Anyone on Gemcitabine with Abraxane? How long? Effective?

On Abraxane and gemcitabine since July 22, 2022. Have had 33 treatments. Missed only one due to increased side effects of Abraxane.

I had been told by one oncologist that "GCA" (Gem+Cis+Abrax) was a particularly nasty combo, but it's been easier for me than "F" (FOLFIRINOX) was, and my CA19-9 has also responded better. (Note: It was not a mid-treatment switch, but rather "F" before the Whipple, and G+C+A for recurrence after the Whipple.)

With with the "F", I felt more fatigued and more nauseous longer than I have with "GCA" so far (7 treatments). But I'm not sure if it's just my biology, or a better mix of anti-nausea pre-meds I get with the GCA (at a different center). By the time those wear off, I've got 4 other anti-nausea prescription alternatives at home, but have barely needed any. The big downside of GCA for me (hair loss aside) is more neuropathy than I experienced with F.

I've heard several times, "You can get the same chemo drugs at Center A or Center B, so just choose whichever is easiest/closest." What I've found is that although you can get the same DRUGS, you won't necessarily get the same CARE. And even then, you might be getting the same "chemo" agents but not the same anti-nausea pre-meds. So I'm taking this recurrence a lot more serious, and have upped my travel threshold to get to a center of excellence.

I also got diabetes along with the PC. Any steroids or sugars in the pre-meds can really mess with your glucose levels and response to insulin. My current oncologist recognized this and reduced my steroid load by 1/3, which has helped.

I'm also pleased/relieved to be getting a CA19-9 test along with each chemo treatment now (every 2 weeks) instead of every other treatment as I did with the biweekly F. Since it's a number that can jump around a lot, filling in the gaps really helps you see the trend.

I was identified as Stage III-IV in August of 2022. My oncologist started me on Gem/Abrax immediately and now I am 9 sessions in. It seems to be working...my numbers are way down. Doctor tells me the chemo is killing the cancer. So far, I have had only two very bad side effect sessions, one especially strong but my body responded well. Now, with anti-nausea meds in the "cocktail" I am doing well, although the back pain persists. This is an individual journey we are on, biology differs in each of us, but the Gem/Abrax is the combination that is doing the job for me...

My husband was on it for 7 mos and cancer stopped responding. He then had radiation we are wait to hear on next scan. He is 84. Chemo took all his strength. He is a Vietnam POW so he is tough. We got a prescription for pain

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!