1. < Pancreatic Cancer

CA 19-9 after two rounds of chemo

Posted by callen76 @callen76, 5 days ago

My mother was diagnosed with pancreatic cancer in August. Her CA 19-9 was 2704 on 9/10/24. In October we were told the cancer had spread to her liver, lymph nodes and abdominal wall. We just received her CA 19-9 results pulled on 12/11/24 and they were 2220. She has had two full rounds of chemo (Abraxane and Gemzar). We have been told this is palliative as there is no cure. Is this test result good news for her?

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markymarkfl | @markymarkfl | 5 days ago

It is good news, because 1) there are a log of cases where CA19-9 actually goes up for a while after initiating chemo; and 2) That's a 16% decrease after "only" two treatments -- pretty good sign of a positive response.

Abraxane + Gemzar (plus Cisplatin for most of the period) has kept my stage-4 PDAC recurrence under reasonably good control for 23 months, with average CA19-9 under 200.

The worst episode was a 4-month break from chemo for a clinical trial, after which my CA19-9 peaked at 2315 and all the tumors being watched increased in size. Upon resuming biweekly chemo in July, it's back under 150. I'll find out this Friday if scans return similarly encouraging results. 🙂

Good luck, and hang in there!

REPLY
2 replies
marienewland | @mnewland99 | 5 days ago

That’s fantastic markymark! So happy to hear that.

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dalegantous | @dalegantous | 5 days ago
In reply to @markymarkfl "It is good news, because 1) there are a log of cases where CA19-9 actually goes..." + (show)
@markymarkfl

It is good news, because 1) there are a log of cases where CA19-9 actually goes up for a while after initiating chemo; and 2) That's a 16% decrease after "only" two treatments -- pretty good sign of a positive response.

Abraxane + Gemzar (plus Cisplatin for most of the period) has kept my stage-4 PDAC recurrence under reasonably good control for 23 months, with average CA19-9 under 200.

The worst episode was a 4-month break from chemo for a clinical trial, after which my CA19-9 peaked at 2315 and all the tumors being watched increased in size. Upon resuming biweekly chemo in July, it's back under 150. I'll find out this Friday if scans return similarly encouraging results. 🙂

Good luck, and hang in there!

Jump to this post

Hi @markymarkfl, very encouraging!! You mention biweekly chemo, is that Gemcitabene/Abraxane given every 2nd week? I am on Gem/Abrax given every week for 3 weeks then 1 week off and it is bringing my CA19-9 down (from 195 now 78) so I am encouraged! But in my 2nd cycle, after the 2nd infusion, I had fever and my ALT spiked to 519. No infection, just a reaction to chemo, white blood count all good. My oncologist cancelled my third infusion to give me a chance to recover, bloodwork showed ALT came back down to 98. So I'm wondering whether Gem/Abrax every 2 weeks might be a different protocol that I could follow, is that what you're on? Thank you!!

REPLY
2 replies
199 | @199 | 5 days ago
In reply to @dalegantous "Hi @markymarkfl, very encouraging!! You mention biweekly chemo, is that Gemcitabene/Abraxane given every 2nd week? I..." + (show)
@dalegantous

Hi @markymarkfl, very encouraging!! You mention biweekly chemo, is that Gemcitabene/Abraxane given every 2nd week? I am on Gem/Abrax given every week for 3 weeks then 1 week off and it is bringing my CA19-9 down (from 195 now 78) so I am encouraged! But in my 2nd cycle, after the 2nd infusion, I had fever and my ALT spiked to 519. No infection, just a reaction to chemo, white blood count all good. My oncologist cancelled my third infusion to give me a chance to recover, bloodwork showed ALT came back down to 98. So I'm wondering whether Gem/Abrax every 2 weeks might be a different protocol that I could follow, is that what you're on? Thank you!!

Jump to this post

When I started in July of 2022 my oncologist said he preferred 2 weeks on and 1 off because he found a lot of patients could not tolerated the 3 on/1 off as well. Later I was switched to every other week for Gem/Abrax.

REPLY
1 reply
carneydh | @carneydh | 5 days ago
In reply to @markymarkfl "It is good news, because 1) there are a log of cases where CA19-9 actually goes..." + (show)
@markymarkfl

It is good news, because 1) there are a log of cases where CA19-9 actually goes up for a while after initiating chemo; and 2) That's a 16% decrease after "only" two treatments -- pretty good sign of a positive response.

Abraxane + Gemzar (plus Cisplatin for most of the period) has kept my stage-4 PDAC recurrence under reasonably good control for 23 months, with average CA19-9 under 200.

The worst episode was a 4-month break from chemo for a clinical trial, after which my CA19-9 peaked at 2315 and all the tumors being watched increased in size. Upon resuming biweekly chemo in July, it's back under 150. I'll find out this Friday if scans return similarly encouraging results. 🙂

Good luck, and hang in there!

Jump to this post

Good luck with your scans

REPLY
markymarkfl | @markymarkfl | 4 days ago
In reply to @199 "When I started in July of 2022 my oncologist said he preferred 2 weeks on and..." + (show)
@199

When I started in July of 2022 my oncologist said he preferred 2 weeks on and 1 off because he found a lot of patients could not tolerated the 3 on/1 off as well. Later I was switched to every other week for Gem/Abrax.

Jump to this post

My post-recurrence regimen was Gem+Abrax+Cisplatin every other week.

I've seen a lot of people with Gem+Abrax using the 3-on / 1-off protocol, but that might be a bit too harsh when cisplatin is included. It's also possible my oncologist just scheduled me bi-weekly because of how far I drive for each chemo treatment.

We dropped the cisplatin about 6 weeks ago, but I'm still on the biweekly schedule. My CA19-9 has continued to drop, so we're trying to assess how much "work" the cisplatin was actually doing. As long as my CA19 is stable or drops w/o cisplatin, I'll continue leaving it out. If numbers go up, I'll resume cisplatin and see if there's a response.

REPLY
revdebb | @revdebb | 4 days ago
In reply to @dalegantous "Hi @markymarkfl, very encouraging!! You mention biweekly chemo, is that Gemcitabene/Abraxane given every 2nd week? I..." + (show)
@dalegantous

Hi @markymarkfl, very encouraging!! You mention biweekly chemo, is that Gemcitabene/Abraxane given every 2nd week? I am on Gem/Abrax given every week for 3 weeks then 1 week off and it is bringing my CA19-9 down (from 195 now 78) so I am encouraged! But in my 2nd cycle, after the 2nd infusion, I had fever and my ALT spiked to 519. No infection, just a reaction to chemo, white blood count all good. My oncologist cancelled my third infusion to give me a chance to recover, bloodwork showed ALT came back down to 98. So I'm wondering whether Gem/Abrax every 2 weeks might be a different protocol that I could follow, is that what you're on? Thank you!!

Jump to this post

I briefly tried Cisplatin on a 2 in a row / 1 week off schedule and had numbers like white blood cell count drop too low. When I switched to Abraxane and Gemsar, the oncologist opted for every other week, feeling that we already knew that I didn’t tolerate having chemo 2 weeks in a row. Every other week works well and gives me a chance for some good days in between.

REPLY
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