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My HIPEC experience and pancreatic cancer

Pancreatic Cancer | Last Active: Jul 8, 2023 | Replies (13)
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@gamaryanne

Signatera at .04 positive and tumor marker up at 207. Scans identified a penny-size anterior met on liver. Possible second (tik tac size) close to surgical site. John’s Hopkins and my doctors say GEMZAR now to target systemic attitude of the disease. 2nd round tomorrow and will discuss what is next if shrinkage shows. They are now saying two cycles (2 months) before discussing next steps. I have KRAS which does not seem to have solid trials available once one has had curative surgeries. If anyone knows of something different, pls post. Much interesting research underway at JH for BRCA mutations

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Replies to "Signatera at .04 positive and tumor marker up at 207. Scans identified a penny-size anterior met..."
markymarkfl | @markymarkfl | Jul 8, 2023

@gamaryanne , sorry to hear that. It sounds a lot like my story -- NED for 3.5 months including Signatera negative with similar CA9-9 levels and trends, then a recurrence confirmed at original site plus mets. 🙁

I don't know if you could handle a treatment more aggressive than GEMZAR alone, or would want to. In my case, the immediate chemo recommendation was for biweekly Gemzar (Gemcitabine) plus Abraxane, with Cisplatin on top of that to target my ATM mutation. It has brought my CA19-9 down from about 677 to 55 over 5 months and Signatera down from 0.14 to 0.00 (negative), but still a little iffy on the MRI. I will know more in a week (new scans and new Signatera).

You might qualify for this trial https://classic.clinicaltrials.gov/ct2/show/NCT04605913 which adds Tumor Treatment Fields (TTF) equipment to my regimen above, but appears to only be available at Mayo in Jacksonville.

There's a new and exciting trial underway using CAR T cells called BASECAMP https://classic.clinicaltrials.gov/ct2/show/NCT04981119 which would check your blood to see if you're eligible for treatment in a follow-on study called EVEREST https://classic.clinicaltrials.gov/ct2/show/NCT05736731 .

Of course, you're reading the HIPEC thread, so depending on the location and extent of your mets, and your ability to tolerate the surgery, this might also be an option if you hook up with the right medical team. I appear to be ineligible for EVEREST, but similar cellular trials are said to be in the works. Until something like that comes through, I will continue barking up the other trees (TTF or HIPEC).

If your only other confirmed mets are in the liver, maybe they could be treated concurrently with radiation or Y-90... (?)

Wishing you the best, and hoping you'll keep us posted.

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