1. < Pancreatic Cancer

Anyone on Gemcitabine with Abraxane? How long? Effective?

Posted by helenar @helenar, Aug 17, 2022

Hi, I'm Helena from South Africa. I have been diagnosed with PC, stage 4, in March. Tumour between body and tail and with one lesion on my liver.
I have been on Folfirinox for 3months, but it had no effect, allthough my markers came down from 3091 to 357, the tumour increased in size and there is another lesion on my liver.
I have started Gemcitabine with Abraxane.
Has anyone been on Gemcitabine/Abraxane?
If so, how long and how effective is this treatment?

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

sprinter345 | @sprinter345 | Oct 8, 2023
In reply to @199 "Last week I finished my 38th chemo with Gemcitabine & Abraxane for stage 4 inoperable pancreatic..." + (show)
@199

Last week I finished my 38th chemo with Gemcitabine & Abraxane for stage 4 inoperable pancreatic cancer started in tail & went to lungs. I started end of July 2022. My CA 19-9 is within normal limits at 18. My CT shows improvement. The worse pains I have had are bone pain and neuropathy from the chemo. I am bald & due have fatigue, but I am still here 🙂 Just had my dose of Abraxane and Decadron reduced, and the schedule changed from 2 weeks on & one off to one on & one off. Will see how that goes. I get Decadron & Aloxi prior to the Abraxane, then normal saline flush & gemcitabine. Would love to have a break soon but will see what my oncologist says. Only taking Percocet & Tramadol for pain so far. Lately I have been taking one of each in the morning, mid-afternoon & 2 in the evening either together or spaced depending on the severity of the pain.

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Did your tail tumor size decrease significantly? Did they find it in the lungs because they were looking for it or did you have symptoms?
I’m always afraid it’s going somewhere and we won’t realize unless he has other symptoms. It had metastasized to the liver when he started.

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1 reply
sprinter345 | @sprinter345 | Oct 8, 2023
In reply to @markymarkfl "@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and..." + (show)
@markymarkfl

@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and get home feeling OK, relax on the weekend, then crash and have to take Monday off work.

I did reduce the decadron in my pre-meds by about 1/3 several months ago because of its impact on my blood sugar. That and a long drive home might be suppressing my insomnia. I do have dexamethasone tablets at home as a backup to Zofran. I rarely take them, but if so, only in the morning because of the insomnia.

@sprinter345 and @199 -- You are true marathon champions. Have your oncologists discussed switching treatments or reducing/eliminating any of your chemo meds?

I've heard the Gem/Abrax (+/- cisplatin) is usually only good for 6-9 months before it either becomes intolerable (neuropathy) or ineffective (cancer develops resistance). My docs have said they have an answer for every side effect but neuropathy, which I accept as a tradeoff for the other positives of treatment.

My CA19-9 leveled off around 40 for about 8 weeks, and two oncologists both started discussing "maintenance therapies" for me, suggesting the Abraxane/cisplatin had done all they were going to do. This would mean reducing/eliminating one/other/both and likely going to nothing but Gem. And then, my CA19-9 this week dropped to 33 -- two points inside the normal range! (Previous week's scans still report "stable disease" and Signatera detects no ctDNA.)

I don't think this regimen has run out of gas yet. I fear if I back off of anything it will give the cancer a chance to regroup and spread. 19 treatments haven't killed me yet. I was ruled out as a candidate for HIPEC, and I might be a candidate for some trials in the distant future, but I don't see anything on the horizon with more promise than what I'm currently on.

Would love and appreciate your insights on this.

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Our oncologist intends to keep him on the gemabraxane with pamrevulab as long as he has stable disease and no bad side effects. Then the current plan is for Fulforinox, then there is hope that the KRAS studies will pan out- they are very promising but not currently being tested in his lab articulation variant.
I am with you - I wouldn’t stop - cancer is very aggressive- I wouldn’t take a chance if it were up to us.

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gamaryanne | @gamaryanne | Oct 8, 2023
In reply to @markymarkfl "@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and..." + (show)
@markymarkfl

@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and get home feeling OK, relax on the weekend, then crash and have to take Monday off work.

I did reduce the decadron in my pre-meds by about 1/3 several months ago because of its impact on my blood sugar. That and a long drive home might be suppressing my insomnia. I do have dexamethasone tablets at home as a backup to Zofran. I rarely take them, but if so, only in the morning because of the insomnia.

@sprinter345 and @199 -- You are true marathon champions. Have your oncologists discussed switching treatments or reducing/eliminating any of your chemo meds?

I've heard the Gem/Abrax (+/- cisplatin) is usually only good for 6-9 months before it either becomes intolerable (neuropathy) or ineffective (cancer develops resistance). My docs have said they have an answer for every side effect but neuropathy, which I accept as a tradeoff for the other positives of treatment.

