Search Results for 'gemcitabine cisplatin'
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Search Results
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Topic: Introduction
Hi, our beloved brother was diagnosed with CC just a few weeks ago. As a family we are working to support him but there is so little on this cancer. His Dr referred me to this site, which I am grateful to have found. He has the equivalent of a stage four cancer and it is considered inoperable as it is also in his lymph nodes and ribs. Presently it is the pain in his ribs that is inhibiting his life style. Their goal will be to balance quality of life with trying to kill the cancer. Right now they are looking at using two strong chemicals (gemcitabine and cisplatin), once a week for two weeks, then one week off. After three rounds of this – or nine weeks – they would check to see if the tumors have gotten any smaller. He has completed the first two treatments and he is tested on this week to see how the treatment is working. We really don’t know what to expect next, but we are hopeful this treatment provide some relief and hope. It is helpful to hear all the good stories on this site.
In reply to: starting chemo on may 1 – any tips
Hi,
welcome to our small world.
1. Gemcitabine and Cisplatin are the current standard of choice of Tx for cholangiocarcinoma(CCA). there are still many other regimens to choose from if this one is not suitable for your mom in the future.
Gemcitabine is easy to take,minimum side effect like low platelets count is one of the the most stand out side effect. Nausea and vomiting,loss of hair,fatigue,body ache,nephrotoxicity(kidney);hypomagnseium and hypopotassium are side effects of cisplatin. Nephrotoxity is accumulative and therefore ,depending on the health of the patient,after certain # of cycle(ie: 6 cycles) ;review of the regimen may be a good way to protect esp. the kidney if the side effects cannot be tolerated well.
To start the chemotherapy each time overnite is a good idea and I don’t know why we cannot do this here in the States. It is less anxiety to the patient and they can sleep thru some of the unwanted side effects of the chemotherapy.
2. 63 years young and otherwise healthy individual after left liver resection, (even had a lympth node positive involvement )has a good chance to live long enough for the next new thing to come in radiation oncology or/and medical oncology to extend our lives with much less side effects and enjoy God’s mercy for those who suffer. I do not see a “magical pill “will be discovered in the near future like penicillin for infection that provide a “CARE” for us.
3. Continue to pursuit other options such as radiation treatment ;read and learn about it and other development of treating this CCA is the way to handle this disease. I am a CCA patient for 35months,like your mother,I had the left lobe completely resected;on gemcitabine for 14 months;off the chemotherapy for 6 months,CCA came back;RFA and chemoembolization; then re-resection again.Now is only on Xeloda(pro-drug of 5FU);and the rest is up to God’s mercy.what I am trying to say is this; CCA is a long and winding road to navigate ; it require courage,knowledge and patience; it is not easy but it can buy time for your mother.
keep in touch,
God bless.hi friends,
my mother had a left hepatectomy on mar 17, for a case of intrahepatic cholangio with spread to the celiac lymph nodes (1 out of 2 nodes positive). we live in india, and are getting treated here (under the guidance of dr. javle from md anderson, who has kindly consented to help us).
she will be starting a chemo combo of gemcitabine and cisplatin from tues. she is a healthy and fit 63 year old, with no health problem (liver has been fine too).
any tips on getting physically and mentally prepared?
the plan is to keep her overnight, and the chemo will be delivered via a port.appreciate your input,
ash.
In reply to: Hello From Mississippi!!!
Thanks everyone for the warm welcome!
All of this started July 2011, for the 1st two weeks my husband complained of headaches, belching & pain in the upper stomach area. Finally I talked him into seeing a dr on July 20th and he was diagnosed with High blood pressure & heart was racing. The dr called an ambulance & he was taken to the ER. Once there drs ordered x-rays & tons of blood work. After about 5 hrs he was admitted to a room & we were told “All blood work showed was Liver enzymes were .2 above normal. An hr & 1/2 later CT & ultrasound was performed…heart dr came in & said “Apparently you’ve had a heart attack”. More test were ran up until midnite.
