I had 12 bi-weekly mFolfirinox over 6 months between Oct 2021 and May 2022, Whipple in June 2022.

Appeared to be NED from then until Oct 2022, with recurrence in surgical bed and a possible met in the abdomen.

I began biweekly Gemcitabine + Abraxane + Cisplatin in Jan 2023, continued until Apr 2024. We tried a slight reduction in Abraxane dose around Feb 2024, but saw an immediate increase in CA19-9 and restored the original, full dose, which brought the numbers down again.

Took a 4-month break (Apr 2024 - July 2024) for a clinical trial that failed.

Resumed biweekly G+A+C late July 2024. I've missed a few of the biweekly treatments or stretched them beyond the prescribed 14 day intervals due to hospitalization for other issues and family events, but am still going strong and getting another round tomorrow. CA19-9 is getting worse fast, so we might soon declare this regimen ineffective due to resistance.

CA19-9 fluctuated between 116 and 236 while on mFolfironox, trending upward over that time. CA19-9 peaked at 2315 after my clinical trial failure, and G+A+C brought it down to 60 from there at one point, so the GAC has been far more effective based on that criteria.

My blood counts have dropped on occasion on the GAC, but never enough to skip a chemo session. Most notable is hemoglobin and hematocrit, which tend to track each other. I've had hemoglobin hover just barely over 8.0 for quite a while, with drops as low as 6.7 last Christmas. I've had about 4 blood transfusions over the last few years to address that, but am not getting injections of Aranesp to bring it up; finally saw a 10.0 on that blood test today! Ideal range is above 13.2, but they don't aim for that because of the increased risk for blood clots.