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Anyone on Gemcitabine with Abraxane? How long? Effective?
Pancreatic Cancer | Last Active: Nov 22, 2023 | Replies (157)Comment receiving replies
@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.
Replies to "@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and..."
Our oncologist intends to keep him on the gemabraxane with pamrevulab as long as he has stable disease and no bad side effects. Then the current plan is for Fulforinox, then there is hope that the KRAS studies will pan out- they are very promising but not currently being tested in his lab articulation variant.
I am with you - I wouldn’t stop - cancer is very aggressive- I wouldn’t take a chance if it were up to us.
I often wonder what the record is for treatments with Gemczar & Abraxane? I made it through 14 months of those chemos and it still seems effective. My CT is stable to improved as of last month. Never missed one chemo due to my CBC results; my chemistry panels have been within normal limits and my CA 19-9 went from 450.4 to 18.8. Down to 8 at one time but I think my arthritis and neuropathies may be reasons for it to vary.
We have talked about changing up my therapy but that was long ago and recently we discussed taking a break. I will see my oncologist on the 26th and we can now have a serious conversation about what is next.
I found that what helps with my neuropathy to my lower legs, ankles & feet is acupuncture. The one thing I need to say is that "reversing" the neuropathy is as bad or worse than getting them. Will let you know how that will work out. I tell myself it is good to feel my feet again & then maybe I will feel safe driving again 🙂
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@markymatkfl;
Where is your metastises?
Gem/abraxane has shrunk my 2 tumors and brought CA19-9 to normal range. Surgery next week to remove them One is a definite, one is very very small and not in a sweet spot. But back up plan is to manipulate the area so it can be radiated. This time I WILL go back on chemo. I have not developed resistance to Fulfurinox or Gemzar so will be listening to recommendations from docs here and elsewhere. But, I will not delay for long!