Search Results for 'gemcitabine cisplatin'

This sounds like a logical plan. I am now on gemcitabine + cisplatin (and tarceva pill every day). My onco said that when/if this combination ceases to be effective, his next line of defense would be to change to gemcitabine + Xeloda. However, I have not gotten to that point, so don’t have first-hand experience to relate. Anyone else out there want to weigh in on this one? Jeff?

Violarob in Texas

Ron,
I hope your gemcitabine treatment goes well. My husband, Anthony, had it combined with cisplatin and he tolerated it all pretty well – for 6 months in all. You mentioned that a trial might be the next step. I don’t know how you would feel about travelling to London for treatment, or, indeed if this trial is also under way in Scotland, but there is a promising trial of a drug called BIBW 2992 at Guy’s Hospital led by Dr Spicer. My husband, Anthony, was offered it but, unfortunately his disease progressed too far before he was able to start it. Just something for you to be aware of and to maybe ask about.
Good luck with the chemo,
Pauline

There are other postings on this web site regarding Tarceva. I think you can do a search to find them. I have been taking Tarceva for 5 months, in conjunction with cisplatin and gemcitabine. I had acne for the first 3 weeks, but none now. I am having no side effects for the past 4 months. My tumors are completely stabilized, with no mets outside the liver. At the moment, I think Tarceva has been FDA approved for only pancreas and kidney cancer, but it is commonly used now for cholangio and HCC. Good luck to you!

Violarob in Texas

This thread is very timely for me. My case was presented to the MD Anderson Liver Study Group in July (I guess I am considered an unusual case). I have mixed cholangiohepatocellularcarcinoma, complicated by chronic hepatitis B and extensive cirrhosis. There are 7 small tumors scattered throughout both lobes. (The largest tumor is only 1.2 cm, and the smaller ones are barely visible on scan). Oddly, my remaining liver reserve is functioning at a very high level with all normal lab values. I have high energy and work every day.

I am not a candidate for liver transplant, and they said radiofrequency ablatioin is too dangerous for me, but they would consider treating me with SIR spheres at some future date.

I will follow this thread, as I am most interested to know anyone who has had this procedure done, and their experience. Tumor shrinkage? Side effects? Insurance battles? Tell all!

In the meantime, I am doing great on my Tarceva/gemcitabine/cisplatin regimen. No side effects, and swimming every day!

Violarob in Texas

Dear Jeff: Ooops! what I meant to say was that I take the Tarceva (erlotinib) 150 mg tablet every day. The cisplatin and gemcitabine are given by IV drip infusion once every 3 weeks.

I had transarterial chemoembolization done at Baylor Liver Center in Houston. The chemo agent was doxorubicin. I don’t know what the embolizing agent was. I had a very bad reaction after the procedure (inflammation, fever and very intense pain for hours, requiring multiple injections of fentanyl). Before the procedure, they told me that in their experience only 50% of those who do it get tumor shrinkage. I don’t know if I benefitted or not, because I transferred to MD Anderson a month later and started a completely different type of therapy. In that one month, the tumors did not shrink, but did not grow either.

I am now on gemcitabine and cisplatin, with Tarceva every day. I feel good and am doing well. Disease is stable according to CT scan.

Violarob in Texas

Hello, Pearland.

I am also being treated with gemcitabine and cisplatin. I get my infusion every 3 weeks. In addition, I take Tarceva (erlotinib) every day. I have had 4 infusions so far. My recent scan showed stabilization; no growth. I am feeling great, and have absolutely no side effects from any of these drugs. I hope you continue to do well.

