← Return to Anyone on Gemcitabine with Abraxane? How long? Effective?

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@mmpace

Looking forward to hearing from others regarding this. My diagnosis is PCAC, metasticized to liver, with the rarer KRAS G12C mutation.
Folfirinox was determined to not be effective enough after 4 months (still some progression in the liver.) I did not tolerate that regimen well. Made me increasingly sick over the 14 day cycle.
Wondering about others’ experiences were/are moving to Gemcitabine/Abraxane.
Did you tolerate Folfirinox well or not as first line? Did you/do you tolerate G/A well or better than Folfirinox?
My other option is a clinical trial that targets the mutation, but it is Phase 1 and there is no historical data on it particularly as it relates to Pancreatic Cancer. It might be more tolerated but total shot in the dark.
Many thanks for sharing your experiences.

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Replies to "Looking forward to hearing from others regarding this. My diagnosis is PCAC, metasticized to liver, with..."

Long story short:

I did 6 months (12 rounds) of Folfirinox before Whipple for PDAC. No obvious progression was ever detected on scans. Post-op analysis of the tumor rated treatment as a "partial response" (2 on a scale from 1-3).

I've done about 17 biweekly rounds of Gemcitabine + Abraxane + Cisplatin since my recurrence in January. I'm tolerating it better than I did the Folfirinox, and am seeing _much_ better reduction in CA19-9. FWIW, I have the ATM mutation.

My sequence of imaging reports are not totally consistent from one to the next. It seems there are more "lesions" noted on newer scans, but they've been calling it "stable disease" for the last 5 months. Will have more scans in 2 weeks and new data then.

As far as trials go, I'm keeping them on the future radar, but trying to stick with the most "conventional" treatments first. It seems like any of the treatments that alter your immune system (mRNA shot, CAR-T or NK cellular treatments) might disqualify you from other future trials.

mmpace - I have adenocarcinoma (Stage 1b) at the head of my pancreas. I had to discontinue neoadjuvant Folfirinox infusions after only four cycles. Though the Folfirinox was effective (some shrinkage of tumor and falling CA 19.9 numbers), I recently had to switch to Gemcitabine/Abraxane due to increasingly severe allergic reactions. The mostly different side effects of the Gem/Abrax have been easier to handle than those of Folfirinox. The effectiveness of Gem/Abrax for me has not yet been determined.

@mmpace, I hope you saw the helpful replies from @markymarkfl and @wjk. I moved your question about changing from Folfirinox to Gemcitabine/Abraxane to this existing discussion:
– Anyone on Gemcitabine with Abraxane? How long? Effective? https://connect.mayoclinic.org/discussion/gemcitabine-and-abraxane/

I did this so you can read previous helpful posts and connect easily with others who have experience with this regimen.

Did you decide to try the clinical trial or opt for Gemcitabine/Abraxane? How are you doing?