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Thread: Folfirinox

  1. #1
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    Folfirinox

    My father was diagnosed in December with Stage IV pancreatic cancer. He has had one round of the folfirinox treatment. Has anyone used this or know someone who has? Is it better than the gemcitabine? So far he has not had major side effects; some nausea and chills.
    I also am curious about the Cancer Centers of America. My brother mentioned this to me and i'm not sure if it's legitimate. Can they REALLY cure pancreatic cancer?
    I don't want to miss out on a cure, but it's my understanding there is no cure in the advanced stages.
    Any insight would be so appreciated.
    Thanks much!

  2. #2
    Administrator Top User brainman's Avatar
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    Hi mbs. I am so sorry about your father's advanced Pancreatic Cancer. I often tell people that Pancreatic Cancer has to be one of the worse cancers a person can have because of its impact on quality of life and because there are so few truly long term effective ways to treat it. Often, a chemo will work for a while but then stop and they need to change to a different one.... over and over.

    The Cancer Centers of America do get a lot of national attention through their TV ads. But from what I have heard they do not offer anything more than a good cancer center does. The say they offer more hope to people. Well, that just depends of the medical team in the hospitals they are comparing themselves to. The most objective system of evaluating cancer center is found at US News and World Report. I hope you do not hear me putting done the CCA. As far as I know, they are good centers. I am just alerting you to the hipe factor

    Good luck.
    Jim
    Long-term cancer survivor
    1992 Astrocytoma grade 2, left motor strip
    2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
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    Thank you for that link! I had suspected and read similar things about the CCA. My father has a very kind medical team, and no bad side effects yet. So I think he's going to continue on this path. Thanks again for your response. I read your story; i hope all is going well for you.

    Marie

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    Hi -- Can you tell me how your Dad is doing with the Folfirinox? My mother is scheduled to start it next week.

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    ginny

    Quote Originally Posted by mbs View Post
    Thank you for that link! I had suspected and read similar things about the CCA. My father has a very kind medical team, and no bad side effects yet. So I think he's going to continue on this path. Thanks again for your response. I read your story; i hope all is going well for you.

    Marie
    Did your father have any trouble getting insurance coverage for Folfirinox? My brother in law is newly diagnosed with pancreatic cancer and is being told that Medicare may not cover the Folfirinox treatment.

  6. #6
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    From Recent Articles

    Liz Szabo Gannett

    7:25 PM, May. 13, 2011|

    Although there is still no cure, a new drug
    combination can help patients live months
    longer than on standard therapy. And other
    studies already under way may soon offer
    patients even more options, researchers
    say.

    Patients taking Folfirinox, a novel
    combination of four drugs already
    approved to fight other cancers, lived 11.1
    months *— 4.3 months longer than those
    given standard chemo, according to a
    French study of 342 patients in today's
    New England Journal of Medicine.

    Although Folfirinox caused more serious
    side effects than standard chemo, patients s
    till rated their quality of life higher, Conroy
    says. That may be because Folfirinox
    prevented their tumors from causing
    serious side effects, such as pain, loss of
    appetite and weight loss.

    Doctors are already changing their practice
    based on the study, which was presented
    at a medical meeting last year, says cancer
    specialist Gauri Varadhachary of Houston's
    M.D. Anderson Cancer Center, who wasn't
    involved in the new study.
    "I see it becoming the
    standard of care. I see patients requesting
    it."

    Others caution that the new drug regimen
    isn't for everyone with pancreatic cancer.

    Patients in the study were under age 76
    and especially healthy, says cancer
    specialist Nilofer Azad, from Baltimore's
    Johns Hopkins Kimmel Cancer Center, who
    wasn't involved in the new study.

    But Azad notes that doctors are testing
    other drug combinations to treat pancreatic
    cancer. She's hopeful that these
    combinations will work as well or better
    than Folfirinox, with fewer serious side
    effects.
    Folfirinox "is going to be one of a host of
    options" for patients, Azad says.
    DOB Sept. 1947. Prostate cancer Gleason 7 (3+4), PSA 5 in Oct 2010. Cryoablation Jan. 2011. Had some complications.
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    I am eating vegan mostly plus a little fish. Take some supplements.
    (Any advice given is the personal opinion of a layman and is not intended to replace the advice of a health professional.)

