Topic: Thoughts about Taxotere after xeloda/gemzar has failed?

This is my first post to this board. My 56-year-old sister was diagnosed in May with  unresectable stage 4 intrahepatic cc. It was a bad period leading up to the diagnosis - they found a mass on her liver, did a biopsy, did a PVE, only to go in and open her up in May and say that the cancer had spread to all parts of her liver, and stomach and lymph, and she was therefore inoperable.

She then went on xeloda/gemzar for 6 months and confounded everyone by doing fabulously. The tumors almost disappeared to nothing. She felt great and it was really hard to believe she was sick. Sadly, for the past 3 weeks we've noticed that she is feeling nauseous again and her CEA levels have gone from around 5 or 6 to 6.6 and then 10.3.

She is going to have a PET scan to basically confirm that the cancer is on the move again. Her oncologist is thinking of moving her off xeloda/gemzar and trying taxotere. It sounds like it's not targeted specifically for cc (it's a broad spectrum drug used for cancer of the breast, prostate, etc). It also sounds like it will be much harder to tolerate.

Does this sound like the best next step? It just seems like many of you have been on other things like oxaliplatin or cisplatin or 5 FU b4 moving to something like this. Her oncologist thinks that any type of chemo like xeloda/gemzar will fail which is why he wants to try this other drugs.

My question to the group is - has anyone ever used Taxotere? And also, does this sound like the best next step?

Thanks so much.

Warmly,
Chris

Re: Thoughts about Taxotere after xeloda/gemzar has failed?

Dear Chris, welcome to our amazing family but sorry you had to find us. We love the word shrinkage and that is the best part of your Sister's story. You are finding out what a roller coaster ride CC can be. I can't help with chemo questions as my Teddy never had it, but I know someone will be along to help. Weekends are a tad slow, sometimes. I just wanted to welcome you and your Sister and sending you best wishes.

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 Chris100 Sun, 27 Jan 2013 15:04:29)

Re: Thoughts about Taxotere after xeloda/gemzar has failed?

Hi Lainy,
Thanks for your response and to hear that the weekend can be slow. Fingers crossed that someone on this board has experience with taxotere/docetaxel.
Best,
Chris

Re: Thoughts about Taxotere after xeloda/gemzar has failed?

Chris....welcome and so sorry that you had to join our fantastic group of people. BTW:  we are neighbors, as I reside in the Bay Area also.  Chris, our JeffG had used Docetaxel with limited results. He was however; 9 years out of diagnoses and had severely advanced disease. The difficulty with treatment of this cancer is directly related to the limited clinical trials conducted and the overall aggressiveness of this disease.  Where is your sister treated and have you searched out a second, professional opinion? 
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

5 (edited by PCL1029 Sun, 27 Jan 2013 22:42:17)

Re: Thoughts about Taxotere after xeloda/gemzar has failed?

Hi,
2nd opinion on medical oncology is highly recommended .
Nab-paclitaxel is another member of the Taxene family besides Taxotere which one of the member of this discussion board is currently on it.

http://www.cholangiocarcinoma.org/punbb … hp?id=9467

http://www.cholangiocarcinoma.org/punbb … 270#p68270

Personally, I do think there are other options than using Taxotere. But I am not a doctor . Xeloda is the same as 5FU but in pill form,therefore your sister did try both the 5 FU and gemcitabine. Besides chemotherapy agents like oxaliplatin, there are also targeted agents like sorafenib ,Tarceva  Avastin etc. that have been used for cholangiocarcinoma. I will ask more questions before I will accept Taxotere as mono therapy. The response rate is around 20% for Taxotere ,which is at the low end as compare to other regimen.
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: Thoughts about Taxotere after xeloda/gemzar has failed?

Chris:
I have no experience with taxotere but I will put in my 2 cents.
My first chemo cocktail was for one tumor and a couple of lymph nodes. The tumor had been biopsied. I was put on gemzar/oxaliplatin. It was fairly tough on me. I had to stop after 6 rounds due to neuropathy. I still have some neuropathy over a year later, but it's okay. The tumor shrunk substantially and the lymph nodes returned to normal size. I went 6 months without treatment as we prepared for my resection, which was cancelled at the last minute because the lymph nodes had grown amazingly quickly and the tumor had grown, too. We tried gemzar/Xeloda. The tumor shrunk but the lymph nodes kept growing. My surgeon said cc has many slightly deviated cell structures.
I know nothing of taxotere but would suggest you ask your doc about one of the platin drugs. They have more side effects, but seem to work well against cc, either shrinking tumors or at least keeping them from growing.
I also suggest a second opinion, as this cancer is so rare.
My prayers are with your sister and your family that she gets the right treatment for her.

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: Thoughts about Taxotere after xeloda/gemzar has failed?

Hi Chris,

I would also like to welcome you to this site and add my 2 cents. First of all, if you have any doubts about your sister's care, I would seek a 2nd opinion. My daughter is one of the lucky ones that has been pleased with her doctor and her care from the get go. I am not a doctor, so what I am saying is just my opinion and what I have observed with my daughter's care. I would ask your sister's doctor about the platin drugs as well. Lauren had good results with Cisplatin and Oxaliplatin. They were both a little rough on her. Cisplatin made her platelets take a nosedive and there were times she could not be treated because they were too low. This is common and happens to many. You cannot be on Cisplatin for a really long period of time because it can cause kidney damage. Oxaliplatin causes neuropathy in hands and feet. You also cannot drink cold liquids or it feels like your throat is closing. Some people have an allergic reaction to Oxaliplatin usually around the 6th or 7th infusion. Lauren was one of them. At her 6th infusion, she turned beet red, her throat and ears began to close and she broke out in hives. Fast action from the nurses and PA got it under control and she can never have that chemo again. They both worked on her, but need to be monitored closely. I hope you discuss other options for your sister. I'm sorry, we don't have any experience with Taxotere. Please let us know what is going on because we all care. All the best to you and your sister.

Love and hugs,
-Pam

My beautiful daughter, Lauren Patrice, will live on in my heart forever.

My comments, suggestions, and opinions are based on my experience as a caretaker for my daughter, Lauren and from reading anything I can get my hands on about Cholangiocarcinoma. Please consult a physician for professional guidance.

Re: Thoughts about Taxotere after xeloda/gemzar has failed?

Hi everyone - Thanks so much for your support and answers/suggestions. You are such an amazing group.

We are considering getting a 2nd opinion and also exploring two clinical trials - the TIL one at NIH and another one using nanoparticles to deliver taxotere in much higher doses. I've also taken a lot of your comments and sent them over to my sister to forward to her doctor. I will keep you all posted.

Warmly,
Chris

Re: Thoughts about Taxotere after xeloda/gemzar has failed?

Chris, I will keep checking in to see his your sister is caring Snd am very interested in what she decides to do (a clinical trial?). What did her do for say a out the platin family if drugs? My sister is treated at Stanfird and couldn't stay on Gemcitabine/Cisplatin due to low platelets. She is now on Xelodea alone after radioembolization with y90 in Jan. stage 4 age 50, disg last July.  Anyhow, we sisters can help simy by digging deep into all the potential options out there. My sister doesn't have the energy or desire to and is afraid to come across horror stories, yet she has been swayed a few times by well meaning friends with some crazy ideas to try drugs not legal in the us or home remedies...she was even begged by a good friend not to do any chemo at all because its "poison" and only "big pharma and doctors out to make money off of you". Thankfully, she puts most of her trust in the doctors but has not opted to get more opinions from experts across the nation. Best to you and your sister,
Willow

Willow