My type chemo, I never see it mentioned here. - 1258529

borntosurvive
Posts:52

I was diagnosed with stage 3b NSCLC , favour adenocarcinoma. (mutation not detected btw)

I was placed on the following regime:
Day1 Gemocitabine
Day8 Gemcitabine and Carboplatin
Day 16 - OFF

First questions is this: On these forums, I never see this combination of Gemocitanie/Carboplatin mentioned, and I wonder why? I was told this is the standard first chemo treatment for what I have. So I'd like to hear what you have to say about this. FYI, I am in Sydney, Australia.

Also, after my first round of 2 weeks on, one week rest, my blood was so affected, that I had to wait a full 4 weeks until I could have another 3 week regime. But because of the impact on my bone marrow, they reduced the dose 25%.

I've since had a three week regime (I can't think of any other way to describe this. 2 weeks on and 1 week break) in which they increased the Gemcitabin by 5% each of the 2 weeks, so that's up to 85% of the normal dose. We hope to get me back up to 90-95% at least. (Then they'll begin to increase the Carboplatin)

However, both weeks my blood test 24 hours prior to treatment was not good enough, but the blood test they did on the day showed that I could be treated. Good news.

They told me that my hemoglobin (I think) is trending downwards, and I've been very, very tired and weak. So the advise me to have a transfusion, which I am having on next Monday.

We have postponed my first post treatment CAT scan because of the interference with the treatments. Should have that in about 4-6 weeks.

I would like comments on the combination of chemo I am on, is it still a standard first line treatment? And also, how having such a long break might affect the success of the treatment, and thoughts on the transfusion. I'm getting 2 bags over 5 hours next Monday.

Forums

JimC
Posts: 2753

First line treatment generally consists of a platinum agent (usually carboplatin or cisplatin) and a second agent. Here in the U.S. it is often paclitaxel or pemetrexed, but the choice of drug does vary geographically, and gemcitabine is a well-tested drug for the treatment of lung cancer.

It's not unusual to need treatment breaks or transfusions in order to keep blood markers at acceptable levels, and skipping one treatment cycle does not usually affect treatment results. There is a GRACE FAQ on the subject: http://cancergrace.org/cancer-101/2010/09/27/cancer-101-faq-treatment-d…

Good luck with your treatment.

JimC
Forum moderator

Dr West
Posts: 4735

If you look at some of the information that provides a general overview of lung cancer, including here, you'll see that we talk about a range of platinum-based doublets but absolutely DON'T say that one is the treatment of choice, because there's really no compelling evidence of any meaningful difference among the commonly used doublets. Cisplatin or carboplatin with gemcitabine, one of the taxanes, perhaps Navelbine (vinorelbine), or Alimta (pemetrexed) are all very fine choices...just with the caveat that Alimta isn't an effective treatment for patients with a squamous NSCLC.

I have given carboplatin and gemcitabine to many patients over the past decade and find it to be a very good treatment, with the leading side effect being significantly low blood counts -- just as you're experiencing.

-Dr. West