Low dose weekly infusion vs. High dose biweekly infusion?
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Hi,
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???
I had 10 rounds of gemzar and cisplatin. I went every 14 days. I started having allergic reactions to the cisplatin, so now I will be doing gemzar and xeloda. I believe Dr. Javle from MD Anderson puts most of his people on every 14 days…
I will say I didn’t have many side effects, other than fatigue and some stomach problems.Hi,
unless your are using the infusion pump like 5FU 48 hr pump for longer duration of infusion per cycle.
the current protocol for Gemox do not called for such infusion scheduled use of the chemotherapy.
Gem/cis is less tolerable than Gemox. and most of them is 1 week with both drugs and the second week just give Gemzar.
but as you know physicians can use the referrence protocols any way they like .
If you can tell me what you mean by High dose eg.give me like I will be on Gemzar 1000mg/m2+25mg cisplatin or Gemzar 1250mg/m2+50mg or 75mg of cisplatin and is that regimen give once a week or twice;then I can have some ideas.
the following web site may be of some value to you even it does not have the most up-to-date regimens on bile ducts cancer as on our chemotherapy web page.
http://www.chemoregimen.comGod bless.
My new ONCO wants to exchange the oxaliplatin for cisplatin. He says it has fewer side effects. Medically I do not have a great prognosis so I want at least maintain a life while I go through this. With the end being the same I am going to pray for the miracle I need and to not be a burden on everyone by using the chemo with the worst side effects.
In the event I survive for a while longer I can have a body that works to a better degree than oxaliplatin is currently giving me.
I also understand that oxaliplatin side effects get worse as the doses go on. Is this true?My first biweekly infusion was on March 26 & 27. Gemzar on Monday and Oxaliplatin on Tuesday. The oxaliplatin side effects are evident with nueropathy and a very achy stomach. No nausea though. I have lost 5 lbs in the last 10 days. I was at 185, now 180. I used to be at 205.
I know I need to force myself to eat, Ok I can do that. More protein, sure.
My question is from the 100’s of people on this board is there an opinion on Low dose weekly infusion vs. high dose biweekly infusion. My newer ONCO is saying research shows the body tolerates the more frequent but lower doses much better than the High dose, with similar long term tumor growth.
Whats are the opinions from those on this board?
Hi,
what is the name of the “Low Dose regimen” called?
and how many chemo agents in that regimen?
and how long (total duration) and how many cycles you need to complete(frequency) for the entire course of treatment.GEMOX,which you are on now ,consisted of Gemzar and Oxaliplatin.
Anorexia ,which is the side effects of both of the agents; each of them either used alone or in combination with other agents will affect your appetite.
For Gemzar, anorexia side effect is =16-19% and for oxaliplatin is 27-35% alone. Therefore the little appetite is not related to your 5 cm tumor but is related to the adverse drug reaction of the chemo agent.
God bless.I am currently in the middle of deciding between using an Onco who prescribes a low dose infusion on a weekly basis, and my current Onco who treated me last week for the first time. My side effects are substantial. Before Chemo I had an appetite and little or no discomfort. Now 9 days later Ive had my socks knocked off. I have some neuropathy from the Oxa, My stomach aches all the time unless I do not eat. Eating is a burden and I have very little energy except to do minor house chores.
I was told that low dose would ease the side effects substantially.
OPINIONS?
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