Violarob in Texas

Dear Stacie,
I did reply to Prof.L and my husband Anthony and I are very keen to see big improvements in care for patients with cc in the UK. A few key points might be worth stressing:
* patients are given different advice and treatment according to which area of the UK they live in e.g. some are told to have no treatments at all whereas others are advised to start chemo straight away. Some are monitored carefully with regular blood tests and scans, others are not.
* it is very difficult to find out where to go for treatment, for example, we have recently discovered that there is an NHS trial at Christie’s and Hammersmith of gemcitabine/cisplatin but we didn’t know about this when my husband needed it.
* many oncologists in the UK seem to be very anti radiation treatment and this means patients rarely get offered it even if they really want it. If you decide you want to try radiation because you have done your research, for example, on the work of the Mayo Clinic it is then extremely difficult to find a hospital willing to do it. They do exist but there is no information available about who does what and it may take you several months of stress to find it. We even heard of a young patient who travelled to Canada for radiation treatment because he couldn’t find it here. (Our experiences in searching for different treatments and finding them actually led us to want to try to help others in our situation and this is why I first started posting on this site).
* as this is a rare cancer it feels as though patients and their families have to do a lot of the hard work themselves, both in terms of research and in finding treatments. When you do locate the treatment you want you can find yourself attending several different hospitals which is clearly not ideal as no one has a complete over view of the patient. What we feel we haven’t had is some one saying ” OK here is the plan – we’ll try chemo and then next we’ll try such and such ” The patient perspective in our experience is one of having to be very pro active and having to push for every thing at every stage.
*Due to the rarity of the cancer and its poor outcomes for patients there is very limited research going on in the UK and therefore we seem to be very slow to be given access to new treatments compared, for example, to patients in the USA and other European countries.
In conclusion it would seem that having specialist centres for cc would enable patients to
1. Access a variety of relevant treatments more easily than is currently the case with a consultant who has a complete over view of their case.
2. Attend one hospital with consultants who would have ever increasing expertise and experience with this cancer.
3. Experience less stress and be able to concentrate more on getting better than on getting treatment .
It would enable doctors to
1. Establish a set of common procedures for patients from which datailed individual patient plans can be developed.
2. Undertake some research into this cancer to further develop plans for patients.
3. Link up with the other centres to pool experiences and results.
4. Develop expertise in and an over view of what really works for patients with this cancer.

I hope this information is useful and Anthony and I are really looking forward to hearing about the outcome of this.

Thanks for taking this issue on board. I am very willing to be involved in whatever way I can in improving things for patients with this disease.
Pauline Roberts

Dear Professor L,
I have written several posts on this site about the problems of finding treatments for cholangiocarcinoma in the UK and my husband, Anthony, and I are very pleased to read your message. Since he was diagnosed a year ago we have spent many hours on the internet researching the disease and then have spent many more hours trying to find out where the different treatments are available in the UK. My husband was keen to try treatments that aimed at reducing the tumour with a view to surgery if this became possible. We read a lot about the pioneering work of the Mayo Clinic and other centres in the States and decided to try to get radiation treatment when 6 months of gemcitabine/cisplatin failed to reduce the tumour.
Our experience was that it was very difficult to find out who would do this in the UK. We nearly travelled to the mayo clinic but after several months of telephone calls and e mails we found a doctor at Barts who was prepared to do it. Our experience was that it is a complete mine field trying to find out who does what and where and even the consultants don’t seem to know. All this really added great stress to an already very stressful situation. It did’t seem necessary that we had to spend so much energy simply trying to find treatments that already exist and are offered on the NHS. I was desperate for some kind of list of available treatments for this cancer but soon realised that it doesn’t exist.
I came onto this site to try to help other UK patients by saving them time if they were trying to search for some of these treatments. I would certainly be very keen to communicate with anyone in the Department of Health with a view to improving this situation.
Anthony and I think that centres for patients with this disease providing all the various treatments( chemo/PDT/external and internal radiation/embolisation/surgery) would be useful but probably even more important to all patients in whatever area of the UK would be clear information on where the different treatments are available so that everyone gets the same chance to access them if they want to and if they are suitable for them. I look forward to further communication with you on this issue.
With thanks,
Pauline Roberts

Great news, Jeff!!! So glad for you.

My wife, Lana had CT scan Wednesday. Tumor or her liver has not increased in size. A few spots on her lungs have reappeared. So, after five rounds of gemcitabine (which she did not tolerate well at all) and six rounds of oxaliplatin, the doc decided to change the treatment to cisplatin along with a smaller dose od gemcitabine. He also set us us for an interview for a clinical trial at the Indiana University Medical Center.

Anyway … that’s wonderful news from you.

Steve