Search Results for 'gemcitabine cisplatin'
-
Search Results
-
[Treatment Outcomes of Gemcitabine and Cisplatin Combination Therapy for Unresectable and Recurrent Biliary Tract Cancer].
Safety and efficacy of afatinib as add-on to standard therapy of gemcitabine/cisplatin in chemotherapy-naive patients with advanced biliary tract cancer: an open-label, phase I trial with an extensive biomarker program.
A SEER-based multi-ethnic picture of advanced intrahepatic cholangiocarcinoma in the United States pre- and post-the advent of gemcitabine/cisplatin.
In reply to: Our New Discussion Board is HERE
Hi Matthew,
Welcome to our community. There is abundant information on the Cholangiocarcinoma Foundation website for newly-diagnosed patients and their caregivers.
There are medical research studies on whether strong cancer treatments such as surgery, chemo and radiation can be safely pursued if the patient is at an advanced age. My recollection of the findings is that, in general, treatment decisions would depend on how robust the health status is of the patient; in other words, that age alone should not be the deciding factor for whether or not to treat a cancer. I would add, as a patient, that the patient’s view on treatment should be carefully considered. It is important to be sure your father is being seen by doctors with experience with this rare cancer. Sometimes doctors who have not seen other cholangiocarcinoma patients may be unfamiliar with the various treatment options, which have evolved in recent years.
For patients not able to have surgery, the most typical first-line treatment is a combination chemo of gemcitabine with cisplatin. For some patients not able to tolerate the side effects, gemcitabine alone might be tried. There have been a few older patients on this board reporting being treated with capecitabine, another chemo. Capecitabine comes in pill form. If the cancer is confined to the liver, there are some possible localized treatment options, e.g., radiation. It is a good next step that your father will be seen by an interventional radiologist.
If a patient has blockages in his or her bile ducts, then steps are taken to address that, e.g., with stents or drains.
This is hard news to receive just before the holiday season. I hope your father is comfortable and has any symptoms under control.
Regards, Mary
Hello,
The last few weeks have been a surreal nightmare. After my wife gave birth to our third child, she started getting itchy and was having dark urine. We thought it was a gallbladder stone, but after many tests she was diagnosed with PSC. We live in the Chicago area so we decided to transfer her care to U of Chicago, where further testing showed CC. At that point we were devastated. However, we have since been much more hopeful, as the PET scan didn’t even show any focal points or lesions. Basically, we know it is there from the actual biopsy, but beyond that there is no actual tumor. We have been told she has a stricture in the common bile duct and that is the source of cancer, however we definitely caught this EARLY, which is wonderful. The team at U of Chicago is great and has her on the a variation of the Mayo protocol for transplant, which is cisplatin and gemcitabine for 6 weeks, followed by radiation and oral chemo, then brachytherapy, then hopefully a liver transplant. The transplant will most likely involve a whipple as well. We plan to explore both live donor and deceased donor when the time comes.
I’m curious if anyone has gone through this type of protocol? Right now, our biggest worry is that the cisplatin and gemcitabine won’t work, but we shouldn’t worry too much as this seems to be the best regiment for this cancer and I’m hopeful it will be even more effective since we caught it early. Additionally, we are planning to visit the Mayo clinic in MN to get a second opinion and ensure we are on the best protocol. My wife is only 33 and is great health, I will do everything I can to ensure she beats this.
Hi all,
I’m writing on behalf of my Mom (68) who was diagnosed a few weeks ago and we have lots of questions for anyone that would like to chime in with their own experience.
After presenting in the ER at Henry Ford Hospital with extreme pain in her abdomen along with symptoms of stomach flue, but without fever. The team conducted ERCP, and a restriction of the bile duct was found. A biopsy was taken and a metallic stent installed. The biopsy was positive for cholangiocarcinoma (extrahepatic or distal).
Some spots in the liver were found on CT and confirmed via MRI to be metastasis. Approximately a dozen nodules up to 12mm were found. No spread was noted elsewhere.