  7. #7
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    Medicare coverage of Folfirinox

    Quote Originally Posted by Ginnyn View Post
    Did your father have any trouble getting insurance coverage for Folfirinox? My brother in law is newly diagnosed with pancreatic cancer and is being told that Medicare may not cover the Folfirinox treatment.
    I have had 19 treatments of Gemcidibine in the last 12 months for stage 3 PC. The drug is no longer effective. My oncologist is recommending Folfirinox. I am concerned about Medicare/Insurance coveage too. I had one treatment with Folfox but don't yet have any results. If you have any input as to Medicare coverage it would be appreciated.

  8. #8
    My dad was diagnosed with stage 4 pacreatic cancer a couple weeks ago, and other than the initial clotting issues he is feeling pretty good. My dad is starting on fulfironx on Wednesday, there have been some recent changes to where medicare is more likely to approve it. I am wondering what to expect, he had a couple rounds of gemzar and tolerated that fairly well, but I here the folfirinox is much harsher. We got a second opinion at the Seattle cancer care alliance, a nationaly recognized cancer center, and the doctor there recommended exactly what our local oncologist had arrange for, so that made us feel more confident in moving forward with treatment.

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    Medicare (our medicare advantage plan) is denying coverage for my husband. Our doctor is very frustrated and we are seeking info on how to fight this. The doctor has had good results in his stage 4 PC patients and thinks my husband is a good candidate. We especially need the increased quality of life as he is suffering greatly right now. He was on a clinical trial but was recently removed due to increase in size of lesions in his liver. He currently is not receiving any treatment except pain meds that are are not working for him. We would appreciate any info as to how to break through the red tape.

  10. #10
    Administrator Top User pbj11's Avatar
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    Peg,

    I'm sorry to hear that this is an issue with Medicare. I found this article from the NCI -- National Cancer Institute and they say that many oncologists are increasingly adopting this regimen. http://www.cancer.gov/ncicancerbulletin/051711/page2

    This has been through Phase III trials, but it was done by France, even though these positive results were published in the May 2011 edition of the New England Journal of Medicine.

    It's best to have your oncologist's office find other doctor's who are getting this approved by Medicare to see how it is being written up and coded. We found it's all about how you do this as to whether something is approved or not. It IS being covered by private insurance companies across the board, so I hope they will consent if this has become a fairly common regimen.

    I wish you the best of luck!

    God bless,
    PBJ
    Husband diagnosed with NSCLC Stage IV in 3/2005. Fought & lived over 2 1/2 years with multiple lines of treatment.

    Post describing our journey: http://cancerforums.net/viewtopic.ph...er=asc&start=0

    Left my embrace to live with our Heavenly Father in October of 2007 and now breathes with ease forever. I will miss this gentle, giving soul with the easy smile for the rest of my days, but have faith we will be together again. He's just getting a little break from me!

  11. #11
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    My mother was diagnosed with stage III pc in Sept. 09 and was treated with Gemcitibine and Cisplatin until the cancer moved into her lungs in June 10. We then went on to Folfox a combination of 5FU and Oxaliplatin. Oxaliplatin (which is also used in Floforinox) was not covered my Medicare. MD Anderson uses a pharmacy reimbursement plan (based on income levels) with the Manufacturer of Oxaliplatin for those who do not have coverage for this drug. We signed up for this plan and the way it worked was Medicare had to deny the claim and MDACC then appealed and if Medicare denied again, the manufacturer would reimburse MDACC the Oxaliplatin so that the patient would receive it for free. Medicare did deny the 1st bill, but then after they received the second appeal, they pulled her medical records, history of treatment, etc. and then began sending us a notice that based on her history they WOULD cover the Oxaliplatin treatment. Of course, Medicare billing is way behind, I just received nofication of approval for Sept/Oct/Nov 2010. In May, the doctor took her off Folfox due to issues in her lungs and put her on Xeloda for 8 weeks and then repeated scans this past Wednesday. We received the results yesterday and the cancer in her lungs has progressed a bit and her CA 19-9 jumped to 400. We will be starting Folfirinox on June 30th. After speaking with the pharmacy at MDACC, the other 2 drugs are covered by Medicare and we know what to expect with the Oxaliplatin, but MDACC knows they will get paid from Medicare it will just take a long time. I hope this helps.


