Gemcitabine and Abraxane: What to Expect

Gemcitabine plus nab-paclitaxel is a chemotherapy combination. The Abraxane label approves it with gemcitabine as a first treatment. It is for pancreatic cancer that has spread (metastatic adenocarcinoma of the pancreas).

Regimen names can look like alphabet soup. They usually combine drug initials, timing, and treatment goals. Use this page to follow the conversation. Do not use it to work out doses or to compare yourself with someone else's plan.

It may come up when combination chemotherapy is preferred. FOLFIRINOX is another combination used in pancreatic cancer. Ask your team why one is being chosen over the other for you.

One regimen name can cover several different situations. Doses, schedules, premedicines, scans, labs, and supportive medicines all vary. They depend on the cancer type, the treatment goal, and the person being treated.

The team may do these things first:

• Confirm the pathology (what the lab found in your tissue), stage, and biomarkers.
• Check organ function, blood counts, and infection risk.
• Check allergies, current medicines, and fertility concerns.
• Decide whether a port or PICC line is useful. This is a thin tube placed in a vein for treatments.

Some regimens call for anti-nausea medicines, steroid instructions, or hydration plans. Others add heart, hearing, kidney, or neuropathy checks.

• What are the names of each medicine in my regimen?
• How long is one cycle, and how many cycles are planned?
• Which side effects are common, and which are urgent?
• Will I need growth-factor shots, transfusions, hydration, or infection precautions?
• How will we know whether the treatment is working?
• What happens if side effects force a delay, dose change, or switch?

The label lists the most common side effects. They include low white blood cells, fatigue, nerve damage (neuropathy), and nausea. Others are hair loss, swelling in the legs or arms, diarrhea, and fever. Vomiting, low appetite, rash, and dehydration are also on the list. Ask how the schedule handles delays.

Ask for written instructions before you leave the infusion center. The most useful handout is specific to the regimen, not a general chemotherapy sheet.

The Abraxane label warns that it can cause low white blood cell counts. These may be severe. It can also cause nerve damage. It also warns of sepsis, lung inflammation (pneumonitis), and severe allergic reactions.

• Call 911 or go to an emergency department if you have trouble breathing, chest pain, swelling of the face or throat, shaking chills you cannot control, or you faint. Do not drive yourself.
• Call 911 or go to an emergency department if you vomit blood or something that looks like coffee grounds, or your stools are black and tarry. These can be signs of bleeding in the gut (MedlinePlus: vomiting blood; MedlinePlus: GI bleeding). Do not drive yourself.
• Treat a temperature of 100.4°F (38°C) or higher as an emergency. CDC treats a fever during chemo as a medical emergency. Ring your team at once, whatever the hour, and go to an emergency department if you cannot get through.
• Call your care team right away, day or night, if you have chills, a sore throat, a new cough, or burning when you urinate. These can be signs of infection during chemotherapy (CDC).
• Call 911 or go to an emergency department if you have heavy bleeding that will not stop. Do not drive yourself.
• Call your care team right away if you cannot keep fluids down, have severe diarrhea, or notice unusual bruising.
• Call your care team right away if numbness, burning or tingling in your hands or feet is new or getting worse, or you have trouble buttoning clothes or walking steadily.

Talk with your doctor or nurse before taking any medicine for a fever, even acetaminophen or ibuprofen. NCI says these can hide signs of a problem.

Sometimes two options offer similar benefits with different tradeoffs. Ask what the alternatives are, and why this plan is preferred. Ask whether a clinical trial is relevant, and whether to get a second opinion before treatment starts.

Start with Chemotherapy and How Chemotherapy Is Given. Then see What to Bring to Chemotherapy, and Low White Blood Cells During Chemotherapy.

• National Cancer Institute — Drugs Approved for Pancreatic Cancer
• DailyMed — ABRAXANE label
• National Cancer Institute — Infection and Neutropenia during Cancer Treatment
• National Cancer Institute — Nerve Problems (Peripheral Neuropathy) and Cancer Treatment
• CDC — Fever During Chemotherapy Is a Medical Emergency