1. < Pancreatic Cancer

Does order of chemo drugs matter?

Posted by sheridanb @sheridanb, Dec 4, 2024

Just curious. My husband started on gemcitabine and Abraxane last month. Three weeks on, one off. He had been on folfirinox for the past year ... part of that time on a reduced maintenance combination. Rise in CA19-9 numbers and new growth seen on scans, so starting gem/abrax. Anyway, noticed that twice in infusion he received the gem first, and the last time he got the abrax first. Does it make a difference? Thanks.

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markymarkfl | @markymarkfl | Dec 4, 2024

The infusion nurse I asked a few months ago thought the order matters, but didn't have a definitive answer or reason why.

I've always gotten my 3 drugs in the same order (coincidentally, alphabetical):
Abraxane (over 30 minutes)
Cisplatin (over 60 minutes)
Gemcitabine (over 30 minutes)

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1 reply
sheridanb | @sheridanb | Dec 4, 2024
In reply to @markymarkfl "The infusion nurse I asked a few months ago thought the order matters, but didn't have..." + (show)
@markymarkfl

The infusion nurse I asked a few months ago thought the order matters, but didn't have a definitive answer or reason why.

I've always gotten my 3 drugs in the same order (coincidentally, alphabetical):
Abraxane (over 30 minutes)
Cisplatin (over 60 minutes)
Gemcitabine (over 30 minutes)

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Thank you. Infusion day tomorrow, so I'll be asking also.

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sheridanb | @sheridanb | Dec 5, 2024

Nurses here today told us they looked it up, and for the two drugs Dan receives, it doesn't matter which order. Good to know.

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sheridanb | @sheridanb | Jan 3 2:23pm

Correction:
I'd asked a while back if the order of drugs given matter in the weekly infusions. The nurse at that time told me, no, doesn't matter with Abrax and Gemzar. So yesterday, a different nurse was delaying the infusions as she said we need the Abraxane first. I told her the other nurse had reported it didn't matter. I could tell this one was pretty certain she was right, but she called the pharmacist to make sure.... and yes, do the Abraxane first.
Just wanted to correct what I had reported before.

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2 replies
markymarkfl | @markymarkfl | Jan 3 7:25pm
In reply to @sheridanb "Correction: I'd asked a while back if the order of drugs given matter in the weekly..." + (show)
@sheridanb

Correction:
I'd asked a while back if the order of drugs given matter in the weekly infusions. The nurse at that time told me, no, doesn't matter with Abrax and Gemzar. So yesterday, a different nurse was delaying the infusions as she said we need the Abraxane first. I told her the other nurse had reported it didn't matter. I could tell this one was pretty certain she was right, but she called the pharmacist to make sure.... and yes, do the Abraxane first.
Just wanted to correct what I had reported before.

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Thank you for the follow-up!

Mine had been delivered in alphabetical order (Abraxane, Cisplatin, Gemcitabine). Since dropping the Cisplatin, it's still Abraxane first, followed by Gem.

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1 reply
199 | @199 | Jan 4 11:29am
In reply to @markymarkfl "Thank you for the follow-up! Mine had been delivered in alphabetical order (Abraxane, Cisplatin, Gemcitabine). Since..." + (show)
@markymarkfl

Thank you for the follow-up!

Mine had been delivered in alphabetical order (Abraxane, Cisplatin, Gemcitabine). Since dropping the Cisplatin, it's still Abraxane first, followed by Gem.

Jump to this post

I always get my Abraxane first followed by the Gemcitabine.

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marienewland | @mnewland99 | Jan 4 11:51am
In reply to @sheridanb "Correction: I'd asked a while back if the order of drugs given matter in the weekly..." + (show)
@sheridanb

Correction:
I'd asked a while back if the order of drugs given matter in the weekly infusions. The nurse at that time told me, no, doesn't matter with Abrax and Gemzar. So yesterday, a different nurse was delaying the infusions as she said we need the Abraxane first. I told her the other nurse had reported it didn't matter. I could tell this one was pretty certain she was right, but she called the pharmacist to make sure.... and yes, do the Abraxane first.
Just wanted to correct what I had reported before.

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Interesting. I get the gem first. What’s the reason for the difference of order when they follow each other right after the other?

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1 reply
sheridanb | @sheridanb | Jan 4 12:15pm
In reply to @mnewland99 "Interesting. I get the gem first. What’s the reason for the difference of order when they..." + (show)
@mnewland99

Interesting. I get the gem first. What’s the reason for the difference of order when they follow each other right after the other?

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I don't know. As I said, the one nurse a few weeks ago felt it made no difference and my husband these past couple months has gotten whichever drug arrives first. But now that the nurse this week, and verified by the pharmacist, say do abrax first... I will continue to ask that it be done that way. But I don't know reasoning.

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1 reply
marienewland | @mnewland99 | Jan 4 12:45pm
In reply to @sheridanb "I don't know. As I said, the one nurse a few weeks ago felt it made..." + (show)
@sheridanb

I don't know. As I said, the one nurse a few weeks ago felt it made no difference and my husband these past couple months has gotten whichever drug arrives first. But now that the nurse this week, and verified by the pharmacist, say do abrax first... I will continue to ask that it be done that way. But I don't know reasoning.

Jump to this post

Thank you, and yes please post any updates.

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