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Gemcitabine / Carboplatin

imagine
imagine Member Posts: 96

Anyone have any experience or tips on this combo. I’m starting this combo on the 19th Nov since Ibrance/Falsodex and Xeloda failed after 11 months in. Thank you in advance for any tips or suggestions. I got my port placed Wednesday.

Thanks so much,

Karen

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Comments

  • moth
    moth Member Posts: 3,293

    Hi Karen, there are a couple threads on it but not very active. But you can get a sense of people's experiences. Search for gemzar in addition to gemcitabine and it brings up most of them I think. Some people take it with carboplatin & some with cisplatin. Here's one with a few detailed posts https://community.breastcancer.org/forum/8/topics/...

    Gemzar/carboplatin is on my MOs list of 'what's next when this stops working' (along with Xeloda) so I'm keeping an eye on these threads myself. I'm an over-preparer lol.

    hope this one does the trick for you & gives you a long regression or stable time and few SEs!

    how's your port incision doing? Mine healed up so quickly & I'm so glad to have the port now (I didn't in 2018)

  • imagine
    imagine Member Posts: 96

    Hi Moth,

    Thanks for the input. What are you on now? My port was just done on Wednesday so a little sore. Had 3 more areas of lesions near in the chest wall area that were removed for retesting to see if I’m still ER+ or if it is changed. They are also sending to foundation one for genomic testing.

  • moth
    moth Member Posts: 3,293

    My sigline is utd - taxol & tecentriq. I am technically stable as tumor volume is same but I had liver mets shrink & lung met grow so I'm having a lung biopsy (primarily to test hormone markers & if they get enough samples, genomic testing too) & then will be in a radiation trial to treat that lung met with rads. But as long as the liver mets keep responding, the plan is to stay on taxol & tecentriq :)

  • Dvdsp
    Dvdsp Member Posts: 23

    i think i wrote in a topic like this, my mum was on this combo during 14 months, maybe the best working and it was her 10th line of treatment. Not many SEs but its true my mum is "weird" because she has lots of se with hormones but not many with chemos

    If you want to know anything tell me!

  • buttonsmachine
    buttonsmachine Member Posts: 339

    Imagine, how are you doing? I might be starting this combo soon.

  • imagine
    imagine Member Posts: 96

    scans in February, so I really don’t know yet. Side effects are really not any worse than with Ibrance so far

  • buttonsmachine
    buttonsmachine Member Posts: 339

    Imagine, thanks for getting back to me. I hope you're hanging in there okay. I remember your other post about failing treatments and what's next. It looks like this combo might be next for me too. I've had significant progression on Ibrance and then Xeloda and it's getting a bit scary. Liver and probable lung involvement now. Would you say it's been similar to TC chemo when you were early stage, or easier than that?

  • imagine
    imagine Member Posts: 96

    I would say it is doable as with taxotere/cytoxan was only 4 treatments and then it ended. So emotionally that was much easier. I’m going to Duke tomorrow as I got my F1 report back and looks like I have a few more mutations that have some possible treatments with Keytruda or Lymparza. Good Luck with Gemzar

  • buttonsmachine
    buttonsmachine Member Posts: 339

    It's great that you might have some other options. I hope it goes well for you!

  • buttonsmachine
    buttonsmachine Member Posts: 339

    To anyone who has done the Gemcitabine/Carboplatin combo - how was the hair loss for you? My MO said maybe some thinning but probably not full-on baldness? I'm just curious how it went for others.

    So far this regimen has been tolerable for me, and I actually feel better on it. It makes me realize how bad the cancer was making me feel. Hopefully my next scans will also show improvement.

  • imagine
    imagine Member Posts: 96

    I have had 4 cycles and my scans are stable to slightly better. I have not lost my hair. I had to skip one week of the last cycle because my neutrophils were too low. ONC is going to reduce dose starting back on the 11th. My main effects are fatigue and then low red and white blood levels. But doable.

  • Hollyli1202
    Hollyli1202 Member Posts: 122

    Appears this is my next line of treatment for three cycles. I will be on Gemzar/Carboplatin/pembro (Keytruda). How was nausea and hair loss? I think those are my biggest worries.

  • buttonsmachine
    buttonsmachine Member Posts: 339

    Hi Holly, I've found the nausea to be very manageable with anti-nausea meds. As for hair loss, I think I might notice a bit more hair coming out in my brush, but it's not noticeable to anyone else or even by looking at me. My sister even commented on how thick my hair looks these days! All things considered I'd say chemo is never easy, but this regimen has actually caused some regression of my cancer when I was progressing on everything else, so I'm glad I did it. I'll be doing cycle 3 next week. Best wishes to you.

