Anyone on Gemcitabine with Abraxane? How long? Effective?

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 ?

@mmpace, I hope you saw the helpful replies from @markymarkfl and @wjk. I moved your question about changing from Folfirinox to Gemcitabine/Abraxane to this existing discussion:
– Anyone on Gemcitabine with Abraxane? How long? Effective? https://connect.mayoclinic.org/discussion/gemcitabine-and-abraxane/

I did this so you can read previous helpful posts and connect easily with others who have experience with this regimen.

Did you decide to try the clinical trial or opt for Gemcitabine/Abraxane? How are you doing?

mmpace - I have adenocarcinoma (Stage 1b) at the head of my pancreas. I had to discontinue neoadjuvant Folfirinox infusions after only four cycles. Though the Folfirinox was effective (some shrinkage of tumor and falling CA 19.9 numbers), I recently had to switch to Gemcitabine/Abraxane due to increasingly severe allergic reactions. The mostly different side effects of the Gem/Abrax have been easier to handle than those of Folfirinox. The effectiveness of Gem/Abrax for me has not yet been determined.

Long story short:

I did 6 months (12 rounds) of Folfirinox before Whipple for PDAC. No obvious progression was ever detected on scans. Post-op analysis of the tumor rated treatment as a "partial response" (2 on a scale from 1-3).

I've done about 17 biweekly rounds of Gemcitabine + Abraxane + Cisplatin since my recurrence in January. I'm tolerating it better than I did the Folfirinox, and am seeing _much_ better reduction in CA19-9. FWIW, I have the ATM mutation.

My sequence of imaging reports are not totally consistent from one to the next. It seems there are more "lesions" noted on newer scans, but they've been calling it "stable disease" for the last 5 months. Will have more scans in 2 weeks and new data then.

As far as trials go, I'm keeping them on the future radar, but trying to stick with the most "conventional" treatments first. It seems like any of the treatments that alter your immune system (mRNA shot, CAR-T or NK cellular treatments) might disqualify you from other future trials.

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.