Folfirinox & Metformin

Hi everyone...I really need some of your help. My husband Dave was diagnosed 3/17/11 with locally advanced PC with major vein and artery involvement. 9cm tumor middle of pancreas. After 10 rounds of Folfirinox,7 rounds of Folfox, 3 months of Tarceva, a failed surgery in August 2011, spleenectomy in Nov 2011, more Folfox through Jan 2012 when his tumor shrunk to 3.8 cm and came off of his veins and arteries enough for Dr. Robert Martin to complete a partial panc the end of Feb 2012, successfully removing the tumor, reconstruction of some veins, removal of 32 lymph nodes, his left adrenal gland and also used the nanoknife (IRE)along the edges of where the tumor had been and around the neural area where all the veins and arteries come together. His pathology came back with clear margins (closest being .5cm)but one lymph node was positive. He then went through 6 months of followup treatment at UT Southwestern in a pancreatic cancer vaccine trial. He had 5 1/2 weeks of daily chemo(5-FU)/radiation to his abdomen,4 months of Gemzar and the vaccines. He was NED from Feb until last week when his tumor markers went from 38 to 255 in one month and his CT scan and subsequent PET showed recurrence in the splenic bed area and an area behind his left kidney. A biopsy of the kidney area confirmed the cancer was out of remission and is now less differentiated then his prior pathology, meaning is more aggressive. He started back on Folfirinox yesterday. I showed his oncologist the recent study results with adding Metformin to the chemo protocal to destroy the cancer stem cells. He is on board but I need more concrete info on doses and contact info on who is using this so we can get Dave's endocrinologist on board...she wants some thing in writing or someone to speak to on protocol. Time is ticking so hoping someone on here who has more info can share that with me.   Bless you all, keep the faith, and keep fighting! Linda

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On Dec 19, 2012 2:12 AM mkldominos1 wrote:

Hi everyone...I really need some of your help. My husband Dave was diagnosed 3/17/11 with locally advanced PC with major vein and artery involvement. 9cm tumor middle of pancreas. After 10 rounds of Folfirinox,7 rounds of Folfox, 3 months of Tarceva, a failed surgery in August 2011, spleenectomy in Nov 2011, more Folfox through Jan 2012 when his tumor shrunk to 3.8 cm and came off of his veins and arteries enough for Dr. Robert Martin to complete a partial panc the end of Feb 2012, successfully removing the tumor, reconstruction of some veins, removal of 32 lymph nodes, his left adrenal gland and also used the nanoknife (IRE)along the edges of where the tumor had been and around the neural area where all the veins and arteries come together. His pathology came back with clear margins (closest being .5cm)but one lymph node was positive. He then went through 6 months of followup treatment at UT Southwestern in a pancreatic cancer vaccine trial. He had 5 1/2 weeks of daily chemo(5-FU)/radiation to his abdomen,4 months of Gemzar and the vaccines. He was NED from Feb until last week when his tumor markers went from 38 to 255 in one month and his CT scan and subsequent PET showed recurrence in the splenic bed area and an area behind his left kidney. A biopsy of the kidney area confirmed the cancer was out of remission and is now less differentiated then his prior pathology, meaning is more aggressive. He started back on Folfirinox yesterday. I showed his oncologist the recent study results with adding Metformin to the chemo protocal to destroy the cancer stem cells. He is on board but I need more concrete info on doses and contact info on who is using this so we can get Dave's endocrinologist on board...she wants some thing in writing or someone to speak to on protocol. Time is ticking so hoping someone on here who has more info can share that with me.   Bless you all, keep the faith, and keep fighting! Linda

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WOW your husband has been through so much my prayers are with you both, my story - diagnosed Sep. 2011 stage 4 in the head of the pancreas with mets to the liver & nodes, started folfirinox Nov.2011 after 16 sessions shrinkage of 30%, no tratment since June last two scans have been stable, spoke to my Oncology Doctor last week regarding trying the Metformin was told that at the moment she doesn't think it is right for me, (just one Doctors opinion) I am not yet diabetic.

I do hope you keep trying and I would be interested to know what your Doctor decides on the dosage, I will keep checking to see other peoples views on this protocol.

Blessings to you both Sheann

Thank you Sheann.  Will post when I have more information.  Keep the faith!  Blessings, Linda

My wife was taking 850mg 2x daily from 2006 until 3/4 way through her 10 months of folfirinox.  She had a slight spike in her blood sugars probably from eating too many carbs that week so her primary care physician bumped up the dosage to 3x daily.  She's maintained this dosage and frequency while on chemo which began in August 2011 thru June 2012.  Metformin is the only medication she is taking currently since her first NED reading last June. 

I've been hearing more and more oncologist's are adding Metformin to patients undergoing chemotherapy not only with pancreatic but colon, stomach and breast cancers.  We know of one person in our circle of friends who is in remission from stage 4 breast cancer who only started the Metformin upon starting her chemotherapy.  She is not diabetic.