Topic: need help deciding

my sister was diagnosed with ccc 4 1/2 years ago. she has been
on multiple regimens. her bloods are great but the tumors are
growing. her ca 19-9 marker is < 10. her doctor has given her
3 possible options. nexavar or gemzar and carboplatin or phase
1 gemzar, avastin and tarceva. her biggest tumor is over 10 cm.
abstract from asco 2007 meeting showed very good results
from gemzar and carboplatin. i am not very computer savvy so
i cannot provide link. any thoughts or suggestions would be
appreciated. thank you in advance and to those responsible for
this great site.

Re: need help deciding

HI Bosco...  I guess from past experience I had the best of luck with gemzar and carboplatin as far a tumor reduction is concerned.  I took the full 9 cycles until it stoppeed being effective.  The carboplatin is pretty harsh and caused alot of nueropahty for me.  I guess if there is no other options of chemo at this time It is as good as any in my opinion.  It took my tumors down 40% but grew right back once completed.  Good luck with your choices and wish your sister the best.
Jeff G.

Take it to the Limit,One More Time! (Eagles)

Re: need help deciding

In case anyone is wondering, this may be the abstract bosco references above.  (although I'm not completely certain)

http://www.asco.org/portal/site/ASCO/me … ctID=33382

Bosco - I think you hit on a question that many patients face - which regime to choose?  I do not feel like it is my place to comment on which regime to choose, as this is an incredibly personal decision with no right/wrong answer.  However, I'd like to make a comment regarding clinical trials due to some misconseptions that seem to exist.  First, I think clinical trials are fantastic.  Without these trials, there will not be advances in the treatment of cholangio.  The researchers that run these trials are relentless at finding positive results, and I believe they will find a good treatment. 

My only comment pertains to the purpose of a clinical trial.  The underlying purpose is to answer the hypothesis posed by the researcher.  However, there is sometimes a perceived purpose from the patient's perspective that the clinical trial presents a means of providing a cure, or at least a reduction in tumor growth, for an individual patient.   Now, this result may very well flow out of the clinical trial, and the individual patient may see positive results.  But what I'm getting at is that the clinical trial is not being presented for the purposes of treating one patient.  Rather, it's being offered to try to answer a question that applies to many patients.  So, I would keep that in mind when evaluating clinical trials. 

I know that doesn't really help you with advising your sister.  My best to you both as you evaluate the options and decide on the next course of treatment.  I will keep you both in my thoughts and prayers.

30-something caregiver

Re: need help deciding

thank you jeff and sara for your kind words and helpful insight.