Search Results for 'gemcitabine cisplatin'
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Search Results
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ABC -03 study
Cediranib or placebo in combination with cisplatin and gemcitabine chemotherapy for patients with advanced biliary tract cancer
Data shows that the VEGF inhibitor in combination with standard of care, Gem/Cis did not improve progression-free survival.
https://clinicaltrials.gov/show/NCT00939848Marion
Cediranib or placebo in combination with cisplatin and gemcitabine chemotherapy for patients with advanced biliary tract cancer (ABC-03): a randomised phase 2 trial
http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00139-4/abstract
Curative Resection After Gemcitabine, Cisplatin and S-1 Chemotherapy for Initially Unresectable Biliary Duct Cancer: A Case Report.
Hi everyone,
I posted this under Introductions about a week ago, but didn’t get any responses. I’m re-posting here hoping for some help.
We live in metropolitan Australia. My mother-in-law is 72 years old and was diagnosed with a 9.9cm solitary intrahepatic cholangiocarcinoma in January 2015. The tumour originated in the right lobe of the liver, but has pushed into the left lobe and is close to the portal vein (we don’t know if it has invaded the portal vein or not), making operation difficult. Her liver function tests have been slightly elevated, but she has no hepatitis or cirrhosis. Her tumour markers were all normal at diagnosis. CT chest / abdo / pelvis suggested no macroscopic spread outside of the liver. She has no other significant medical conditions.
My mother-in-law received 3 cycles of gemcitabine plus cisplatin, with minimal response. The tumour stayed the same size. In late May, she had Sir-spheres inserted into her liver, and the PET scan to determine response will be in mid-July.
Meanwhile, she has had molecular testing results come back from Foundation One. Four genetic changes were identified (FDA-approved therapies in other tumour types are in parentheses):
– CDK4 amplification – equivocal (Palbociclib)
– ERBB2 amplification – equivocal (Ado-trastuzumab emtansine; Afatinib; Lapatinib; Pertuzumab; Trastuzumab)
– IDH1 – R132C (Azacitidine; Decitabine)
– APC – A2122_C2123insA (none)My MIL’s oncologist believes that the ERBB2 and IDH1 genetic changes hold the most potential for targeted therapy.
Here are my questions:
(1) I was wondering if anyone on this board also had one or both of these genetic changes with their molecular testing?
(2) If so, which chemo agent(s) worked best?
(3) Does a poor response to gemcitabine mean that there is less likely to be a good response to azacitidine or decitabine?Thanks in advance!
Aussie83
Jean……. Biliary Cancer are Cholangiocarcinomas (bile duct cancer ) derived by location of occurrence either: intrahepatic, hilar (perihilar) or distal, and gallbladder cancer and Ampulla of Vater.
The ABC study was a multinational clinical trial and the largest study ever conducted on Cholangiocarcinoma patients. The data clearly proved that the combination of Gemcitabine with Cisplatin was superior to treatment with gemcitabine alone. Although not curative but effective, the overall survival on this treatment averaged anywhere from 3 months to 9 months and some to 12 months.
These results established the “first” standard of care for Cholangiocarcinoma patients.Standard of Care is called best practice, standard medical care, and standard therapy and a treatment that experts agree is appropriate, accepted, and widely used.
I like to compare this cancer to that of a chronic disease in that many patients are unable to have a curative resection, but are able to sustain life with repeated resections (with or without other treatments) or have a positive response to other agents.
Side effects are to be expected with nearly any drug. The major issue is how the treatments interfere with the quality of life of the individual patient. It is a very personal decision and that is what I believe you are addressing with your post.
Your husband made the choice for alternative treatment. That makes perfect sense to him and undoubtedly (for him) is the right way to go.
Although cancer chooses us, we, the individuals affected are able to make choices based on what we feel is right for us. Education empowers us and enables us to do so because; ultimately all of us want to beat this cancer.
All my good wishes are heading your way.
Hugs,
MarionIn reply to: Newly diagnosed in Australia
Hello everyone,
An update since March this year. My mother-in-law has now had 3 cycles of gemcitabine plus cisplatin, with little response. The tumour stayed the same size. In late May, she had Sir-spheres inserted into her liver, and the PET scan to determine response will be in mid-July.
Meanwhile, she has had molecular testing results come back from Foundation One. Four genetic changes were identified (FDA-approved therapies in other tumour types are in parentheses):
– CDK4, amplification – equivocal (Palbociclib)
– ERBB2, amplification – equivocal (Ado-trastuzumab emtansine; Afatinib; Lapatinib; Pertuzumab; Trastuzumab)
– IDH1 – R132C (Azacitidine; Decitabine)
– APC – A2122_C2123insA (none)My MIL’s oncologist believes that the ERBB2 and IDH1 genetic changes hold the most potential for targeted therapy. I was wondering if anyone on this board also had one or both of these changes with their molecular testing? If so, which chemo agent(s) worked best?
Thanks in advance!
Kind regards,
Aussie83In reply to: Mom’s diagnosis
Dear Jenny –
Welcome to the best little family that no one really wants to be a part of. Sorry that you have to join us. You have however found a great resource to help you and your family.
So glad that is sounds like you are being very proactive. It also sounds like you have a good plan going.
