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Options for Peritoneal Mets

Posted by rockie66 @rockie66, Sep 26 9:48am

Hi I had FFX prior to whipple but cancer came back and I am now a stage 4 PDAC patient with peritoneal mets. I had a moderate response to FFX prior to whipple but never tried G/A so we were hoping it would at least work some. Unfortunately, it barely moved the CA 19-9. Now we are switching to FOLFOX and after just one cycle, it wiped me out and CA 19-9 keep doubling each week at a scary speed. I also feel symptomatic and have to start take painkillers for the first time since surgery.

My local oncologist is saying my mets is becoming chemo-resistant. I brought up HIPEC/PIPAC/IP Chemo but she was dismissive saying those are just fancier ways of delivering same chemo so it wouldn't work. I read systematic chemo doesn't work well with peritoneal mets anyway so am looking to see what other options there are for patients like me? There are HIPEC and PIPAC but I don't think I qualify HIPEC because my CA 19-9 is not controlled yet.

Has anyone tried PIPAC or IP (intro-peritoneum) chemo and would like to share their experience? It seems it's only done in clinical trial setting for PDAC. It's scary to know that I am running out of options. Thank you so much!

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markymarkfl | @markymarkfl | Oct 19 4:27pm
In reply to @rockie66 "@markymarkfl I hope the trial works great for you! Unfortunately, having been on RMC-9805 excluded me..." + (show)
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@markymarkfl I hope the trial works great for you! Unfortunately, having been on RMC-9805 excluded me from most inhibitor trials (of which there are a lot now) so I am facing very limited options in clinical trials.

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@rockie66 , I sent you a direct message with my contact info. I can give you more details and contacts regarding the NK-CAR (Natural Killer cell) trial at MDACC if you're still interested in that. Too much to type here.

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gsf | @gsf | Oct 26 8:33am
In reply to @markymarkfl "@gsf , I'm in the MOONRAY clinical trial, https://www.clinicaltrials.gov/study/NCT06586515 . It's a KRAS G12D inhibitor administered..." + (show)
Profile picture for markymarkfl @markymarkfl

@gsf , I'm in the MOONRAY clinical trial, https://www.clinicaltrials.gov/study/NCT06586515 .

It's a KRAS G12D inhibitor administered by oral tablets from Eli Lilly. I take 6 per day at bedtime, along with a pill to control nausea and diarrhea. Too soon for my first scan, but CA19-9 has gone down quite a bit.

The travel requirements aren't bad. The first month has a couple all-day trips to the center for hourly blood tests, but after that, it's about one trip per month.

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@markymarkfl Thank you very much for the information on the clinical trial you are in! I wish you the very best of luck in the trial. I plan to look into the trial using the link you so kindly gave us. My wife's oncologist told us recently that, since my wife completed radiation (at Dana Farber in Boston) just recently, most trials won't take her until the next scan determines cancer progress (or lack thereof!). Scan won't take place until January, 2026. Thanks again!

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