    Quote Originally Posted by pegspeas View Post
    Medicare (our medicare advantage plan) is denying coverage for my husband. Our doctor is very frustrated and we are seeking info on how to fight this. The doctor has had good results in his stage 4 PC patients and thinks my husband is a good candidate. We especially need the increased quality of life as he is suffering greatly right now. He was on a clinical trial but was recently removed due to increase in size of lesions in his liver. He currently is not receiving any treatment except pain meds that are are not working for him. We would appreciate any info as to how to break through the red tape.

  12. #12
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    My wife was a stage I at the end of May and on July 1st was diagnosed as now being a stage IV. Her oncologist told her that insurance only covers Folfirinox if the cancer has metastasized.

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    My father in law just found out he had cancer in his pancreas, liver, adrenal glands and one or more lymph nodes 2 weeks ago. Had first oncologist appt yesterday and they think he is a good candidate for this drug, he is 51 and otherwise healthy. They are going to biopsy his liver ASAP to make sure it's meta pancreatic cancer before they proceed.

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    The doctor is giving my dad that.

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    I would be cautious in making broad statements about Medicare covering a specific treatment such as Folfirinox. Each case is reviewed individually by Medicare. It is my understanding this is done on a regional level. I have a family member receiving Folfirinox treatment for stage IV Pancreatic Cancer and Medicare is paying. However, the same doctor providing this treatment has patients that Medicare is not covering. Before we knew if Medicare would or would not pay, we asked the doctor if he understand the critieria for coverage and he simply said "no". I am not supporting Medicare's decision to be inconsistent but I thought I would at least share what I know about the process. On a personal note, after 6 treatments with Folfirinox our family member is doing relatively well. Cancer marker numbers have dropped from 8000+ to under 200. Pet scan shows tumor size reduction. Unfortunately, he has experience 25-30 lb weight reduction. The side effects of Folfirinox are very harsh. The recovery time after each treatment seems to be longer.

  16. #16
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    My dad is on Folfox and folfirinox now and he is doing good. His tumor markers went from 70,000 to 8,000 with only 3 treatments.

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    Help

    Quote Originally Posted by Tony22 View Post
    My dad is on Folfox and folfirinox now and he is doing good. His tumor markers went from 70,000 to 8,000 with only 3 treatments.
    My dad was diagnosed with pc stage 4. He went to a hospital and they performed PTD procedure, so he is walking with the bag.
    Looks like Forfirinox is the best chance today on the market.
    We went to couple of professors and all have different opinion due to his billirubin - 5.5. Some of them are not wiling to perform due to high billirubin and saying this is high risk as his body has issue clearing itself.

    He was suggested Folfox at this stage until his billirubin drops.

    Can someone feedback what his billirubins were and how harsh are the treatments.

  18. #18
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    Quote Originally Posted by Ari View Post
    My dad was diagnosed with pc stage 4. He went to a hospital and they performed PTD procedure, so he is walking with the bag.
    Looks like Forfirinox is the best chance today on the market.
    We went to couple of professors and all have different opinion due to his billirubin - 5.5. Some of them are not wiling to perform due to high billirubin and saying this is high risk as his body has issue clearing itself.

    He was suggested Folfox at this stage until his billirubin drops.

    Can someone feedback what his billirubins were and how harsh are the treatments.
    Folfirinox is the best treatment out there. It comes with a price though. This chemo treatment is really powerful and usually have side effects. My dad doesn't have any side effects though.

  19. #19
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    Hi Ari,

    My dad is also on Folfirinox. He has had 5 treatments with little to no side effects. The only thing he has had is a being a little sensitive to cold.

    They would not do chemo on my dad until his bilrubin was down to a almost normal range which we were told is .30 to 1.4 We were told that if the bilrubin is too high then the chemo is more harmful because it damages the liver.

    They had to do an ERCP procedure to put a stent in to relieve my dad's bilrubin.

    You and your dad are in my thoughts and prayers.

    Lisa

  20. #20
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    Tony

    Thanks for reply.
    How is Forfox and what can you say about it's results.
    How many treatments your dad has?

 
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