Everyone responds differently, but I was confirmed Stage-4 last January, and have spent the last 8 months quite healthy (except for baldness, fatigue, and neuropathy) on Gem/Abrax/Cis. I'm very fortunate so far my only ill effects are from the chemo and not from the cancer, but I'll take that any day!

I've heard this regimen often becomes intolerable or ineffective after 6-9 months. I'm about to have my 19th biweekly treatment, but another member posted here not too long ago about doing well after #33 and counting.

There is a lot of hope for longevity if the right things go well, and pre-planning the next treatment option if they don't. A lot of that depends on things like genetic mutations she might have. For example, with the ATM mutation, it made sense for my oncologist to add cisplatin to the Gem/Abrax. I'm looking at every clinical trial possible for when/if this runs out of gas for me.

Make sure to ask the oncologists about the options and next steps when they go over the scan results with you tomorrow.

Best wishes to you both!

My husband is now on twice a month due to platelet issues. He is the one formerly 33 treatments on here. He did 3 times per month and has been twice a month since June. Still responding/stable disease- 19-9 down from over 5000 to 25.
The 19-9 does often go up after a couple cycles in the beginning due to the treatment working and the cancer cells shedding, as I understand it. Happened to us and it’s alarming.
God bless

Last week I finished my 38th chemo with Gemcitabine & Abraxane for stage 4 inoperable pancreatic cancer started in tail & went to lungs. I started end of July 2022. My CA 19-9 is within normal limits at 18. My CT shows improvement. The worse pains I have had are bone pain and neuropathy from the chemo. I am bald & due have fatigue, but I am still here 🙂 Just had my dose of Abraxane and Decadron reduced, and the schedule changed from 2 weeks on & one off to one on & one off. Will see how that goes. I get Decadron & Aloxi prior to the Abraxane, then normal saline flush & gemcitabine. Would love to have a break soon but will see what my oncologist says. Only taking Percocet & Tramadol for pain so far. Lately I have been taking one of each in the morning, mid-afternoon & 2 in the evening either together or spaced depending on the severity of the pain.

Yes! First night(Friday) I’m ready to go out to dinner stay up all night! But Saturday afternoon when the Onpro shot goes off it’s downhill for two days. Very predictable. I guess the steroid gets us out of the doctor’s office with no complaints until Monday!

@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and get home feeling OK, relax on the weekend, then crash and have to take Monday off work.

I did reduce the decadron in my pre-meds by about 1/3 several months ago because of its impact on my blood sugar. That and a long drive home might be suppressing my insomnia. I do have dexamethasone tablets at home as a backup to Zofran. I rarely take them, but if so, only in the morning because of the insomnia.

@sprinter345 and @199 -- You are true marathon champions. Have your oncologists discussed switching treatments or reducing/eliminating any of your chemo meds?

I've heard the Gem/Abrax (+/- cisplatin) is usually only good for 6-9 months before it either becomes intolerable (neuropathy) or ineffective (cancer develops resistance). My docs have said they have an answer for every side effect but neuropathy, which I accept as a tradeoff for the other positives of treatment.

My CA19-9 leveled off around 40 for about 8 weeks, and two oncologists both started discussing "maintenance therapies" for me, suggesting the Abraxane/cisplatin had done all they were going to do. This would mean reducing/eliminating one/other/both and likely going to nothing but Gem. And then, my CA19-9 this week dropped to 33 -- two points inside the normal range! (Previous week's scans still report "stable disease" and Signatera detects no ctDNA.)

I don't think this regimen has run out of gas yet. I fear if I back off of anything it will give the cancer a chance to regroup and spread. 19 treatments haven't killed me yet. I was ruled out as a candidate for HIPEC, and I might be a candidate for some trials in the distant future, but I don't see anything on the horizon with more promise than what I'm currently on.

Would love and appreciate your insights on this.

@sprinter345 -- Thank you for that! Is the pamrevulab approved yet, or just part of a clinical trial?

@gamaryanne -- It's hard to follow all the radiology reports because of changes in terminology and landmarks, and nothing has a definitive, positive biopsy, so everything is just based on imaging, but there are suspicious lesions or nodules or masses or deposits at the original surgical site (head of pancreas); tail of pancreas; central mesentery; peritoneal wall; liver; spleen; paracolic gutters, and other parts of the anatomy I've never heard of!