My CA19-9 leveled off around 40 for about 8 weeks, and two oncologists both started discussing "maintenance therapies" for me, suggesting the Abraxane/cisplatin had done all they were going to do. This would mean reducing/eliminating one/other/both and likely going to nothing but Gem. And then, my CA19-9 this week dropped to 33 -- two points inside the normal range! (Previous week's scans still report "stable disease" and Signatera detects no ctDNA.)

I don't think this regimen has run out of gas yet. I fear if I back off of anything it will give the cancer a chance to regroup and spread. 19 treatments haven't killed me yet. I was ruled out as a candidate for HIPEC, and I might be a candidate for some trials in the distant future, but I don't see anything on the horizon with more promise than what I'm currently on.

Would love and appreciate your insights on this.

Jump to this post

@markymatkfl;
Where is your metastises?

Gem/abraxane has shrunk my 2 tumors and brought CA19-9 to normal range. Surgery next week to remove them One is a definite, one is very very small and not in a sweet spot. But back up plan is to manipulate the area so it can be radiated. This time I WILL go back on chemo. I have not developed resistance to Fulfurinox or Gemzar so will be listening to recommendations from docs here and elsewhere. But, I will not delay for long!

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markymarkfl | @markymarkfl | Oct 8, 2023
In reply to @bella71 "My mom started chemo about 6 weeks ago. The Dr. says it is to give her..." + (show)
@bella71

My mom started chemo about 6 weeks ago. The Dr. says it is to give her a better quality of life and slow the growth of her cancer. The doctor warned us that eventually the chemo would stop working. Does anyone know how long the chemo can keep a person alive? She is stage 4 and she is having scans tomorrow at Mayo Clinic to see if the chemo is even working. She is feeling pretty good , just weak and tired. Pain is under control. Her CA19-9 is 118,800 and has been the exact same number for two weeks. I can only think that at least it stayed the same. The previous number was 50,000. I’m so nervous for the news we will find out tomorrow.

Jump to this post

@gamaryanne and @ncteacher -- Your comments are right on, LOL! I have chemo on Fridays and get home feeling OK, relax on the weekend, then crash and have to take Monday off work.

I did reduce the decadron in my pre-meds by about 1/3 several months ago because of its impact on my blood sugar. That and a long drive home might be suppressing my insomnia. I do have dexamethasone tablets at home as a backup to Zofran. I rarely take them, but if so, only in the morning because of the insomnia.

@sprinter345 and @199 -- You are true marathon champions. Have your oncologists discussed switching treatments or reducing/eliminating any of your chemo meds?

I've heard the Gem/Abrax (+/- cisplatin) is usually only good for 6-9 months before it either becomes intolerable (neuropathy) or ineffective (cancer develops resistance). My docs have said they have an answer for every side effect but neuropathy, which I accept as a tradeoff for the other positives of treatment.

My CA19-9 leveled off around 40 for about 8 weeks, and two oncologists both started discussing "maintenance therapies" for me, suggesting the Abraxane/cisplatin had done all they were going to do. This would mean reducing/eliminating one/other/both and likely going to nothing but Gem. And then, my CA19-9 this week dropped to 33 -- two points inside the normal range! (Previous week's scans still report "stable disease" and Signatera detects no ctDNA.)

I don't think this regimen has run out of gas yet. I fear if I back off of anything it will give the cancer a chance to regroup and spread. 19 treatments haven't killed me yet. I was ruled out as a candidate for HIPEC, and I might be a candidate for some trials in the distant future, but I don't see anything on the horizon with more promise than what I'm currently on.

Would love and appreciate your insights on this.

REPLY
3 replies
gamaryanne | @gamaryanne | Oct 6, 2023
In reply to @bella71 "My mom started chemo about 6 weeks ago. The Dr. says it is to give her..." + (show)
@bella71

My mom started chemo about 6 weeks ago. The Dr. says it is to give her a better quality of life and slow the growth of her cancer. The doctor warned us that eventually the chemo would stop working. Does anyone know how long the chemo can keep a person alive? She is stage 4 and she is having scans tomorrow at Mayo Clinic to see if the chemo is even working. She is feeling pretty good , just weak and tired. Pain is under control. Her CA19-9 is 118,800 and has been the exact same number for two weeks. I can only think that at least it stayed the same. The previous number was 50,000. I’m so nervous for the news we will find out tomorrow.

Jump to this post

Yes! First night(Friday) I’m ready to go out to dinner stay up all night! But Saturday afternoon when the Onpro shot goes off it’s downhill for two days. Very predictable. I guess the steroid gets us out of the doctor’s office with no complaints until Monday!

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199 | @199 | Oct 5, 2023
In reply to @ken240 "I am on Gem/Abrax currently, 3 weeks on, 1 off. I, too, receive Decadron as a..." + (show)
@ken240

I am on Gem/Abrax currently, 3 weeks on, 1 off. I, too, receive Decadron as a pre-med with Aloxi or Zofran. I was thinking about asking my oncologist to reduce the Decadron dose because I think it causes insomnia. May I ask why your dose was reduced?

