KRASG12D mutation and Gem/Abr

I was on gem-abraxane for 12 months and it shrunk or got rid of a liver lesion so that it couldn't be seen on any CT or PET scans and also my 1.7cm lesion shrank to 0.9cm. I also had 2 very small peritoneal nodules that only be seen by my ERCP (endoscopic US) and it keep those at the size they were for over 1 year until I was taken off abraxane following radiation of my 0.9cm on liver as my CA-19 remained normal for almost 6 months while just on gem.

I have a post just on histotripsy, if you want to check it out.

That must have happened to me also. I am on the gem/Abax now. Done 4 rounds.scanned this weekend.

I meet with my doctor tomorrow to see if it is working or not…

I have a germline ATM mutation and a somatic KRAS G12D mutation.

I had a ho-hum response to Folfirinox before my Whipple.

After Whipple and a recurrence, I started Gemcitabine + Abraxane + Cisplatin and had a great response for about 15 months. I stopped to get a break from the neuropathy and participate in a clinical trial, which didn't work.

My tumors grew in size and number during that 4-month break. When I resumed the Gem/Abrax/Cis, I had another great response for about 8 months before resistance developed. With no other options, I switched to 5FU+Onivyde, which doesn't seem to be doing much. Still looking for a KRAS inhibitor trial with openings.

For liver mets, there's also a HAIP (hepatic arterial infusion pump) where they implant a chemo pump inside your body and inject low-dose chemo directly into your liver arteries. Dr. Poruk (Mayo/Jax) has it listed on her bio page as a procedure she performs, but from reading up on it, it seems to have limited applications and narrow criteria for use.

Thank you so much for sharing your journey. We are hoping to get results from the GA that will buy us the time needed to get into a clinical trial. So far everyone we have reached out to is no longer recruiting. Apparently the info on clinical trials at the NIH site hasn’t been updated since July 18th. Please keep us posted! I asked my oncologist about histotripsy for my liver Mets but was told he doesn’t believe it to be useful unless you have one tumor that can’t be treated with any other method.

I recently spoke to a patient in Florida that had histotripsy performed on two tumors and is doing well. So the “one tumor theory” may depend on talking with a physician that performs it or someone that has been doing the procedure in volume.

I see it may also depend on whether that facility has the equipment to even do the histotripsy procedure, if they don't, then they may not even promote it as a viable choice.

Gem/Abax is not working. Looking for a clinical trial. I think I am out of options. Preparing for the worst.

Where do you live?

There are so very many drug combos out there. And procedures. And 6236 alone or in combo trials. Etc etc Hope you have a pancreatic center of excellence with all the latest research and greatest minds near you. Don’t give up hope !