  • Hollyli1202
    Hollyli1202 Member Posts: 122

    Buttons - Thank you for the reply. What day(s) do you feel the worst?

  • buttonsmachine
    buttonsmachine Member Posts: 339

    I think I feel worst on days two through four. It's not for all of those days, but I find that just about every cycle I have about a 36 hour period where I am pretty much just in bed. I also had some physical pain that accompanied this chemo regimen, which in my case was actually because the chemo was working and killing the cancer. Even though chemo is never easy (at least for me), I found this regimen to be a overall more tolerable than the TC and AC chemo I did previously.

  • Bliss58
    Bliss58 Member Posts: 938

    Anyone taking Gemzar as a monotherapy? I had my first infusion last Friday.

  • buttonsmachine
    buttonsmachine Member Posts: 339

    I'm still on the Gemzar/Carbo combo.

    Do you have a port? One thing I will say after a few months of doing Gemzar without a port, is my veins are pretty blown out. (I'm told it's the Gemzar, not the Carbo.) Anyway, if you don't have a port you may want to just get one and save the trouble.

    Best wishes for Gemzar, Bliss!

  • Bliss58
    Bliss58 Member Posts: 938

    Buttonsmachine, thanks. Yes, I have a port and very glad I do. My first go with chemo was TCHP in July 2015. My breast surgeon just scheduled the port without asking me first, but I'm glad she did and got things rolling. I lost my hair back then, but think it was the taxotere for sure. Does carbo cause hair loss?

  • buttonsmachine
    buttonsmachine Member Posts: 339

    I haven't lost hair on this regimen, which is really nice. I thought I noticed a bit more shedding in my brush, so I was worried, but now I'm a few months in and my hair looks the same as ever.

  • Bliss58
    Bliss58 Member Posts: 938

    Buttonsmachine, that's great. Just was curious in case I need to add carbo. Thanks.

    Is this treatment working for you? When did your tumor markers start dropping?

  • buttonsmachine
    buttonsmachine Member Posts: 339

    Bliss, we saw regression after only a four rounds (or two cycles) for me. This regimen cleared up my liver which was great, and it lessened a lot of the cancer in my dura which had been causing me serious problems. My bone lesions got better too, although the response in and around my lungs was somewhat mixed.

    I'm not sure if my MO monitors my tumor markers. (Or maybe they do and I just don't know!) I'd be interested to know more about tumor markers - what is measured? I've got a pretty high burden of metastatic disease, so we monitor how well the chemo is working primarily by looking at my imaging. I get regular PET/CT scans and brain MRIs.

    My MO said that at some point I might be able to go down to just Gemcitabine, but we are not there yet. Even though this regimen has worked better than Ibrance or hormone therapy for me, my cancer is putting up a hard fight, but we'll see.

  • Hollyli1202
    Hollyli1202 Member Posts: 122

    buttons - How many rounds of carbo/gem are you doing? Glad to see you're doing so well on it. My MO ordered 3 rounds before restaging scans. I am hoping I don't have to do anymore. He is talking about continuing carbo+Keytruda and dropping gemcitabine. I know this chemo regimen is working. My tumor marker (CEA) is now finally going down and not up. This treatment plan is better than the first of AC+T as I don't get nearly as sick as the first.

    I've had to start injecting Zarxio after Day 1 for three days and I get Neulasta after Day 8 Gem since my WBC and neutrophils tanked. My hair is still on my head, but it's definitely thinning. I'd like this to be my last round of treatment (after Day 8) so I can keep my hair. :) Plus I got my two doses of COVID vaccine in between chemo time. That was a trip. LOL.

    Good luck to you, Bliss! Hope Gemcitabine does the trick for you. My tumor markers are coming down after 7 weeks. They peaked on 4/26, about 4 weeks after I started chemo. I just had them taken yesterday 5/17 and my CEA dropped from 14 to 6 (normal being under 2.5). Hoping they still continue to come down and new scans show that.

  • buttonsmachine
    buttonsmachine Member Posts: 339

    Holly, I'm not sure how much longer I'll continue on this regimen. I've been thinking about moving on to something else, if there's another good option for me, but we'll see what my MO says.

