Search Results for '5fu'

Hi, Pamela,

“Thanks Percy. Now when you have the time, can you explain the difference between each one and why they use some more than others”

This is a very difficult question to answer.but I hope my revision of the message will provide you some answers; if you need more info.
the best way to answer your questions will be if you can give me specific regimen to work with;like GEMOX or FOLFOX.

5FU and Gemzar are the FIRST line chemo agents to use; it is more or less like building a house;this two drugs are the foundation of the house(or in this case ,the regimens);the platinum family of drugs and others are adding to the 2 FIRST LINE drugs to provide the synergic effects of the regimens and that is why they(the add on drugs) are used less.

Gemzar and 5FU(like Xeloda) can be used alone by itself(mono therapy) too.

God bless.

Hi, Pamela

Here is the list of chemo agents that mostly used for CCA that I can find at this point. most of them are used in combination to get the best results (synergy) out of the combo that used in the regimen.

Taken by Mouth:(not necessary FDA approval indications for CCA but doctors can use them out of protocol)
1.Xeloda(oral form of 5FU)-see 5Fu below;diarrhea and hand and foot symptoms are the side effects.

2.erlotinib(Tarceva)—EGFR cell pathway inhibitor(tyrosine kinase inhibitor);
inhibit angiogensis (cut off blood supply to cancer cells and cause them to die);cause cell death by interrupting the reproduction of cancer cells;smoking will decrease the drug effects by 24% which may result in treatment failure.

3.sorafenib.(Nexavar)—Multiple cancer cell pathways inhibitor; inhibit cell proliferation and angiogenesis(cut of blood supply to cancer)
4. Celecoxib-an antiflammatory agent belongs to the COX2-an enzyme family.but use much less recently.

Taking as Infusion:
1. 5FU.—a chemo agent belongs to the Antimetabolite family that inhibits RNA synthesis and function ; may also on DNA synthesis but to the less degree. in doing so,cause cancer cell to die.

2.Gemzar—a chemo agent belongs to the Antimetabolite family that inhibits the DNA synthesis in the cancer cells;induce tumor cell death (apoptosis);
some study indicated Gemzar is more effective in treating CCA than 5FU,but both 5FU and Gemzar are FIRST LINE chemotherapy agents of choice to combine with other chemo agents in CCA regimens;other study indicated effectiveness of both agents are more or less the same.

3.Cisplatin—1st generation of the platinum family, an alkylating agent affects cell DNA replications thus causes cancer cell death(apoptosis);may cause kidney impairment and impairs hearing (ototoxicity);usually use in combination with Gemzar or 5FU to provide the synergic effect of the regimen of GEM/CIS or FOLFOX.
4.Oxaliplatin— the 3rd. generation of the platinum family;less kidney impairment than cisplatin but more patients experienced peripheral neuropathy
5.Carboplatin— the 2nd generation for the platinum family;decrease platelet production;much less toxicity on the kidney compare to others in the platinum family; cause less peripheral neuropathy than oxaliplatin.

6.Avastin(bevacizumab)-a VEGF cell pathway inhibitor— an angiogensis inhibitor to cut of blood supply to tumor cells.and cause cancer to die.

7.Erbitux(cetuximab)-an EGFR cell pathway inhibitor;blinds to the cancer cells surface receptor of EGFR and block their stimulation;therefore renders the cell pathway useless.

8.Leucovorin(it is not a chemo drug but used to enhance 5 FU effect)

9.FUDR(Floxurdine)-it is an analog of 5FU,belongs to the Antimetabolite family. Administered via the hepatic artery(pump);hepatic toxicity is high.

10.Epirubicin— a chemo agent belongs to the Anthracyclines family which is less used nowadays.
11.Adriamycin—a chemo agent belongs to the Anthracycline family;interrupt the DNA and RNA synthesis in cancer cells and cause cell death;used in chemoembo in CCA;major BOX warning by FDA is myocardial toxicity ;also neutropenia and leukopenia(75%)

12.Irinotecan(Camptosar)-inhibits DNA synthesis in tumor cells by inhibiting an enzyme called topoisomerase1 ; useful but tough to take.

13.Docetaxel-chemo agent belongs to the Taxane family,interrupt the mitosis of the cancers cells cycle to reproduce and cause tumor death.

14.Mitomycin- a chemo agent belongs to the Alkylating family; inhibit DNA and RNA synthesis and thus cause cancer cell death ;use in chemoembo for CCA and can be combined with 5FU for treating CCA too.

15.Panitumumab(similar to cetuximab ;but difference from them is that this is the first 100% HUMAN monoclonal antibody direct against EGFR cell pathway; therefore you may expect less allergic reaction from Panitumumab.

16.paclitaxel-(Taxol) a chemo agent in the Taxane family that primary inhibits the cell cycle during mitosis;thus the tumor cell cannot duplicated and die;Taxol should be given before cisplatin if both drugs are used at the same time for maximum benefit of the combo.;also inhibits angiogenesis but is very tough to take.

God bless.

My wife experienced quite a bit of pain the first few days after her port went in. She had to take Tylenol on a regular basis. Once the surgery site healed, the port has been trouble free.