The next day oncology dr came by & told us that Don had cancer. CT showed spots on liver & lungs. He was then scoped up one end & down the other to see if any other problems. Was told he also has acid reflux & hiatal hernia. then by noon, heart test was done & showed needed 2 stents in heart. That was put on hold til a biopsy could be done on the liver.
Don was in the hospital July 20th-26th , we even celebrated our daughter’s 23rd bday at the hospital. He was sent home with follow-up @ the West Clinic (Cancer Clinic) in town.
His appt was Aug 3rd…had MRI & was waiting to have liver biopsy but the dr decided to do it with a lymph node in his neck that was swollen. Said he didnt want the hubby to have to indur more pain that wasn’t necessary. Results 5 days later showed no clue as to where cancer started….so more test was going to be done. While waiting for those results ,hubby had the port put in and the 2 stents in his heart.
On Aug 18th, we were told the tests showed cancer started in the liver & spread to the lungs. Cancer was called “Cholangiocarcinoma and we needed to start paperwork for disability because he would never work again.” Forgot to mention that Don is 54 years old.The dr asked if we had questions & I asked him what stage of cancer. His response was “I don’t want to tell you…it’s Stage IV”. He said I must have known what stage because I was asking a lot of questions…that I must have been looking it up. Then he said “I REFUSE TO SAY HOW LONG YOU HAVE TO LIVE”.
Before leaving a plan of treatment was scheduled & then scheduled for stents & portacath to be put in.
On Aug 31st, chemo was started with cisplatin & gemcitabine once a week for 2 weeks then off a week…this would go for 12 times. On the 5th time of treatment CT was done…showed everything was the same. Treatments continued til the 9th one ,CT showed lung spots smaller…liver the same & a spot on spine. While all this is going on, I’m at the hospital w/our 15 yo…kidney stones. It seemed like our lives were falling apart at the seams. Hubby was only able to do total of 11 treatments because of low blood counts. Last treatment was on Dec 21,2011.
Now it’s a new yr, on Jan 11th…CT showed spots on lungs were back & liver the same. It was discussed w/us about hubby going on a Trial study. We talked w/dr & our kids, decided to do it. He was put on Tesatexol & Xeloda. Did fine until almost finishing the 2nd bottle of Xeloda…had a reaction to it. Feet & hands swelled to the point of not being able to walk or hold anything…also in alot of pain. Treatment was stopped on Mar 9th.
Sorry this is so long…didn’t realize it was so late. Will write more tomorrow after getting some sleep.
Thanks for “listening”.Topic: Clean Scan
Hello all,
My wife, Marina, had a full body CT scan last Thursday. Our oncology nurse called us today with great news. The scan was CLEAN!! No evidence of recurrence.
The nurse gave us a heads up: our oncologist will offer us another chemo cycle. Gemcitabine/Cisplatin cycle #6. The nurse said he likes to add a cycle or two *after* a clean scan. We will see him tomorrow (Thursday) to discuss this. I’m not sure yet what we are going to do.
I also want to mention that we reached a milestone. Tuesday marked the one year since Marina’s CC symptoms showed up. April 10th, 2011 she came down with severe abdominal pain. We thought she caught a bad case of food poisoning at a friend’s dinner party (little did we know).
So there you go. A clean scan at the one year mark. I hope Marina’s good news give hope to others!
My very best wishes to each and every one of you.
Hugs,
EliHi,
First, It is inappropriate to compare the cisplatin and oxaliplatin on a “mg per mg” basis. since they are not the same in chemical structure and molecular weight. and I think 100gm/m2 for Gemzar was a typing error.
Second, Base on http://www.chemoregimen.com and other resources for biliary CCA;the dose schedule are as following:Gemcitabine + Cisplatin
Gemcitabine (Gemzar) 1250 mg/m2 iv d1, 8
Cisplatin (CDDP) 75 mg/m2 iv d1
Q3w (every three weeks)Thongprasert S et al. Phase II study of gemcitabine and cisplatin as first line chemotherapy in inoperable biliary tract carcinoma. Ann Oncol 2005; 16:279 (link to the article).
