Topic: Sanity check on chemo treatment recommendation from new Oncologist

Hello.  I am new here and this is actually my first post.  I was hoping I could get some opinions/questions answered from you kind folks.

My Mom was recently diagnosed with CC.  She was ineligible for surgery or other radiotherapy treatments.

Her first oncologist put her on Gemzar + Xeloda.  Before finishing the first treatment, they performed an MRI and learned that the tumors in her liver grew by about 30%.  At that point the Oncologist said that she didnt believe the Gemzar + Xeloda was going to work.

It was my belief that Gemzar + Ciscplatin is actually the standard treatment protocol for CC with the highest potential benefit.

So we went to a new Oncologist at one of the top-5 Cancer Center hospitals.  They agreed that they couldnt ignore the fact that Gemzar + Xeloda seemed to not work, and that in their opinion trying  Gemzar + Ciscplatin would just be asking "too much" of the second drug as Gemzar is the primary drug that does most of the legwork.  Is that true?

As such, they thought it was best to shift gears altogether and go with Folfox.  Does this recommendation make sense to those of you with experience on this?

The new Oncologist mentioned that they believed Folfox would likely become the treatment protocol in a few years (as opposed to Gemzar + Cisplatin today).   Does anybody know where can I get more information on the efficacy of Folfox, and any related studies pertaining to it?

Thank you very much in advanced for your reading my thread and I look forward to reading your answers.

Re: Sanity check on chemo treatment recommendation from new Oncologist

Dear CC Caretaker, welcome to our extraordinary family but sorry you had to find us. While I can't help on the chemo questions, I just wanted to welcome you and I know you will get a lot of posts here that may help. Also if you go to our search engine above and type in Folfox all the posts about Folfox will appear. Wishing your Mom the best and please do keep us posted, we truly care.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

3 (edited by eli Wed, 28 Mar 2012 18:58:25)

Re: Sanity check on chemo treatment recommendation from new Oncologist

Hello fellow CC Caretaker,

Welcome to the forum.

It's true that, in Gemzar/Cisplatin combination therapy, Gemzar is the primary drug. Cisplatin is added to make the treatment more effective. Gemzar is sometimes used on its own in the patients who cannot tolerate the combination therapy. Cisplatin is not used on its own.

In Gemzar/Xeloda combination, the distinction between the two drugs isn't as clear cut. Both Gemzar and Xeloda can be used on its own.

FOLFOX is the standard chemo for colon cancer. The data on FOLFOX in cholangiocarcinoma is sparse. I linked two studies in this post:

http://www.cholangiocarcinoma.org/punbb … 889#p56889

That's all I was able to find when I did the search a month ago.

Re: Sanity check on chemo treatment recommendation from new Oncologist

Hi CC Caretaker,

Folfox was the first chemo that my husband was treated with.  After two treatments they added Avastin.  He then had ten more cycles before taking a chemo break.  He continued to use Avastin until his scans showed progression.  He was put back on Folfox since he had significant success the first time.  At the end of his sixth cycle, he had tremendous pain in his back.  They still scheduled him for his seventh cycle.  At the beginning of that cycle, he started shaking with chills and they had to keep putting heated blankets on him.  They attributed this to an adverse reaction to the oxaliplatin.  He was diagnosed Stage IV ICC in August '08.  His next treatment was with Gem/Cis until this started affecting his remaining kidney.  Then they switched him to Xeloda.   He just had a chemoembolization 5 weeks ago and will have another on April 17.  I personally felt that he had his best results with the Folfox.  Hope this helps and welcome to our family,  PeggyP