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FOLFIRINOX for patients over 75


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Having read a number of posts, its great to see how positive everyone stays - despite it all!

My mother has recently been diagnosed with stage IV pancreatic cancer (met in liver). We are meeting with the oncologist today. My mum really wants to go for FOLFIRINOX, but I am concerned about how hard this will hit her and whether she would be better off opting for Gem/Abraxane instead.

The latter seems to have had some very positive results and wondered if it is still considered 'lesser' to FOLFIRINOX. I'm also concerned that if mum goes for FOLFIRINOX and it doesn't work out/she doesn't tolerate it, we will have blown our chance to try Gem/Abraxane.

Sorry - lots of questions. I'd appreciate shared experience/thoughts.


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Hello and welcome to the forum :)

First thing to say is that I think (I'm no expert!) that Folfirinox is still deemed to get the best results. Your oncologist will decide whether your mum is strong enough to tolerate it, it is quite toxic. Any drug affects everyone differently so it may be that she would tolerate it very well.

Again it depends on your doctor but you may well be able to get gem/abraxane if Folifirnox doesn't seem to be working. We tried for this after we were told the Fox wasn't doing its job but Abraxane wasN'T on the CDF list then so we were offered just the gem.

These are all questions you can put to your onc directly, don't be afraid to ask. Ask and question at all times!!!

Hope your mum is doing okay and good luck with any treatments.


Edited by J_T
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My mum is 76 and was diagnosed in May. The oncologist offered her folfirinox and she had 3 treatments which she tolerated well . They have reduced the dose 20% so she can tolerate it better. After the 3 she became quite poorly and they found the tumor was pushing against her duodenum . She had a stent to relieve this which has worked well. She is back on the folfirinox and is still tolerating it well. She has her 6th one tomorrow and is then having a CT scan at the end of the month to see how she is doing.

My Mum is very positive and wants to have this treatment. She has lost most of her hair now but not her eyebrows or eyelashes. She has also lost a lot of weight but sees a dietician regularly.

Everyone is different and I don't think anyone knows how they will react.

Hopefully the oncologist will answer all your questions and put your minds at rest. This is a hard journey and like a roller coaster ride. This forum is great and the people on it very informative and helpful. The nurses are also great and on the end of the phone if you need them.

Stay strong and positive and take care of yourself as well. Sue x

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  • 2 months later...


Thank you for your answers - sorry for my delayed response.

Mum had two doses of Folfrinox and didn't tolerate it at all well. Mum is now due to start Gem on the 5th Jan.

Mum was very sick with the first treatment, despite having anti sickness drugs - we later found out that as mum suffered from morning sickness that she was likely to react badly. For the second treatment she was given a more 'heavy duty' anti sickness drug, which worked well.

Unfortunately when the standard course of steroids ran out, mum completely lost her appetite and felt very weak and tired. She lost a lot of week and was deemed unfit for the 3rd treatment.

I know you are supposed to be grade 0-1 (performance status) to have Folrinox. I think mum was at best a 2 and shouldn't have started it.

Fingers crossed she tolerates Gem better.


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