Chemo

“The median overall survival was 11.1 months in the group treated with FOLFIRINOX as compared with 6.8 months in the patients treated with gemcitabine, and the median progression-free survival was 6.4 months in the FOLFIRINOX group and 3.3 months in the gemcitabine group. ”
For more information on the multidisciplinary treatment of patients with pancreatic cancer at johns Hopkins visit: http://pathology.jhu.edu/pancreas/

 Danny’s Chemo Treatments (Sept.9 -Oct.21 , 2013)

These are the chemotherapy drugs danny is taking:

1.  Fosaprepitant-525 ml/hr
2. Oxaliplatin 476 ml/VTBI
3. Irinotecan
4. Levoleucovorin 250ml
5. Zophran

Oxaliplatin is a platinum-based antineoplastic agent that is used in cancer chemotherapy. It is an anti-cancer (chemotherapy) medicine that is used with other anti-cancer medicines called 5-fluorouracil and leucovorin

*discovered in 1976 at Nagoya City University by Professor Yoshinori Kidani, who was granted U.S. Patent 4,169,846 in 1979. Oxaliplatin was subsequently in-licensed byDebiopharm and developed as an advanced colorectal cancer treatment. Debio licensed the drug to Sanofi-Aventis in 1994. Eloxatin gained European approval in 1996 (firstly in France) and approval by the U.S. Food and Drug Administration (FDA) in 2002.

*typically administered with fluorouracil and leucovorin in a combination known as FOLFOX for the treatment of colorectal cancer. Oxaliplatin is marketed by Sanofi-Aventis under the trademark Eloxatin or by Medac GmbH under the trademark Oxaliplatin Medac.

Elimination

The major route of platinum elimination is renal excretion. At five days after a single 2-hour infusion of ELOXATIN, urinary elimination accounted for about 54% of the platinum eliminated, with fecal excretion accounting for only about 2%.

Treatment Day 1:

ELOXATIN and leucovorin are given through a thin plastic tube put into a vein (intravenous infusion or I.V.) and given for 2 hours. You will be watched by a healthcare provider during this time.

Right after the ELOXATIN and leucovorin are finished, 2 doses of 5-fluorouracil will be given. The first dose is given right away into your I.V. tube. The second dose will be given into your I.V. tube over the next 22 hours, using a pump device.

Treatment Day 2:

You will not get ELOXATIN on Day 2. Leucovorin and 5-fluorouracil will be given the same way as on Day 1.

What activities should I avoid while on treatment with ELOXATIN?

• Avoid cold temperatures and cold objects. Cover your skin if you must go outside in cold temperatures.
• Do not drink cold drinks or use ice cubes in drinks.
• Do not put ice or ice packs on your body.

The most common side effects of ELOXATIN include:

• Decreased blood counts: ELOXATIN can cause a decrease in neutrophils (a type of white blood cells important in fighting bacterial infections), red blood cells (blood cells that carry oxygen to the tissues), and platelets (important for clotting and to control bleeding).
• High blood pressure (hypertension)
• Infection Call your doctor right away if you get any of the following signs of infection:
  

  ▪ fever (temperature of 100.5 F or greater) ▪ chills or shivering ▪ pain on swallowing ▪ sore throat

  ▪ cough that brings up mucus ▪ burning or pain on urination ▪ redness or swelling at intravenous site

• Bleeding or bruising. Tell your doctor about any signs or symptoms of bleeding or bruising.
• Diarrhea
• Nausea
• Vomiting
• Constipation
• Mouth sores
• Stomach pain
• Decreased appetite
• Tiredness
• Injection site reactions. Reactions may include redness, swelling, pain, tissue damage at the site of injection.
• Hair loss (alopecia)

• Dehydration (too much water loss). Call you doctor if you have signs of dehydration including:
  

  ▪ tiredness ▪ thirst ▪ dry mouth

  ▪ lightheadedness (dizziness) ▪ decreased urination

Oxaliplatin is a platinum-based antineoplastic agent that is used in cancer chemotherapy.

Oxaliplatin is a platinum-based antineoplastic agent that is used in cancer hello

Oxaliplatin is a platinum-based antineoplastic agent that is used in cancer chemotherapy.

• Fosaprepitant (Emend)
• was developed by Merck & Co. and was approved by the United States Food and Drug Administration (FDA) on January 25, 2008 and by the European Medicines Agency (EMA) on January 11 of the same year.
• prevention of chemotherapy-induced nausea/vomiting (CINV), particularly during the delayed phase (DP; 25 to 120 hours).
• works by blocking one of the body’s natural substances (substance P/neurokinin 1) that causes vomiting.
• This medication will not treat nausea or vomiting if you already have it.

Chemotherapy for exocrine pancreatic cancer

Chemo may be used at any stage of pancreatic cancer. It is commonly used when the cancer is advanced and can’t be removed completely with surgery. Chemo may also be used after the cancer has been removed with surgery to try to kill any cancer cells that have been left behind (but can’t be seen). This type of treatment is called adjuvanttreatment. This lowers the chance that the cancer will come back later. Chemo can also be given before surgery to try to shrink the tumor. This is known as neoadjuvant treatment.

When chemo is given along with radiation, it can help the radiation work better. This, known as chemoradiation orchemoradiotherapy, has more severe side effects.

Chemo drugs kill cancer cells but also damage some normal cells. This can lead to side effects, which depend on the type of drugs, the amount taken, and the length of treatment. Common short-term side effects include:

• Nausea and vomiting
• Loss of appetite
• Hair loss
• Mouth sores
• Diarrhea

Because chemo can damage bone marrow, where new blood cells are made, blood cell counts might become low. This can result in:

• Increased chance of infection (from a shortage of white blood cells)
• Bleeding or bruising after minor cuts or injuries (from a shortage of platelets)
• Fatigue and shortness of breath (from too few red blood cells)

Many of the chemo drugs used for pancreatic cancer can cause diarrhea. Other side effects can occur depending on what chemo drugs are used. For example, cisplatin can cause kidney damage (called nephropathy). Doctors try to prevent this problem by giving the patient lots of fluid before and after the drug is given. Both cisplatin and oxaliplatin can cause nerve damage (called neuropathy). This can lead to symptoms of numbness, tingling, or even pain in the hands and feet. For a day or so after treatment, oxaliplatin can cause nerve pain that gets worse with exposure to cold. This often causes pain when swallowing that is worse when trying to swallow cold foods or liquids. If you will be getting chemo, ask your cancer care team about the drugs being used and what side effects to expect.

Most side effects disappear once treatment is stopped. If you do have side effects, there are treatments that can help reduce them or make them go away. For example, drugs can be given to prevent or reduce nausea and vomiting.