Gemcitabine vs Topotecan

[Lamets]

Hi all

Was wondering if anyone had opinions or experience of whether Gemcitabine or Topotecan have advantages/disadvantages over each other?

Either would be given together with Avastin on a weekly basis.

My wife has been in discussions with our onc due to her High grade serous BRCA -ve recurrence having not responded to carbo/caelyx combo and also niraparib not slowing progression.

Onc has given my wife the bad news that if no response then she expects my wife to be in hospital in 2/3 months due to complications with the way progression is ongoing.

Also doesn’t expect my wife to be around next July for daughter wedding.

It seems we are coming to the end of treatment options with very little hope which is obviously very distressing for everyone.

Any input appreciated.

🙏 🙏

Thanks

Steve & Jo

[Starbarn]

I’m sorry to hear the treatment isn’t working at the moment. I can’t help you with these treatments either.

We know gemcitabine as gemzar and if you type this into the search bar you will get some information. As for topotecan I’m not sure it’s used in the uk .

I hope you gets some response soon from people that have further information.

Good luck.

[Saffery1 in reply to Starbarn]

nhs.uk/ipgmedia/national/Ma...

Seems it is used here.

[Starbarn in reply to Saffery1]

Thank you for correcting my post. I hope lamets gets the information needs.

[Saffery1 in reply to Starbarn]

I'm interested because it's one of my next options.

[Lamets in reply to Starbarn]

Thank you I’ll search for gemzar and see what I can find.

[delia2]

Hi. Sorry to hear your news. I haven’t had either of the chemos you mention but what about weekly taxol? That seems to often be effective in people at your wife’s stage. You might want to get a second opinion even while having the suggested treatment.

[Lamets in reply to delia2]

Delia

That’s what I’m thinking, start on the topotecan with Avastin and try to get another opinion.

She has gone downhill pretty quickly in the last week and is now getting very disorientated and struggling to walk without some sort of support. This has all happened since the terminal diagnosis last Wed.

She worked a full 8 hour shift last Monday and did a 3km walk on Sat but the diagnosis seems to have broken her spirit and everything seems to be physically overwhelming her.

Today she has fallen/collapsed quite badly and myself and the kids are obviously worried sick, especially if it means they pull any treatment options away.

😪 😢

[Popmil]

Hi sorry to hear your news. I would ask for 2nd opinion & also are there any trials available? I was on Avastin given every 3 weeks for 18 cycles but before this I was on a trial that wasn’t working for me. If your on FB join Ovarian Cancer Community, they have a few talks about trials. Sending lots of positive thoughts to you & your wife xx

[Trickysite]

Dear Lamets,

On the other hand, your wife may respond well to the treatment on offer. I sincerely hope she does. The onc is working on statistics, but we are all individuals and there are always outliers on the statistical band who last a great deal longer than the statistical average. Wishing you and your family strength and hoping to hear news that your wife attended the July wedding surrounded by her loving family. Remind your wife what she was able to do last week. She is probably in shock at the moment but she has that July goal to give her strength.

[Worsuz]

Hi Lamets. We’re based in the UK. My wife is currently on Topotecan, it’s been difficult for her to tolerate so far and currently the third round has been pushed back as she is neutrapenic due to this treatment so is having GCSF injections to get the neutrophils up. Platelets also low. She was on gem / carbo combination previously but that was only effective fir a very short time so the treatment was changed to this one. We’ll get the mid way scan in a couple of weeks to check effectiveness but the CA125 levels had reduced significantly after the first treatment. The topetecan has affected her mental state and she has become hyper worried about things and a bit paranoid, also weird dreams. All the best with the treatment 🌼

[Lamets in reply to Worsuz]

Worsuz,

Thank you for the response,

My wife had first dose of topotecan yesterday together with Avastin.

She is on weekly Topotecan for three weeks then a week off with Avastin every other week.

Previously her neutrophils have always been bad while on chemo and she’s required multiple injections and also transfusions for platelets.

We have asked for a reduced dose although I am sure the nurses have dosed normally.

Hopefully this one works as the short term outlook doesn’t look good ATM as we have had continual progression since Recurrance in Sept.

Last week she fainted and since then she has lost feeling in her feet and her legs are very weak.

This was all before Topotecan started and post stopping a PARP inhibitor, we are hoping that this is only a temporary condition and she improves over the next couple of weeks.

Fingers crossed for both of us 🤞