    Here's a few reasons why: my last PET showed a mixed response. The places where this chemo is not working are causing me more side effects lately, and I want to deal with that if possible. However, this chemo has been awesome in the places it did work, so it was definitely worth doing. That being said, I'm coming out of round eight and it's been hard on my WBC counts. I also had to add Neupogen shots on day 2-3 in addition to the Neulasta on day 9 just to stay afloat. Also I'm just getting tired of the chemo sick feeling. It's easier than TC and AC, yes, but it's still not fun. My hair is still shedding, but it's still not noticeable by looking at me, thankfully.

    I have another PET scan and a visit with my MO coming up, so I intend to discuss the plan again then.

  • buttonsmachine
    buttonsmachine Member Posts: 339

    Holly, how did you feel getting the covid vaccine between rounds? I'm supposed to do that too and I'm nervous about it! 😬

  • Hollyli1202
    Hollyli1202 Member Posts: 122

    Button - yes, after my first round of carbo/gem, my WBC and neutrophils tanked. Even my platelets went down to 500! I was put on Zarxio and have to self-inject on days 2-4. Then after Day 8 (just Gemzar), I get the Neulasta. It seems to be working. I am scheduled to do only 3 full rounds or 6 treatments total. I go in for a CT and bone scan on June 2. I am nervous, since I don't really want to continue on the chemo. But my tumor markers are coming back mixed. My CEA went from 14 to 6 in three weeks. But my CA15-3 is going up. Three weeks ago it was 15 and now it's 23. It was at its lowest on the day that I started the chemo on 3/29 and it was 11. So now I am worried that it's spread to my liver or more bone involvement and the carbo/gem is not getting at those areas. But I have seen that sometimes those numbers go up while undergoing chemo treatment. I guess the CT and bone scan will tell the story. As for the COVID vaccine, I got Pfizer. The first shot was right after my first round of Day 8 gemzar and my arm got sore. My neutrophil count was around 880 at the time. One week later, I got a reaction - low grade fever, arm sore again and swelling around the injection area. It didn't last long. I have a feeling my WBC kicked into gear and noticed the protein spike since it was a week later and my immune system was near or at its lowest. The second shot was again after a Day 8 gemzar infusion (but this time I was on Neulasta). The side effects came right after - arm soreness and low grade fever which I took Tylenol for (after getting it approved by the MO). The low grade fever lasted about 24-36 hours and then I was good after that.

  • buttonsmachine
    buttonsmachine Member Posts: 339

    Glad you made it through getting the vaccine okay! It's a lot on top of everything else we are doing for sure.

    I'd love to believe there is something out there that is easier to tolerate and would work better for me than Gem/Carbo, but I don't know. I'm interested in some of the newer drugs that are soon to be approved, like Trodelvy for HR+ BC and Enhertu for Her2 Low. Or the new SERDS to replace Faslodex.

    Gem/Carbo got my liver to NED, lessened my bone mets, and shrunk the cancer on my dura which was pressing on my brain. (I don't have brain mets, but I have skull/dura mets that were causing terrible headaches!) This regimen allowed me to avoid whole brain radiation for that reason, and for that I am eternally grateful. The downside is that the response in and around my lungs is mixed. I also have some lymphatic and under the skin involvement on my right side that is getting worse. The cancer is tangled around my right brachial plexus, so my right arm and hand has become painful and partially numb, and I'm afraid of losing function. Gem/carbo doesn't seem to touch those areas. :-(

    We're all in a tough spot, and just hoping for the best I think. One foot in front of the other I suppose!

  • Zillsnot4me
    Zillsnot4me Member Posts: 2,122

    my first infusion of gemzar this am. Not in combo with anything. Did you all have any premeds? I had 500 ml of fluid and 12 mg of dexamethasone. I did have some nausea in the way home and took some zofran.

  • Hollyli1202
    Hollyli1202 Member Posts: 122

    Zill - my premeds for gemzar are zofran and dex. Hope your infusions go well and you don’t have bad side effects.

  • Wanderingneedle
    Wanderingneedle Member Posts: 220

    Hi, everyone, 👋🏻

    I’m starting this combo on Friday, one of the last treatments available to me. I’m hoping it works on my extensive skin mets. When do side effects hit? Trying to plan ahead.

    Thanks,

    Libby


  • s3k5
    s3k5 Member Posts: 411

    How's everyone doing on Carbo/Gemzar combo? I am getting this every other week along with Keytruda. It is a tough combination but hopefully it will work on the liver mets.

    Please update about your scan results and side effects with this combo. What schedule do you have for this chemo?