The surgical oncologist who was hoping that with no spread would recommend whipple as my mom is otherwise very healthy, however our understanding is he would not perform this with metastasis as no possibility to cure – does anyone have any reason to believe there is other options? The team at HFHS is recommending standard of care of gemcitabine and cisplatin (her port was installed today).
We’ve been calling around and pushing to get in somewhere else for 2nd opinion at University of Michigan, MD Anderson, and locally here at Karmanos and even a consultation with Dr Berri at Ascension to discuss HIPEC. I understand HIPEC is really for metastasis in the peritoneum, which was not noted in CT or MRI, and only performed along with resection.
Henry Ford also had no suggestion for radiation, so they did not bring in the radiation oncologist to meet with us. Does this make sense? My understanding is she is not a good candidate due to the number of nodules in the liver.
Unless things start moving soon, the earliest we can get in to University of Michigan is 2 weeks, and not until January for MD Anderson. Does anyone think we should get second opinion before beginning first line treatment? We’re also going back to Henry Ford tomorrow to figure out what needs to be done to send samples for genomic testing. My mom will likely not consider trials that are not near home (Detroit) or family (Salt Lake, Seattle).
Obviously we know that there’s a tough road ahead and the outlook is not good. Any thoughts or comments on course of action are appreciated!
-Chris
Thanks to Mary for compiling this info.
News for Patients and Caregivers
The 2018 Congress of the European Society for Medical Oncology is meeting this week, and pharmaceutical companies working on new cancer treatments are presenting their progress. There is much good news to report for cholangiocarcinoma patients and caregivers. For example, an analogue of gemcitabine (“Acelarin”), two new treatments for cholangiocarcinoma patients with the FGFR mutation, and two new treatments for patients with TRK mutations all show promising results in clinical trials. I would like to take this opportunity to express appreciation to cholangiocarcinoma patients and their caregivers who, with courage and commitment, have participated in these and other clinical trials that benefit our community.
Links to press releases appear below.
Acelarin (NuCana): “In this Phase Ib multi-center, open-label study in front-line treatment of patients with advanced biliary tract cancer, Acelarin combined with cisplatin was observed to continue to achieve approximately a doubling of the response rate expected with the standard of care, gemcitabine plus cisplatin.”
http://www.nucana.com/downloads/NuCana21October2018.pdf
Infigratinib, formerly BGJ398 (QED Therapeutics): “These results show that infigratinib has strong potential to make a real difference in the lives of people with cholangiocarcinoma,” said Susan Moran, M.D., M.S.C.E., chief medical officer of QED Therapeutics. “Importantly, we have initiated a pivotal, Phase 3 study in first-line cholangiocarcinoma in the hopes of offering patients an upfront chemotherapy-free treatment option.”
Pemigatinib, formerly INCB54828 (Incyte Corporation): “In patients with FGFR2 translocations who were followed for at least eight months, interim study results demonstrated an overall response rate (ORR) of 40 percent, the primary endpoint, and a median progression free survival (PFS) of 9.2 months, a key secondary endpoint.”
Entrectinib (Roche): “ ‘These data demonstrate the potential of entrectinib to treat a range of difficult-to-treat and rare cancers regardless of their site of origin,” said Sandra Horning, MD, Roche’s Chief Medical Officer and Head of Global Product Development.'”
https://www.roche.com/investors/updates/inv-update-2018-10-21.htm
Larotrectinib (Loxo Oncology): “‘It is exciting to see larotrectinib deliver durable responses to patients in these studies with TRK fusion cancer, regardless of age, tumor site of origin, or CNS involvement,’ said Ulrik Lassen, M.D., Ph.D., Department of Oncology, Rigshospitalet, Copenhagen.”
Thanks to Mary for this and to all of the companies and organisations listed and linked to above.
Gavin
Clinical Benefit of Maintenance Therapy for Advanced Biliary Tract Cancer Patients Showing No Progression after First-Line Gemcitabine Plus Cisplatin.
