Anyone on Gemcitabine with Abraxane? How long? Effective?

Posted by helenar @helenar, Aug 17, 2022

Hi, I'm Helena from South Africa. I have been diagnosed with PC, stage 4, in March. Tumour between body and tail and with one lesion on my liver.
I have been on Folfirinox for 3months, but it had no effect, allthough my markers came down from 3091 to 357, the tumour increased in size and there is another lesion on my liver.
I have started Gemcitabine with Abraxane.
Has anyone been on Gemcitabine/Abraxane?
If so, how long and how effective is this treatment?

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@markymarkfl

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!

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Thank you so much. That was very helpful!!! I’m glad you are tolerating the treatment. I will need to ask more about the genetics. I don’t think my mom has had all of those tests yet. I know it’s been discussed, Good luck to you and keep fighting.

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@bella71

My mom started chemo about 6 weeks ago. The Dr. says it is to give her a better quality of life and slow the growth of her cancer. The doctor warned us that eventually the chemo would stop working. Does anyone know how long the chemo can keep a person alive? She is stage 4 and she is having scans tomorrow at Mayo Clinic to see if the chemo is even working. She is feeling pretty good , just weak and tired. Pain is under control. Her CA19-9 is 118,800 and has been the exact same number for two weeks. I can only think that at least it stayed the same. The previous number was 50,000. I’m so nervous for the news we will find out tomorrow.

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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

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@sprinter345

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

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This is a little off-topic from the original post, so I apologize in advance for that. I am curious about your husband's current treatment regimen. I am on maintenance chemo, which in my case is Folfirinox minus the oxaliplatin, dosed every other week as always. My CA 19-9 has consistently dropped, but I'm still not into the normal range for results. (I just finished round 10 yesterday, so the CA 19-9 isn't back yet.) Now that your husband's reading is 25, is he still on chemo or a watch-and-wait protocol?

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@bella71

My mom started chemo about 6 weeks ago. The Dr. says it is to give her a better quality of life and slow the growth of her cancer. The doctor warned us that eventually the chemo would stop working. Does anyone know how long the chemo can keep a person alive? She is stage 4 and she is having scans tomorrow at Mayo Clinic to see if the chemo is even working. She is feeling pretty good , just weak and tired. Pain is under control. Her CA19-9 is 118,800 and has been the exact same number for two weeks. I can only think that at least it stayed the same. The previous number was 50,000. I’m so nervous for the news we will find out tomorrow.

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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.

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@ncteacher

This is a little off-topic from the original post, so I apologize in advance for that. I am curious about your husband's current treatment regimen. I am on maintenance chemo, which in my case is Folfirinox minus the oxaliplatin, dosed every other week as always. My CA 19-9 has consistently dropped, but I'm still not into the normal range for results. (I just finished round 10 yesterday, so the CA 19-9 isn't back yet.) Now that your husband's reading is 25, is he still on chemo or a watch-and-wait protocol?

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He is still on chemo and will be until this protocol stops working. The tumor is half the size it was but still very much there, as are the liver lesions.

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@199

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.

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I am on Gem/Abrax currently, 3 weeks on, 1 off. I, too, receive Decadron as a pre-med with Aloxi or Zofran. I was thinking about asking my oncologist to reduce the Decadron dose because I think it causes insomnia. May I ask why your dose was reduced?

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@ken240

I am on Gem/Abrax currently, 3 weeks on, 1 off. I, too, receive Decadron as a pre-med with Aloxi or Zofran. I was thinking about asking my oncologist to reduce the Decadron dose because I think it causes insomnia. May I ask why your dose was reduced?

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I'm not the poster you're querying, but yes, I agree that dexamethasone causes insomnia, at least for the first night or two. I always feel pumped up on the steroid for 24-48 hours, and then it begins to wane. I also think it causes hiccups, as least for me.

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@ncteacher

I'm not the poster you're querying, but yes, I agree that dexamethasone causes insomnia, at least for the first night or two. I always feel pumped up on the steroid for 24-48 hours, and then it begins to wane. I also think it causes hiccups, as least for me.

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ncteacher - Like you (and Ken20), I'm convinced Decadron (dexamethasone) causes insomnia following Gem/Abrax infusions. After my last infusion one week ago I slept only 2 hours that night. Sleeplessness happens every time. No hiccups here however.

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@wjk

ncteacher - Like you (and Ken20), I'm convinced Decadron (dexamethasone) causes insomnia following Gem/Abrax infusions. After my last infusion one week ago I slept only 2 hours that night. Sleeplessness happens every time. No hiccups here however.

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On those sleep-deprived nights, I just camp out on the living room couch with the TV on. I drift in and out as needed. It also helps that my daughter is a night ER nurse, so she's often either awake at work or awake at home, and we can chat while I'm awake.

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@mommacandy

Well my friend's oncologist changed him to the Gemzar/abraxane combo after he received the all clear from the infectious doc regarding the mssa infection he had gotten as a result of the port being put in.. obviously the port was removed, on home IV antibiotics all last week, and got all clear on Monday...so yesterday he got his first treatment with the new combo and I gotta say he tolerated it a whole lot better..
One thing I am concerned about is his ca19 reading has gone up another 1000 in the past month... I get part of that is probably due to his only having the one treatment of chemo before the infection kicked up...Aug 31 it was 32040 yesterday it was 33080..should I be that concerned ?

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@mommacandy, I think you'll appreciate these related discussions:
- Anyone on Gemcitabine with Abraxane? How long? Effective?
https://connect.mayoclinic.org/discussion/gemcitabine-and-abraxane/

- Changing chemo regimen after 4 cycles of Folfirinox?
https://connect.mayoclinic.org/discussion/changing-chemo-regimen-after-4-cycles-of-folfirinox/

Regarding wild fluctuations in CA-19, see these discussions:
- Pancreatic cancer and CA19-9
https://connect.mayoclinic.org/discussion/pancreatic-cancer-and-ca19-9/
- CEA and CA19-9 Results as Predictors of Treatment Outcome
https://connect.mayoclinic.org/discussion/cea-and-ca19-9-results-as-predictors-of-treatment-outcome/
- CA-19 has elevated even more
https://connect.mayoclinic.org/discussion/ca-19-has-elevated-even-more/

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