Folfirinox is generally considered a harder chemo treatment to tolerate than Gemcitabine + Abraxane (GA). I started GA + Cisplatin 2 years ago after my post-Whipple recurrence with metastasis, and am doing well on it -- better than I did pre-Whipple on Folfirinox. It depends a lot on the patient (individual responses vary widely). Wish I had done the GAC before Whipple.

My husband is on Gem-Abraxane; has been for almost a year - 3-week intervals between sessions now but initially once a week for 3 weeks a month and then once a fortnight before oncologist spaced it out to once every 3 weeks. He did not respond well to Folfirinox. Like many people have said on this forum, it depends on the individual. Gem-Abraxane works for my husband. I am told that the reason the oncologist is doing this long-term is because pancreatic cancer is aggressive and oncologist does not know if there are cancer cells still in the body after surgery to remove the tumour.

The combination Gemzar/Abraxane is much more effective as a combination. I was given just Gemzar alone initially in 2012 after my Whipple surgery as Abraxane was not yet FDA approved and that’s when the trouble started.

Having one positive lymph node positive indicates metastatic cells broke off from the primary tumor. That increases the chance there could have been undetected circulating tumor cells that are micrometastatic and undetected due to the limitation of the sensitivity of imaging systems. The combination Gemzar/Abraxane is added insurance to eliminate and undetected minimal residual disease which is implicated in recurrence in up to 80% of patients within two years post Whipple and adjuvant chemotherapy.