The most common chemo drugs go through port:

Gemcitabine
Cisplatin
Oxaliplatin
5FU

One notable exception:

Capecitabine (Xeloda)

It’s a pill that you take at home.

===============

IMPORTANT:

When port is not being used, it has to be flushed once a month with saline solution. If you ever go on a long break between chemo treatments, remember to arrange the flush.

To help Percy, I will post all chemo protocols listed in NCCN Treatment Guidelines.

Unresected And Metastatic Cases

Phase III clinic trial supports this protocol:

gemcitabine + cisplatin

Phase II clinic trials support the following protocols:

Combination protocols for patients with good performance status

gemcitabine + oxaliplatin
gemcitabine + capecitabine
capecitabine + cisplatin
capecitabine + oxaliplatin
5FU + oxaliplatin
5FU + cisplatin

Single agent protocols for patients with poor performance status

gemcitabine
capecitabine
5FU

Resected Cases

There are no Phase III clinical trials to support chemo protocols for resected cases.

Phase II clinic trials support the same protocols as listed above for unresected cases.

=================================

The protocols refer to drugs by their “proper” medical names.
Here are the trade names of the same drugs:

Gemcitabine = Gemzar
Cisplatin = Platinol
Oxaliplatin = Eloxatin
Capecitabine = Xeloda
5FU = Adrucil, Carac, Efudix, Efudex, Fluoroplex

Hi Derin,

My daughter is on Gem/Cis and 5FU. She has had no major problems with three chemo drugs. She felt a little queasy the first few rounds, but nothing major. She has had to have her Cisplatin dose lowered a few times because of low platelet counts. She has also lost all of her hair and now has little, short what I call ducky fur. She looks really adorable though. She gets Aloxi in her IV before chemo for nausea that lasts 3-5 days. She also takes Compazine for a few days after chemo. She is coming up on her 12th round of all of this chemo and is doing very well and her tumors are shrinking as of the last MRI. She will be having another MRI and full body CT on March 8. Hopefully, things are still looking good. Her doctors are all amazed at how well she is doing. I think you and my Lauren are two of the lucky ones that don’t feel cruddy from their chemo. I say YAY to that!!!

-Pam

How amazing!!! God is grand! My husband had the whipple 06/23/12, followed by chemo using Gemzar & 5FU (discontinued 5FU after 3 weeks), and along with 25 radiation txs. Then, because of cancer recurrence about 6 months out, he was given 4 months chemo using Gemzar and Cisplatin. After it’s completion, a CAT scan revealed that the cancer had grown a smidge, so now, we are in a 3rd chemo using Oxaliplatin and Xeloda.

I keep telling my husband that he will just have to be my little miracle. We hope this last chemo cocktail will shrink his cancer, which is in the surgical bed area pressing on the transverse colon.

Your news is truely terrific. Stay strong in faith for with God nothing is impossible. Luke 1:37

I also had the same treatment as Kathyb. I had 6 weeks of 5 days a week radiation with 24/7 5FU chemo pump adminsterd thru my port. I had no major side effects untill all was done and then I was extremely tired, just climbed in my recliner and stayed there!!!.
Lots of prayers and HOPE-Cathy

I have been on chemo for 20 months and have only missed 1 because of low counts. There is no end to my chemo treatments. I hate when people ask, I just say there is no end I have to do this forever. I have been stable for 20 months, but the Gemzar /xeloda just stopped working and I had a little growth.
He has put me on oxiliplatin with 5fu and had my second treatment yesterday. Hoping and praying this treatment works as well as the last. I can’t have surgery as it has spread to liver, lymph nodes, lungs, and peritoneal area. It was in all of these place at my original diagnosis.
Jtoro

Jtoro:
I did 6 rounds of oxaliplatin. The first round wasn’t bad. The 2nd caused a tingling in my hands and feet, and my throat couldn’t stand cold, but it went away after a few days. Was a little nauseous, but able to handle it with meds. The 3rd I finally succumbed to the nausea. It actually made it easier because I was fine aferwards. But the neuropathy lasted longer: almost the 2 weeks until the next treatment. The 4th, 5th and 6th gradually increased the neuropathy until it didn’t go away in my feet. My hands occasionally tingle, but my feet always tingle and occasionally burn. The nausea never went past the 1st day because I let it win. After about an hour I felt much better, and never felt nauseous the rest of the time. My feeling is the oxy was definitely worth it for me at least. It really worked on shrinking my tumor.
I was on Gem/Ox. I was also on FUDR thru a pump. Have not had the 5fu.
My suggestion is warm socks, and mittens/gloves and a scarf. You might want them if the neuropathy starts immediately. And you’ll want room temp drinks for a while after chemo.
Kris

My sister just started a FOLFIRINOX regimin (5FU, Oxaliplatin, Irinotecan, Leukovorin) this week and she was not a happy camper. She did 8 cycles of Gemzar & Xeloda in 2009 and experience some nausea but nothing else significant. I’ll keep you posted but I can already tell this is harder on her from a nausea standpoint.