Topic: Im new!!! HIIII
Hello every one! Well, my name is Laura, i am 28 y.o and I was diagnosed with stage IV cholangiocarcinoma with tumors on my liver n somw on the lymp nodes. I was diagnosed on June and lets just say my life did a full 360. It didnt fully hit at first but now it’s finally sunk in. My last CT scan showed two of the bigger tumors on my liver shrunk by 2cm n there has been no change on the other ones. I have faith that I will get through this. What are some alternatives that have worked for you guys? Im undergoing chemo (gemcitabine and cisplatin) n cbd oil. Anything else I should be trying?
Prognostic implications of hepatitis B virus infection in intrahepatic cholangiocarcinoma treated with first-line gemcitabine plus cisplatin.
Selumetinib (Sel) and cisplatin/gemcitabine (CisGem) for advanced biliary tract cancer (BTC): A randomized trial.
Liposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU) and leucovorin (LV) or gemcitabine plus cisplatin in advanced cholangiocarcinoma: The AIO-NIFE-trial, an open label, randomized, multicenter phase II trial.
Biweekly cisplatin and gemcitabine in patients with advanced biliary tract cancer
https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.31144#.Wte97aQwkoI.twitter
Thanks to International Journal of Cancer and Wiley for this article.
Topic: Inoperable bile duct cancer
My husband (60) is presently in treatment with chemo. He’s taking gemcitabine and cisplatin. We were told at beginning that it was inoperable because of vein entanglement, but on an off chance, they sent us to a surgeon in Toronto. He confirmed that it was inoperable at that time, but that chemo may reduce it enough to allow for surgery.
Has anyone had surgery after originally being told it was inoperable? Our medical oncologist told us yesterday, that the likelihood of surgery was pretty low.
Hubby continues to look fine, he has virtually no symptoms from the cancer itself and is tolerating the chemo very well.
We are wondering next steps:
– once this chemo is done, what would they do next (assuming scans aren’t worse)
– would he go on another chemo, or are there other protocols?
– how weird is it that he continues to feel so well? Is it a matter of waiting for the other shoe to drop
Any info/advice/support would be appreciated
We are in Ottawa ??
In reply to: Chemotherapy What can we expect?
Hi Kate,
Stable is good news! And it is also good that you and the doctors are looking ahead to figure out next steps should they be needed.
My impression is that there is no way of predicting how long a chemo regimen will stay effective for a specific patient. The experience seems to vary from patient to patient. I have come across fellow patients who have been on gem-cis for well over a year.
Hearing loss is a potential side effect for cisplatin. Not everyone experiences this but enough do that doctors watch out for it and some periodically send gem-cis patients for hearing tests. I saw a study recently on this – here is the citation: https://www.cancer.gov/news-events/cancer-currents-blog/2018/cisplatin-hearing-loss
Gemzar is the brand name for gemcitabine. The famous ABC-02 study which compared gemcitabine alone with the gem-cis combo showed the combo to be more effective, and was the basis for gem-cis now being a standard of care. That said, some patients do report being treated with gem alone (which does have effectiveness with cholangiocarcinoma, just somewhat less so than gem-cis) in cases where they are not able to tolerate the stronger two-drug treatment.
My understanding is there is no standard second-line chemo regimen for cholangiocarcinoma. Patients report undertaking various combos, including Folfox, Folfiri and others. Looking into clinical trials is another option. Has your husband had genomic testing to see if his cancer shows genetic defects for which there are targeted treatments available through trials?
The experience with second-line treatments and clinical trials is also variable, but for many they do buy time. Some patients have gone years shifting from treatment to treatment, with a good quality of life. There is always hope.
This is the best I can do with your questions, not being a doctor. Since there is a range of possible next treatments for when your husband needs to move on from gem-cis, it will be important to be armed with info and questions for your medical team to be sure the next phase of the journey is the best possible option for him.
Keep us posted! Regards, Mary
