Folfirinox failed to shrink my tumor

Thomas401
Thomas401 Member Posts: 1 Member
edited March 2022 in Pancreatic Cancer #1

I had a scan on the 23rd after 2 months on Folfirinox and the tumor scarcely shrank--while inching closer to encasing the mesenteric vein. My oncologist did not give me my 5th Folfirinox on Monday but switches me to Gemcitabine/Abraxane tomorrow. My question is, why would Folfirinox not work? Did anyone else have that issue? Thankx!

Comments

  • StageIVSurvivor
    StageIVSurvivor Member Posts: 19 Member
    #2

    I had the opposite occur. In 2012 I was started on Gemzar (Abraxane did not become available to a few years later). I had no response from Gemzar and it was believed that I lacked the specific liver enzymes to metabolize Gemzar into metabolites toxic to the tumor. So I was then switched to Folfirinox and that worked was effectively.

    if you had some effect from the Folfirinox albeit small, it is likely because tumors are heterogeneous by nature. That means the malignant cells that compose them are not all the same. Some cells may have been sensitive to Folfirinox which would account for the small amount of shrinkage. Another cell population of the tumor may have already had a resistance to the drug and that accounted for slow growth that lead to SMV.

    Once my chemo was switched, I had a robust response that get the situation under control and eventually led to a status of NED.

  • Teagan
    Teagan Member Posts: 2 Member
    #3
    https://csn.cancer.org/discussion/comment/1691766#Comment_1691766

    Hi! What kind of side affected did you guys experience from Folfirinox?


    Thank u

  • MJSchultz
    MJSchultz Member Posts: 1 *
    #4

    Side Effects:

    • Severe Nausea for 5-7, required multiple anti-nausea drugs along with a lot of discipline to eat. Still lost 20 lbs.
    • Neuropathy in feet
    • Severe Cold sensitivity (pain) in hands and throat
    • Reduced blood counts - white blood cells and platelets.
    • Low Energy

    Folfirinox reduces tumor size in 20% of patients, is effective for an additional 60% with no shrinkage (that's me) and has no affect on the last 20%. The severe nausea and potential that effectiveness was diminishing caused doctor to switch me to Gemzar/Abraxane. Since the switch, I have gained 15 lbs, my CA19-9 is down to 57 from 71 with some possible shrinkage (0.5cm) of the tumor. Still have to track the blood counts closely, neuropathy in feet is worse and I lost 80% of my hair, but I got to keep 20% even though they are all white.

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