Gemcitabine + Oxaliplatin
Gemcitabine (Gemzar) 1000 mg/m2 iv d1
Oxaliplatin (Eloxatin) 100 mg/m2 iv d2
Q2w (every two weeks)Andre, T et al. Gemcitabine combined with oxaliplatin (GEMOX) in advanced biliary tract adenocarcinoma: a GERCOR study. Ann Oncol 2004; 15:1339 (link to the article).
Therefore I do not think you are under treated .On the contrary, I will worry about the subsequential side effects especially the kidney toxicity produced by the WEEKLY administration of cisplatin.
Below are the MAXIUM dosage suggested by each manufacturer (including the use in other forms of cancer) ;of course the physicians have the right to use the drug beyond those limits if supported by appropriate documentation
and the performance status and disease state of the patient.Cisplatin=100mg/m2 .(per dose)
Oxali[platin=130mg/m2 (per dose)In the famous ABC-02 trial, (CCA pop=242 out of total pt pop 410)the dose of Gemzar is 1000mg/m2 on day 1,8,and the cisplatin is 25mg/m2 on day 1.repeat every 3 weeks for 6 courses.
Depending on what your oncologist means “less side effects”( I think he was referring to the neuropathy side effect that you have ) oxaliplatin is more tolerable than cisplatin overall.
God bless.
.My high doses are gemcitabine 1000mg/m2 (1st day) and Oxaliplatin 210 mg/m2 biweekly. (2nd day)
My low dose Onco wants to give me a weekly treatment of 100gm/m2 gemcitabine and 40mg/m2 of cisplatin.
my calculations show a biweekly comparison of 1/5 for gemcitabine and 4/5 for oxaliplatin vs cisplatin.
Am I being under treated with the low dose of gemcitabine?
Anyone have any links to research for low dose ICC chemotherapy???
In reply to: My Father’s story…..
Thanks for sharing this info queenzerka. Would you mind sharing where you purchased DCA for your father? I’m seriously considering this for my Mom who’s been diagnosed with a tumor the size of a baseball…I’m open to anything that will help shrink my Mom’s tumor. She’s currently on her 2nd round of cisplatin/gemcitabine chemo regimen.
Thank you in advance.
Topic: My Father’s story…..
I just wanted to write my father’s story for everyone.
Early December 2011 my mother noticed while they were playing cards how yellow my father was and told him that he needed to get that checked. He made an appointment with the doctor, when he got there he told the doctor his symptoms and the Drs response was that there was an 80% chance he had pancreatic cancer and that more tests need to be performed. They sent him for a CT and some other tests. When they came back, the Dr said it was not pancreatic cancer, however there seemed to be a narrowing in the bile duct and that he would have to go to the hospital for a ERCP and EUS to take a look the next week.
After his tests, the results came back, it was cholangiocarcinoma, the doctor did not think it was resectable based on what she saw but she was willing to schedule a surgical consult at the U of Minnesota (we are lucky enough to live by both the U of M and Mayo).
The surgeon agreed to try surgery and it was scheduled for 12/22, when they opened him up it was clear that it was indeed not resectable. He wasn’t a candidate for Mayo’s liver transplant either since the tumor was so big (about 3 inches long, kind of narrow and following the bile duct up to the liver but no liver spots seen). We had him take a photo of the ugly thing. Not the Christmas present we wanted.
