Pancreatic Cancer spread to the liver: What's next?

I was Stage 1b after distal pancreatectomy and splenectomy. I was on Folferinox for six months, after which a scan showed spread to liver. I was switched meds at that time to gemcitabine and Abraxane for another six months, which was not successful in containing progression in the liver. That is my experience, and everyone reacts differently. I hope this is helpful. Best wishes.

Did the doctor tried other therapies like radiation with both chemo drug failure to contain? I am asking my doctor to see that is an option.

In my case, besides the liver, there was also a small mass on the sutured portion of my pancreas, so, although I asked about radiation, oncologist thought cancer might spread to other areas, hence the concentration on chemotherapy. However, I believe we patients should ask as many questions as we have. Best wishes.

Hello ken240,
I'm in a similar situation. Distal/splenectomy followed by 5FU for 6 months; spread to my liver and abdominal peritoneal area. I recently started gem-abraxane-cis, but based on how aggressive my type is, I don't expect full containment. My hope is when it proves unsuccessful that I'm strong enough to enter a clinical trial. I switched my care this year from Hoag to UCLA (though UCLA asked me to get my chemo sessions at their facility in Orange County).
There are some new clinical trials starting. Has your dr. suggested you try a clinical trial?

I forgot to add that my UCLA oncologist (not the Hoag one) is not having me do radiation (because of too much spread, I think), and is having me do "3 months of intensive chemo".

FWIW, my oncologist has said several times that radiation is inappropriate for me because my cancer was beyond the pancreas. The surgeon saw several small, flat lesions during staging laparoscopy, although no lesions have ever appeared on the CT scan, only the main tumor. My MD said the beam can't be targeted enough to attack all the cells and that high-dose radiation could actually make me sicker. So chemo is our plan of choice. That said, I have seen posts here about people with cancer spread receiving chemo and radiation together, or one following the other, or HIPEC (heated intraperitoneal chemo), and my MD has said all of those are inappropriate in my situation. So, yes, it's definitely worth asking questions and exploring options, but it's also probably worth getting into chemo ASAP in order to keep the cells under control or, better yet, kill them off. (I'm not a medical professional of any type, so please take what I say with many grains of salt!)

Yes, the oncologist first suggested clinical trials back in late October. Travel during winter (I am in New England) and time commitment dissuaded me, but I still research possible trials closer to home.

I am also being treated at UCLA. I was asked to sign up for the following clinical trials:
https://classic.clinicaltrials.gov/ct2/show/NCT05156866
https://www.uclahealth.org/clinical-trials/first-human-study-torl-2-307-adc-participants-with-advanced.

Hi

I was diagnosed in May 2023 with stage 4 PDAC with large mass in pancreas body and lots of lesions throughout my liver. Subsequent genetic test showed brca2 mutation.

I had 8 rounds of folfirinox, 2 rounds of gem / cis and 2 rounds gem / carb.. changed regime due to neuropathy.

My lesions have all shrunk significantly and some have disappeared. So chemo has worked for me without other treatments. I am now on a chemo break for a couple of months before next CT mid Feb.

I am also looking at clinical trial options.

Good luck.

@spicerpa please find Steve Merlin. He is a long term warrior and went to UPenn to fight braca mutation. He is on Facebook and I think pancan site. He will share information to help. Bless all of us.