Any experiences with Gemcitabine + Abraxane as second line treatment?

My husband did 6 months of folfironox, then a reduced regimen of it until numbers started going up. His cancer had spread to lungs and bones/spine before diagnosis so that part was different than what you describe. Other than hair loss I don't think the abrax/gem was as debilitating with side effects, however unfortunately it did not work for him. The oncologist had an experimental drug that he was going to try next but his cancer got him first. Other people on this forum have had success for many, many months/years with gem/abrax so I am wishing the best for you.

@sheridanb
I was diagnosed with stage IIB pancreatic cancer, the most common kind, in 2016. I was put on gemcitabine and Abraxane for four months of neoadjuvant chemotherapy. I tolerated it very well. My CA 19-9 went from 1300 to 20-25, and I went on to the Whipple surgery. As you know, we are all different. Good luck.

My wife PC stage 4, met to her intestines, could not tolerate Folfiri ox when she first was diagnosed 2 + years ago. She switched to Gem/Abrax and it gave her two years of life with moderate side effects, mostly fatigue and some nausea. It stopped working two months ago, and she is trying a low dose of Folfiri. Side effects still quite harsh. What she needs in the Revolution Medicines pill, but they aren’t releasing it ahead of completion of clinical trials. Understand their position, but it comes with a fatal blow to current sufferers.

@castell Did surgery go fairly well for you?

Did gem-abraxane-cisplatin in 2024 for 9 months and then just gem-Abrax for remaining 3 months in 2024. Got 2 chemo treatment a month. Nausea and weakness for 9 months, but it was only for first 3 days after chemo treatment. Developed neuropathy in foot in December, but most of it went away by late January 2025. Cancer free (due to MRIdean radiation tx in October 2024). Got peritoneal cancer in April 2025 and went back on abraxanxe-gem but this was new oncologist and I was put on 3 weeks in a row prob cause my ca19-9 was around 14,000 at the time. I was on it full strength (as opposed to a 60% dosage) from August 2025 - December 2025. Last treatment was Dec.11th. Got very bad hematuria and severe cystitis which I learned from my visit with infectious disease dr can be a rare side effect from gem. I went through that for 3 horrible months before I looked it up myself on internet and found out it was true that gem can cause that. Then Abrax hit me like a ton of bricks and I couldn't walk due to neuropathy and it affected my hands (still not working). I had to tell my oncologist that my consulting oncologist from UCLA said to take a 1 month break from chemo. I also got internal neuropathy which I'm still suffering from. I think the 3 weeks of treatment in a row for that many months was too strong for me and I should have been taken off and switched to 2 weeks per month when i started to show the side effects. I've been off chemo for almost 3 months now and I think my liver lesions are back and peritoneal nodules are growing. I'm looking for a clinical trial mow that offers Zolbetuximab with folfirnox that will address the CLD18.2 protein I have that can cause stomach cancer and I'll do radiation again on tne liver lesions. I'm probably the worst case example of side effects from gem abraxane, so there you have it. I wish you much better luck!!

@casey1959

I was borderline resectable when first diagnosed (age 72) because tumor (just under 3 cms) was touching (but not encircling) the mesenteric vein. At the end of the four months of neoadjuvant chemo, three experienced surgeons could see I was eligible for immediate surgery (without going to radiation first).

I was at the Kaiser Hospital in San Francisco. (Subsequently I exchanged letters with the head of the hospital: she told me they had decided to specialize in hepatobiliary surgeries and patient outcomes had improved.)

I was in the hospital for a week -- no complications. I left without drains or attachments. I went back on chemo (largely gemcitabine) for six months. It was a couple of months before I could walk at my usual speed.

I was diagnosed more than seven years ago and entered a clinical trial that included triplet chemotherapy — Gemcitabine, Abraxane, and Cisplatin — along with vitamin D. I received treatment two weeks on and one week off for 18 weeks, followed by 33 days of radiation.

I am now seven years and two months from diagnosis and remain on 5-FU every 14 days, infused over 46 hours. I do live with some neuropathy from treatment, which is a reminder that chemotherapy leaves its mark, but it has been manageable. My CA 19-9 remains within the normal range; the most recent value was 20.

What I have learned is this: chemotherapy is a strange companion. It saves you while it drains you. It brings hope while it takes strength. I learned to show up for infusions not because I wanted to, but because it mattered.

One practical lesson I’ve learned is the importance of seeking care from specialists who focus on pancreatic cancer. There are only a limited number of centers with deep experience in this disease. A second opinion at Mayo Clinic in Rochester is a very good idea. Having a pancreatic cancer specialist review your case can be essential, even if you ultimately continue treatment close to home.

I wish you strength and clarity as you move forward, and I am here if you ever want to talk.

Michael

@mcharlesfrancis
That's amazing, 7 years. He tells everyone he's going to make it 15yrs and I sure hope he's right. Had yours metastasized at all? This has just been such a roller-coaster ride. I'm worried what the future holds.

I don’t know how long I’m going to be. I take one day at a time and I was very lucky. I was diagnosed at stage 2B not metastasized. The only reason I was considered 3B is because my tumor was surrounding my superior Masonary artery by 180°.

@williebadger, you may also be interested in this related discussion:
- Anyone on Gemcitabine with Abraxane? How long? Effective? https://connect.mayoclinic.org/discussion/gemcitabine-and-abraxane/

See all: https://connect.mayoclinic.org/search/discussions/

How is he doing after starting Gemcitabine + Abraxane? How are YOU doing?