Anyone on Gemcitabine with Abraxane? How long? Effective?

My dad (76) was diagnosed with stage iv pancreatic cancer with several liver mets. Did 5 cycles of FOLFIRINOX 5-FU. Progression scan this week showed mix results. Seems the pancreatic tumor was demonstrating some dying cells, some liver Mets grew while some decreased. Our Dr. Recommended switching to abraxane/gemcitabine given his cancer symptoms were not really improving. He got his first round this week- he has been experiencing the worst pain he has yet after this treatment. I am worried that we may have not made the best decision and he is reluctant to get a second opinion. Can anyone share their experience of switching chemo regimens? How long does it usually take to notice a difference? Any advice is appreciated- at such a loss right now. There is so much information to read and each case is so different- but hearing other stage iv stories give me a clearer picture. Thank you all in advance.

A feW days into his Sxs he was instructed by his Rx team to go to the urgent care facility at the hospital. They worked him up , CXR, blood cultures etc. All came back negative. Sent him home w antibiotics. Fevers finally subsided. He was able to have his second treatment this past week. So far all is good except for fatigue, although his Hgb was 8 at the time of Rx. I questioned the treshold for holdimg Rx but was told he could proceed. Hope he adjusts to this chemo. Thanks for your feedback. Best to all battling this dreaded cancer.

Hi,

I was diagnosed 10/20/22 with PanCan IV MS to liver. Began FU chemo regimen...after 4 cycles had scans and showed progression so switched to Gemcitabine with Abraxane. Completing 6th cycle now and CT scans scheduled for 2/22/23. had AC-19-9 after 3 Gemcitabine with Abraxane and my numbers dropped from 42k to 1,595 so that "could" indicate it is working but need scans to confirm. Have had few side effects from either chemo. FU lost hair and sensitive to cold; taste bud changes; loss of hair; fatigue. With G+A fatigue, abdominal skin rash; gas, and some chills. Gaining weight with help from Creon and Gas X(relives gas pains) and overall feeling pretty good. Have positive attitude; great Family/Friend and FAITH and trust my healthcare team. Am in it to win it! Prayers for you!

Not I, although I have had a sensation of being chilled fairly often (we live in an old COLD farmhouse in snow country).

From my reading chills with fever seems to be regarded as an ominous combination, with a consistent recommendation that anyone experiencing this combination of signs does need evaluation to rule out an infection being present that has reached the blood stream.

Perhaps at least worth a call into whatever your triage system is.

My significant other recently ( Feb 7) started Gemza/nab-paclitaxel (second line) after having completing 24 cycles of folfirinox/folfiri. He was diagnosed with Stage 4 pancan in August 2021. In Jan2023 his CT scan showed disease progression ( increase size liver Mets/new mets to liver).
The first day following his new treatment was a breeze. The next day he was hammered with fever, chills, body aches. Body aches improving but fluctuations in temperature ( range 99-102) continue. He has been in bed the last two days. Does it get better? I know every patient is different but has anyone experienced fever upon their initial/ongoing treatment? thanks in advance for any feedback.

@beachdog How long was the gap between surgery (what kind?) and chemo? What drove the change in chemo regime from Floforinox to new one? I’m headed into surgery in
March and am curious as to your experience. Thank you!

Hello, I have heard that there are targeted therapy clinical trials out there for a BRAF mutation, but am not 100% sure, as I am not a doctor. In other words, I've heard that it is considered "potentially actionable". A qualified pancreatic cancer specialist oncologist should be able to help you find clinical trials that would be potentially helpful. Please make sure you are seeing a top research pancreatic oncologist and a major cancer center such as Sloan Kettering, Johns Hopkins, MD Anderson, Cedars, or Mayo. If you are getting care at a non-cancer center hospital, they probably won't be able to help much with clinical trials. If the mutation is actionable, it may be a positive game changer for your spouse's medical care. You can also search for clinical trials on the clinical trial government homepage or call PANCAN for help. Please do not delay this search, as it could end up being very helpful. Please let me know if you have any questions.

Hello Susan. I just read your cousin story and was wondering if she had more then one opinion. My sister had a pancreatic cancer with tumor wrapped around celiac artery and vein. She ended up with a 16hrs surgery and is cancer free at this time. She saw Dr Corvera at UCSF. he was wonderfully. She is still recovering but so far so good. Hope it helps. Isabelle

granite,

When you say no effect re chemo regimen, do you mean no evidence of shrinkage on CT and PET scans?

As I understand, CA 19-9 is considered to be a useful adjunct when evaluating changes, but is not used as de facto evidence. Any result over 37 is considered a sign of potential cancer ... that your spouse's started at 35 and got no higher than 80 could mean the cancer was caught early?

I have a similar question. Previously fit and active 68 year old Spouse was told there was no effect from 5 months/10 infusions of Folfirinox before laparoscopic Whipple this November (several setbacks). Its pathology report showed 4/31 lymph nodes involved. Margins clear. Tumor 2.7 cm. Moderately differentiated. CA-19-9 levels went from 35 when diagnosed in April with adenocarcinoma, stayed at 80 for several months, but now has dropped to 10 while he is recovering from surgery. Told not to place too much stock in blood test. He is now walking a couple miles a day. Few digestive issues.He will resume with 6 months of Gemcitabine/Abraxane regime at end of month. Cancer type is not typical BRCA or RAS, but BRAF. Anyone with a similar history or comment on clinical targeted therapy, etc.?