 105.2. My oncologist is watching it closely to see if we need to change.
The treatments are not bad, but now I am feeling bone pain and really lousy for about 5 days after each treatment. My blood work remains about as good as in 2022. My CT scans are stable. Just having to really keep an eye on the slowly rising CA19-9.

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1 reply
sheridanb | @sheridanb | 13 hours ago
In reply to @199 "I have been on gemcitabine/abraxane since the end of July 2022. I had 4 months off..." + (show)
@199

I have been on gemcitabine/abraxane since the end of July 2022. I had 4 months off but my CA19-9 rose & had to restart in May of 2024. I have now had a total of 59 treatments. At first, I was on 2 on with 1 week off. After several months we switched to every other week until my break Jan-April 2024 & restarted on every other week. My CA 19-9 had gone down to 24.9 but without treatment in Nov due to pneumonia, it started to elevate & is now to 105.2. My oncologist is watching it closely to see if we need to change.
The treatments are not bad, but now I am feeling bone pain and really lousy for about 5 days after each treatment. My blood work remains about as good as in 2022. My CT scans are stable. Just having to really keep an eye on the slowly rising CA19-9.

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Thank you for sharing.

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