Anyone on Gemcitabine with Abraxane? How long? Effective?

Looking forward to hearing from others regarding this. My diagnosis is PCAC, metasticized to liver, with the rarer KRAS G12C mutation.
Folfirinox was determined to not be effective enough after 4 months (still some progression in the liver.) I did not tolerate that regimen well. Made me increasingly sick over the 14 day cycle.
Wondering about others’ experiences were/are moving to Gemcitabine/Abraxane.
Did you tolerate Folfirinox well or not as first line? Did you/do you tolerate G/A well or better than Folfirinox?
My other option is a clinical trial that targets the mutation, but it is Phase 1 and there is no historical data on it particularly as it relates to Pancreatic Cancer. It might be more tolerated but total shot in the dark.
Many thanks for sharing your experiences.

@amchurch , I am confused about this like you are. HIPEC (the Heated IntraPEritoneal Chemotherapy) treatment is usually done in conjunction with CytoReductive Surgery (CRS) which is basically going in surgically and removing every metastatic tumor they can find -- the exact scenario for which they would close you up and not even perform a Whipple.

My gut instinct is they should do this first, but I think there's a selection process involved, in which they're taking extra time to make sure the patient is responding to the same chemo that would be used in HIPEC, and that the patient/disease is stable -- no rapid spread they would miss despite the CRS surgery.

As far as issues with other veins, arteries, and organs: I think that is a slightly separate case. The HIPEC/CRS is mainly focused on spread to the peritoneum, whereas the others might just be cases where the particular surgeon's skill at vascular reconstruction is far above average, and the affected organs with mets might be treatable by another method like radiation.

I really don't know much about this, but those are my questions and thoughts. I sincerely hope someone else can chime in with more experience, knowledge, and detail.

So sorry to hear of your loss. Condolences to you and your family

My dads Dr. Said that this wouldn’t be an option. He did folfurinox which didn’t work- then gem/Abrax which also didn’t work. He just passed away august 5th after a 7 month battle.

Thank you. So far so good. She had her second treatment of G/A yesterday and is starting to lose her hair. She’s a little tired, but continues to have zero nausea and vomiting. She uses Tylenol as well and says it seems to work. She will have scans after two more treatments. I pray this is helping her. Best wishes to you.

Thank you. I know there are so many variables to the CA19-9, but seeing a jump to 50k just made me sick to my stomach. Best wishes to you.

Curious. I hear of stage iv people having the whipple or pancreaectomy. Many doctors claim to work on cases that were deemed inoperable with massive vein involvement, liver, Mets, lymph nodes, etc.
if chemo shrinks the pan mass and the metastatic spots are gone or necrotic, will surgeons still do the surgery? I’ve spoken to many stage iv survivors who have had this chance…why is that some can and some can’t? Look forward to some insight. Inspiration. I know some are even many years out with no evidence of disease or in remission with chemo alone.

I am also on Gemzar. Initially my numbers jumped but are now trending downward. My history shows that the CA19-9 tracks with the tumor activity in me; however my doctors say that is not the case with everyone. It has been explained to me that it is reasonable to see the numbers jump initially if the treatment is new to your body and causes the tumors to shed. For me that is the case as the scans do show shrinkage. This was true also with Fulfurinox in 2021-2022.
However, I would have raised a flag if the numbers rose more than 2 times. My blood work is every other week. Had my numbers continued to rise, I would have insisted that Cisplatin be added to my “recipe”.

From my experience of one year of pancreatic cancer, and what my oncologist tells me, is that CA numbers in and of themselves do not tell full stories. Accompanying scans will shed more light. I had a jump in CA when I switched from Folferinox to Gemzar Abraxane treatment, that consequently decreased, so there are lot of variables in that blood test. Best wishes. I hope this is somewhat helpful.

Hi Helena
How are you doing with your treatment ? Glad to hear that you are not experiencing any nausea. My cousin Maryann was on Gemcitabine Abraxane for almost 2 years and she did really well. Her tumor is also in the tail and near a main vein so they cannot operate. Now Maryann is on 5 Fluorourcil She is doing fine on this chemo. Will go for cat scan next month. Keep positive. We are all in this together.
Sincerely Susan