It does seem that Gemcitabine and Cisplatin are the drugs of first line. The platin drugs in general are the second drug. My husband did Oxaliplatin and I know others have done carboplatin. One thing to keep in mind is that while surgery may not be an option it very will could be later down the road. There are those on here who have been told that and ultimately been able to have surgery. Also there a several studies out there that you may look into.http://cholangiocarcinoma.org/professionals/research/clinical-trials/
Good luck and keep us posted.
KrisVIn reply to: Mom newly diagnosed with Stage IVa CC
I would like to thank everyone for their genuine concern and support. My mother is stage IVa and is being treated at Yale New Haven Hospital and Dana Farber. She is having a port put in on Wednesday and chemo will start on Thursday. The regimen will include Gemcitabine and Cisplatin. From what I have read so far these seem to be the drugs of choice. Fingers crossed she will tolerate things well.
My best to all,
DonnaIn reply to: Novartis BGJ 398 Clinical Trial
I believe that all major cancer centers initiate tumor type genotyping and I assume it to be comprehensive. Those treated in smaller centers may have to request their tumor tissue testing for genomic profiling by an independent research testing lab. By analyzing tumor tissue for certain genetic abnormalities, patients may then be able to be treated with a targeted drug based on the specific abnormality however; presently, not all mutations have a targeted drug for treatment and individual insurance coverage for testing varies. Similar to the NCI driven MASH initiative (Molecular Analysis for Therapy Choice Program) patients must no longer respond (or have never responded) to standard therapy and tumor is progressing. Please note: standard therapy for Cholangiocarcinoma consists of Gemcitabine and Cisplatin.
The MASH instantiated clinical research studies will be conducted in 2,4000 centers across the US however; as indicative to all clinical studies, patient accrual and launching of the MASH trial is a lengthy process and immediate results of the conducted studies may not be available for years to come. Speak with your physician about molecular testing and the upcoming MASH initiative.
http://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/nci-match
Hugs,
MarionHugs,
MarionHello all,
My name is Garrett, I live in Holland and I am 59 years old. I was diagnosed with cholangiocarcinoma on 26-3 after having sudden pains in the right abdomen. After some more scans and a biopsy the oncologist simply said it was a mean type of cancer. I had a life-expextancy of 7 months without therapy, and a median Life-exp. of 11 months with Cisplatine/Gemcitabine chemotherapie. That was it! I had several meta’s in the lungs, in the liver-hilus, and positive nodes around the aorta and infra-clavicular. Not very good. I felt I had to do something immediately!
So I went to Dr Vogl in Germany to have a TACE done, and took Xeloda afterwards.
Then I went to the University Hospital in Utrecht, where they also only offered CIS/GEM chemo.
Because I had “systemic” disease they could not do Yttrium or Holmium radio-embolisation.
Then I contacted the University Hospital in Antwerp (Belgium), and put in all my papers and scans. They are willing to give me the Yttrium-90 therapy, but the Dutch insurance does not pay for that. But there seems to be a way around that. So next week I will start my Cis/Gem chemo. And in a few months I will do the Yttrium-90 radio-embolisation. I am also trying to avoid sugar, as the tumor likes that very much, but that is not easy!
I have a wife and 3 sons: 13, 11, and 8 years of age. 11 months (median) is simply not acceptable to me!
But maybe I will just have to live with it…….
Does anyone has any other options? In the meantime are house is on the market now, as we have to move to a smaller and cheaper house if we lose my income.My Dad (diagnosed in Nov 2013) has had great success with Gem/Cis combination but is now experiencing side effects from the prolonged usage of Cisplatin (2nd round). Since stopping treatment the cancer has had substantial growth which we were disappointed but not shocked to hear. His Oncologist is suggesting using the Gemcitabine as a single agent to see how the cancer reacts since she feel that other types of chemo wouldn’t be in his best interest.
Has anyone tried the single agent Gemcitabine treatment before?? We are hoping and praying that the results will be good but I can’t find much online.
A phase I trial of binimetinib in combination with gemcitabine (G) and cisplatin (C) patients (pts) with untreated advanced biliary cancer (ABC).
Adjuvant chemotherapy with gemcitabine and cisplatin compared to observation after curative intent resection of cholangiocarcinoma and muscle invasive gallbladder carcinoma (ACTICCA-1): A randomized, multidisciplinary, multinational phase III trial.
Hi,
My father had an operation due to extrahepatic bile duct cancer. His tumor is resected, now he is getting adjuvant therapy.
He received two cures of 5-Fluorouracil. We have changed the oncologist. Now he started a new treatment with gemcitabine+oxalpin. By the way, the oncologist explained that 5-Fluorouracil is also fine.
Is there anybody who knows anything about these medicines? As far as I understood, gemcitabine + cisplatin is the most widely mentioned medicines in this forum. But our oncologist did not choose to use them, I am not sure why.
I would be grateful if you share your experience with me.
Thanks.
I wish the best for all of us.Congratulations on successful surgery. Hope your mom recovers soon!
I want to share our experience. My husband was diagnosed with ICC in November 2010 and had surgery in December 2010. It was a single lesion (~4cm) in the left lobe at that time. He had successful surgery with clean margin followed by 6 cycles of adjuvant chemotherapy (cisplatin plus gemcitabine) 6 weeks after surgery. However, his tumor came back 4 months after he finished chemo. Recurrence of ICC is high so adjuvant chemo therapy would be a valid option. Please discuss with your onc.
Lee
