ONIVYDE irinotecan liposome

Posted by beachdog @beachdog, Dec 14, 2021

Has anyone here been treated with Onivyde? After 10 treatments with gemcitibine/abraxane/cisplaten and 8 treatments with gemcitibine/abraxane, my wife's CA19-9 is still climbing and a lung nodule has grown 30% in 6 weeks since the last CT.

Today the oncologist presented 2 options. Switch to Onavyde + 5fu, OR, some yet unidentified clinical trial.

The Onivyde is supposed to be a reformulated irinotican which is more well tolerated. My wife's pre-surgery regimen was folfirinox (9 treatments) which included the old irinotican + 5fu + oxalyplaten. It worked well dropping the CA19-9 below 35 and making the tumor operable.

We've been asking the oncologist about switching back to folfirinox because the gemcitibine/abraxane has not worked and this Onivyde + f5u might be a good option.

She has also just started the screening process for a clinical trial but it will be awhile before we know the details and whether they accept her. The clinical trials have appeal because they are targeted therapies based on specifiecally identified tumor mutations rather than the nuclear approach of the tradioinal chemos.

Any comments on the Onivyde?

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

Almost exact same for my wife. She just started Onavyde + 5fu last week, and don't know yet the results but the side effects have been much less than when she was on irinotican + 5fu + oxalyplaten. We'll know after a full cycle and a scan. Hoping for the best as she has had most all chemos available for metastatic pancreatic cancer. She was diagnosed in July 2015, had whipple in Dec. 2015 and was cancer free until June 2018 when a spot showed on her lungs during a 6 month scan.
Been in treatment since. Her 19-9 #'s continued to grow while on gemzar/abraxane for the last 6 months but tumors stayed stable until last scan, thus the change to Onavyde + 5fu. Hoping it works and finding a trial that looks promising that she might qualify for

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Yes, very similar pattern and treatment regimens. Your wife had a longer NED interval than my wife. Her post distal pancreatectomy surgery CA19-9s increased very gradually for 10 months then rocketed up for 2 months when a scan revealed an ovarian tumor. After the ovary surgery the GAC and GA cycles initially dropped the CA19-9s but they never got below 200 before starting a rapid rise.

The same day that our local oncologist told us about ONIVYDE, the Moffitt Cancer Center contacted us about a trial. We'll probably start the ONIVYDE while she goes through the extensive screening for trial eligibility.

Happy to hear your wife has easier side effects so far. We'll pray she gets good results. Let's keep each other posted here.

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I am reading about clinical trial eligibility. Is this something y’all did on your own or did the doctor help with that? If not, how do you know which is best for the biomarkers a person has. My husband has stage IV pancreatic cancer and was diagnosed in June 2021 with start of 5flu with oxiplatin and irinatican which did not shrink tumors but did not allow much growth either. He has had about 3 cycles of Gemzar/Abraxane and it does not make him as sick. They just added cisplatin to the mix. He’s 62 and is in good shape-other than being sick from chemo and losing about 40 lbs. He’s a fighter and has a good attitude but this stuff is rough. I wish y’all the best. Hopefully they will come up with something that will cure this awful mess.

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@cindysavant

I am reading about clinical trial eligibility. Is this something y’all did on your own or did the doctor help with that? If not, how do you know which is best for the biomarkers a person has. My husband has stage IV pancreatic cancer and was diagnosed in June 2021 with start of 5flu with oxiplatin and irinatican which did not shrink tumors but did not allow much growth either. He has had about 3 cycles of Gemzar/Abraxane and it does not make him as sick. They just added cisplatin to the mix. He’s 62 and is in good shape-other than being sick from chemo and losing about 40 lbs. He’s a fighter and has a good attitude but this stuff is rough. I wish y’all the best. Hopefully they will come up with something that will cure this awful mess.

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Here is a great source for trial info, Pancreatic Cancer Action Network,

pancan.org

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@beachdog

Yes, very similar pattern and treatment regimens. Your wife had a longer NED interval than my wife. Her post distal pancreatectomy surgery CA19-9s increased very gradually for 10 months then rocketed up for 2 months when a scan revealed an ovarian tumor. After the ovary surgery the GAC and GA cycles initially dropped the CA19-9s but they never got below 200 before starting a rapid rise.

The same day that our local oncologist told us about ONIVYDE, the Moffitt Cancer Center contacted us about a trial. We'll probably start the ONIVYDE while she goes through the extensive screening for trial eligibility.

Happy to hear your wife has easier side effects so far. We'll pray she gets good results. Let's keep each other posted here.

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Will do. Also she has been on Creon since surgery in 2015 and has been very good for her.

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@cindysavant

I am reading about clinical trial eligibility. Is this something y’all did on your own or did the doctor help with that? If not, how do you know which is best for the biomarkers a person has. My husband has stage IV pancreatic cancer and was diagnosed in June 2021 with start of 5flu with oxiplatin and irinatican which did not shrink tumors but did not allow much growth either. He has had about 3 cycles of Gemzar/Abraxane and it does not make him as sick. They just added cisplatin to the mix. He’s 62 and is in good shape-other than being sick from chemo and losing about 40 lbs. He’s a fighter and has a good attitude but this stuff is rough. I wish y’all the best. Hopefully they will come up with something that will cure this awful mess.

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@cindysavant As posted above pancan.org can help. If you have DNA analysis of biopsies, they'll review them and identify appropriate trials. Depending on where you live, you can also contact a National Cancer Institute Research Center (there are 71 in the US) and get screened there.

To answer your question, we have done all of the above. At Johns Hopkins, they automatically identified trials for us when they completed the DNA analysis. Our local oncologist needs to be handed trials we've identified for his review. When we went to the Moffitt Cancer Center they also identified trials and picked one we should explore.

Good luck and prayers for your husband. Cisplaten is very rough. My wife had 9 treatments with oxalyplaten and 10 with cisplaten and the side effects are very rough.

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Sorry I am just now seeing this. Day 5 after the first dose of cisplatin and it is rough. Hate to see him feeling bad. Has felt really bad since Saturday. Hoping he will feel better soon as chemo is definitely rough on a person. Thanks for sharing. I will check into all that you mentioned.

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