He started chemotherapy with a combination of gemcitabine and cisplatin as a palliative therapy. The oncologist gave him 6 to 18 months. Everything we read said that he had no chance, unresectable tumors have a 0% five year survival rate so I went on a mission to look for a miracle. I dove in feet first, reading open trails, clinical trail reports, medication studies, got access to a university database and ran through that as well (I’m an analyst so doing research sifting through large amounts of data is what I do). I came across a drug called Sodium Dichloroacetate (DCA), Universities have been studying it, it has open trails but isn’t available in the US. We went to the dca site, found a guy named Bill who has survived since 2005, after he had a whipple and it came back. I googled Bill to make sure that he did in fact exist and was a real guy, and he was. We talked to him on the phone, his advice was to start DCA right away, don’t wait until the 4th round of chemo when your body is destroyed to do this as a last ditch effort. After that conversation, my dad ordered DCA from a website.
He started using DCA as soon as he got it, 10 mg per kg with caffeine and b1 daily, 5 days on, two days off (chemo day and day after). The oncologist isn’t aware of this, he didn’t even want my father to take vitamins because they may interact with chemo. Harold has not had any reaction to the DCA, the chemo I can’t say the same, he has fevers and nausea from it right after as well as low blood counts.
Fast forward 3 months:
My father went in for a CT scan, when the results came back and showed significant tumor shrinkage. The doctor was amazed at the results and highly encouraged. I personally feel it’s a combination of the DCA and chemo. We’ll let the oncologist in on our little secret in a bit after a couple more scan results.I’m not recommending people to do what we have, but it seems to be working for us right now, I’ll let you know in a couple months what the next test shows (hoping it keeps going in the right direction). We were also looking at metformin since it has open trails as well but more for pancreatic cancers however it shows to help reduce metastasis of cancer which would help in addition to the DCA and Chemo. (still trying to find a dr to off label that one for us)
MIT has put in a patent for a cisplatin/DCA treatment called MITAPLATIN.
Hi all. My Mom just finished her chemo #2 today. So far, so good! Anyway, as expected Cisplatin went up first followed by Gemcitabine (I believe there’s hydration pre-, in between and post).
@PCL – here’s the link provided by my Mom’s oncologist.http://www.nejm.org/doi/full/10.1056/NEJMoa0908721
It’s a clinical study published in the New England Journal of Medicine.
@Pamela – I appreciate all the information you provided. I wish you and Lauren all the best as well. Lauren is very blessed to have you fighting this battle with her.God bless!
Hi! So far, so good with my Mom post-first chemo round. She has been feeling the need to sleep more. I guess this is better as opposed to being sick in the stomach or something.
@PCL – Sorry for the late response. I understand what you mean about shorter infusion time. It was an hour shorter because the RN administered both the IV hydration and Gemcitabine at the same time. Anyway, we’ll be seeing her Oncologist on Monday and I’ll make sure to ask him about the rationale behind the Cisplatin first then Gemcitabine next.
Hi,
your wrote
“Her Oncologist ordered specifically for her to receive Cisplatin 1st as opposed to their usual routine of Gemzar then Cisplatin. This was also clarified by the nurse. Apparently, there has been a study/clinical trial done sometime in 2011 regarding this matter.”In my opinion,the only regimen(Taxol/Cisplatin or oxaliplatin and carboplatin) that may use for liver or CCA is the only chemotherapy regimen that required a specific order of adminstration. that is Taxol first and cisplatin later for the maximum benefit.if you want ,you can go the the experience forum look under the chemo forum title:Hey percy,could you—-” and you will have a general knowledge about each chemo agent;also look under title”systemic chemotherapy” for the combination regimens; for controlling nausea/vomiting ,go to the adverse reaction and side effects forum look under:”suggestion for medication for nausea and vomiting “
I look up the oncology nursing handbook as well as a couple regimen protocols from univ. of Pitt and another univ. out patient chemotherapy clinic; and the hospital I had my chemotherapy before; All are giving the pre-med zofran first,then give the gemcitabine over 30 min;Iv 0.9% sodium cholide for hydration and then give you the cisplatin over 2 hours.;
sometimes longer. Inside the cisplatin bag;they also add the manitrol (a diuretic)to facilitate the kidney function to deal with the toxic effect that will caused by the cisplatin.And after you finish the whole infusion;they will ask a you to drink more fluids (4-6glass of 8oz) to help flush out the cisplatin and protect your kidney better.When gemcitabine and cisplatin giving together they will have the so call “synergistic effects” for the combination of the two chemotherapy agents.
