Topic: changing chemos

Husband needs to change regimens quickly.  Liver enzymes and bilirubin going up.  doctor wants to switch to xeloda/oxiliplatin combo from gemzar/xeloda.  Wondering if Gemzar/cisplatitin is better way to go. What are your thoughts?

Re: changing chemos

dmj4ctj, Please keep in mind that everything seems to work differently for different people and situations however, GEM/CIS seems to be the 'cocktail' of choice. Sending you much good luck and hugs!


Re: changing chemos

Actually I think your oncologist did his/her homework for your husband' CCA.
The Gem/Cis is not an universal treatment of choice for ICCA but it is easier to prescribe since that is appear to be the easiest and  most prescribed regimen in CCA.

But other regimens work as well as Gem/cis and cause much less side effects.
1.Xeloda( 5FU in oral form) provides patient compliance by the oral route;
2,Oxaliplatin is much less toxic than cisplatin;unlike cisplatin, oxaliplatin is not associated with significant renal(kidney) or auditory toxicity(tinnitus)  and hematological toxicity (blood cells) is usually mild .
3.Both platium agents will cause nausea and vomiting but usually it will be taking care by the pre-chemotherapy antinausea medications, such as Aloxi,Zofran and Decadron .
4. Both platium agents will elevate the hepatic enzymes and bilirubin and the same apply to both capecitabine and gemcitabine.

If the the tumor is "stable",and nothing else changes significantly, I guess your oncologist wants a consistent (5FU) level from you by asking you to take the Xyloda twice daily after meals.And he/she wants to start use one of the agent from the platium family-oxaliplatin to see whether the result will be better than gemcitabine.
It is a cautious decision and I like your oncologist. In short, every body can recommend the use  of GEM/Cis first,but I think your oncologist does more than just that. May I ask what is his/her name and where he/she works?
This is just my opinion, the rest is up to you. remember I am just a patient as your husband havine the same ICCA  and I am not a doctor.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: changing chemos

Lainey and Percy,
   Thanks so much for your quick replies.  This has been such a bone of contention between us.  I was starting to believe that he (Dr. R. Smith, SC Oncology) wasn't being aggressive enough (too afraid of side effects) and Chris wasn't anxious to go down the Gem/Cis route either.  I was starting to get frustrated with the whole thing and worried we weren't doing the right thing.  You really set my mind at ease.  Thanks.