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The Decadron dose was reduced due to the thinking that the swelling in my feet & ankles & whole body might be related to it as it is a steroid. Not sure if that changed much for the swelling. I too have insomnia the first and sometimes second nights of getting the Decadron. That did not change when I got the lower dose. I was still "wired" the night of chemo and the next. Lack of sleep & steroid equals one cranky person 🙂 Try to stay away from people who do not get it & that ends up being most people 🙂

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MommaCandy | @mommacandy | Oct 5, 2023
In reply to @colleenyoung "@mommacandy, I think you'll appreciate these related discussions: - Anyone on Gemcitabine with Abraxane? How long?..." + (show)
@colleenyoung

@mommacandy, I think you'll appreciate these related discussions:
- Anyone on Gemcitabine with Abraxane? How long? Effective?
https://connect.mayoclinic.org/discussion/gemcitabine-and-abraxane/

- Changing chemo regimen after 4 cycles of Folfirinox?
https://connect.mayoclinic.org/discussion/changing-chemo-regimen-after-4-cycles-of-folfirinox/

Regarding wild fluctuations in CA-19, see these discussions:
- Pancreatic cancer and CA19-9
https://connect.mayoclinic.org/discussion/pancreatic-cancer-and-ca19-9/
- CEA and CA19-9 Results as Predictors of Treatment Outcome
https://connect.mayoclinic.org/discussion/cea-and-ca19-9-results-as-predictors-of-treatment-outcome/
- CA-19 has elevated even more
https://connect.mayoclinic.org/discussion/ca-19-has-elevated-even-more/

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Ty I did read through those (one was one of my own post lol) and it was interesting reading some others... the Gemzar/abraxane has definitely been easier for him to tolerate and he's at least eating a little more. My biggest issue ATM is making him realize he's diabetic and needs to take insulin regularly..
This week's treatment wasn't terrible on him so we'll see how he does
Ty for sharing thise

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Moderator
Colleen Young, Connect Director | @colleenyoung | Oct 5, 2023
In reply to @mommacandy "Well my friend's oncologist changed him to the Gemzar/abraxane combo after he received the all clear..." + (show)
@mommacandy

Well my friend's oncologist changed him to the Gemzar/abraxane combo after he received the all clear from the infectious doc regarding the mssa infection he had gotten as a result of the port being put in.. obviously the port was removed, on home IV antibiotics all last week, and got all clear on Monday...so yesterday he got his first treatment with the new combo and I gotta say he tolerated it a whole lot better..
One thing I am concerned about is his ca19 reading has gone up another 1000 in the past month... I get part of that is probably due to his only having the one treatment of chemo before the infection kicked up...Aug 31 it was 32040 yesterday it was 33080..should I be that concerned ?

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@mommacandy, I think you'll appreciate these related discussions:
- Anyone on Gemcitabine with Abraxane? How long? Effective?
https://connect.mayoclinic.org/discussion/gemcitabine-and-abraxane/

- Changing chemo regimen after 4 cycles of Folfirinox?
https://connect.mayoclinic.org/discussion/changing-chemo-regimen-after-4-cycles-of-folfirinox/

Regarding wild fluctuations in CA-19, see these discussions:
- Pancreatic cancer and CA19-9
https://connect.mayoclinic.org/discussion/pancreatic-cancer-and-ca19-9/
- CEA and CA19-9 Results as Predictors of Treatment Outcome
https://connect.mayoclinic.org/discussion/cea-and-ca19-9-results-as-predictors-of-treatment-outcome/
- CA-19 has elevated even more
https://connect.mayoclinic.org/discussion/ca-19-has-elevated-even-more/

REPLY
1 reply
ncteacher | @ncteacher | Oct 5, 2023
In reply to @wjk "ncteacher - Like you (and Ken20), I'm convinced Decadron (dexamethasone) causes insomnia following Gem/Abrax infusions. After..." + (show)
@wjk

ncteacher - Like you (and Ken20), I'm convinced Decadron (dexamethasone) causes insomnia following Gem/Abrax infusions. After my last infusion one week ago I slept only 2 hours that night. Sleeplessness happens every time. No hiccups here however.

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On those sleep-deprived nights, I just camp out on the living room couch with the TV on. I drift in and out as needed. It also helps that my daughter is a night ER nurse, so she's often either awake at work or awake at home, and we can chat while I'm awake.

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wjk | @wjk | Oct 5, 2023
In reply to @ncteacher "I'm not the poster you're querying, but yes, I agree that dexamethasone causes insomnia, at least..." + (show)
@ncteacher

I'm not the poster you're querying, but yes, I agree that dexamethasone causes insomnia, at least for the first night or two. I always feel pumped up on the steroid for 24-48 hours, and then it begins to wane. I also think it causes hiccups, as least for me.

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ncteacher - Like you (and Ken20), I'm convinced Decadron (dexamethasone) causes insomnia following Gem/Abrax infusions. After my last infusion one week ago I slept only 2 hours that night. Sleeplessness happens every time. No hiccups here however.

REPLY
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