As you know I am not a doctor; I am only a patient,but I do not think the order of administration in CCA to give cisplatin first is that much a deal; I ,myself only will not change it since the order of administration that use now already provide the “synergistic effect” benefit and use for quite a long time.
However,the following link is very interesting and give you another opinion that support the current order of administration of gemcitabine first,then cisplatin.
http://www.cecilyadams.com/gemzar.htm
I love to know where your doctor got the idea; if you can find out the article for me,I appreciate.
God bless.
In reply to: New thread – am I getting enough????
Hi Derin,
Re: the number of cycles
Several considerations:
1. ABC-02 trial used 8 cycles to treat nonresectable/metastatic cases. I think it’s logical to conclude that adjuvant chemo should do less than 8 cycles.
ABC-02 is British Phase III randomized trial that proved Gem/Cis to be superior than Gem alone
http://www.nejm.org/doi/full/10.1056/NEJMoa09087212. Biliary Tract Cancer Treatment Protocols recommend the same protocol as in ABC-02 trial:
Quote:Systemic therapy for nonresectable or metastatic diseaseSelected stage III-IV (T3-4, Any N, M0-1):
Standard-of-care front-line chemotherapy for patients with good performance status (ECOG score ≤ 2):
Cisplatin 25 mg/m2 on days 1 and 8 plus gemcitabine 1000 mg/m2 on days 1 and 8; then every 21d for up to 24wk or until disease progression
Up to 24wk = Up to 8 cycles. Again, this is for nonresectable or metastatic cases. Adjuvant chemo should probably do less.
3. Before my wife started Gem/Cis chemo, our oncologist said he wanted to do 4-6 cycles. I asked him why not 8? (based on the info above). He explained that they usually do adjuvant chemo for up to 6 months, including 5FU/Xeloda chemo done concurrently with radiation. Marina did 5FU chemo-radiation for 2 months. That left her with 4 months to do Gem/Cis chemo. Enough for up to 6 cycles.
4. As I mentioned in another thread, we were on the fence about continuing adjuvant chemo past the 4th cycle. We met our oncologist last week. We asked him if more cycles is better. He said they don’t have any data to support any particular number of adjuvant cycles. For what it’s worth, we decided to do the 5th cycle. We are scheduled to do CT scan after the 5th cycle. No decision on the 6th cycle at this point. One cycle at a time…
Hope this helps,
EliIn reply to: Heading to Michigan for scans.
Pam…..it may just be that Lauren has reached maximum benefit. If so, then (most likely) they will start another protocol. As far as I remember, she is in the phase II clinical trial: Gemcitabine, Cisplatin, and Fluorouracil. There are other drugs to use. Stay hopeful and strong.
Tons of hugs,
MarionMy Mom has been having low grade temperature (37.6 – 38C) for almost a week now. To make her feel better, she takes Ibuprofen 200 mgs as needed (is this the correct drug of choice if someone has a fever? Or maybe, Tylenol?). I was able to take a peek on her lab results last week and today, it was 12. + and now 13.+. It is elevated, right? She is scheduled to have a port placed tomorrow and very first dose of chemotherapy (Cisplatin and Gemcitabine) on Monday. With the elevated WBC and low grade fever, is it safe for her to proceed with the port placement and chemotherapy? I’m thinking anti-biotics as soon as possible. Will chemo be delayed because of these factors?
@PCL – Thanks for your advise. It seems like Y-90 has a higher success rate in shrinking tumor/s, I wonder why my Mom’s oncologist opted for systemic chemotherapy first. I wonder if he’s aware that there’s a 2-4 week “rest period” needed in between…
Thanks in advance.
