Gem/Cis v. Folflorinox
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Thank you for your responses.
PCL1029, as of now, we have not made up our mind. In fact, we are still on schedule to begin the Gem/Cis treatment this Wednesday. We have reached out to the Oncologist from our first consult to ask her the same question. When we met with her, she suggested Gem/Cis to start and had mentioned the names of 5-FU and oxaliplatin as possible alternatives to the Gem/Cis. That was the first time we heard of these drugs (I am still naive and trying to learn more every hour about this disease). Then when the second consult introduced Folfirinox, it triggered some thoughts that we’ve now heard about these alternate drugs twice and this treatment plan had better (relative) success.
The doctor was very confident that Folfirinox would have similar effects with ICC as it had with pancreatic cancer. He did say he would only recommend this to patients who are otherwise healthy because it has potentially more side effects.
We do need to make this decision today and the reason we are considering the alternate plan is to take advantage of whatever strengths we have to fight this disease. If my wife’s physical health is a current strength, we want to use it to its fullest.
Your feedback is truly appreciated.
Hi,
If the diagnosis for your wife is ICCA, and if I were her, I will start the 1st- line chemotherapy such as GEM/CIS first. and if it is not working later, then I will start the 2nd-line chemotherapy such as Folflorinox. You can get some ideas about the toxicity of each regimen like GEM/CIS and Folflorinox by combining
each individual drugs(GEM/CIS=gemcitabine+cisplatin) and (Folflorinox=5FU+oxaliplatin+irinotecan,the folinic acid is not a chemotherapy agent).http://www.cholangiocarcinoma.org/punbb/viewtopic.php?pid=57198#p57198
I think your doctor’s original suggestion of GEM/CIS and radioembolization is a logical and good combination choice for non-resectable ICCA.
But I think you have had made up your mind already. So good luck and
God bless.Dear Carl, I am not proficient when it comes to Chemo as my Husband never had it but I want to wish your wife much good luck and it sounds like you have a good and aggressive ONC. Read up as much as you can on Folfirinox as knowledge is our best tool for fighting CC. Wishing you both the very best and please do keep us informed of her progress as we truly care.
Hi Carl. My husband had a resection for ICC in November 2011 but it recurred in September 2012. His oncologist sent him for a consultation at the U of Chicago where they were doing a Folfirinox trial. My husband wasn’t eligible for the trial but the two oncologists recommended he try Folfirinox anyway. His first treatment was on November 1, 2012. He had very few side effects for the first eight weeks but then began experiencing more serious problems with diarrhea and fatigue as well as neuropathy. After my husband had completed sixteen weeks on Folfirinox, the doctor modified the treatment somewhat by reducing the dosage of one of the drugs and eliminating oxaliplatin. These changes greatly reduced the side effects and the recent scan showed that the tumors are still stable.
My husband is ten years older than your wife but he was able to handle the side effects pretty well and has kept working full-time throughout the treatment. However, each person reacts differently and Folfirinox is a very tough regimen that many people are unable to tolerate. The data seems to show that it is the preferred treatment for pancreatic cancer but research on its effect on cholangiocarcinoma is limited. Best wishes to your wife.My wife was recently diagnosed with non-resectable ICC. We have gone to 2 outstanding Cancer Centers for consult visits prior to starting treatment. We thought she might qualify for an interesting clinical trial, but sadly the trial (Phase 1) is on hold.
We heard a common message for the treatment plan (Gem/Cis) from these specialists. But yesterday, we learned about Folflorinox as an alternative chemo plan. My quick reading indicates this has generated more documented information for pancreatic cancer (which the doctor told us) and the success rate seems to be better for those who can manage the side effects. The doctor said my wife would be a good candidate as she is young (56), fit and otherwise healthy.
Can you share your experience, thoughts, and ways to prepare for Folflorinox treatment. It would be greatly appreciated.
Thanks,
Carl, aka Scheitrumc
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