Berger Erika P, Johannes Chad M, Jergens Albert E, Allenspach Karin, Powers Barbara E, Du Yingzhou, Mochel Jonathan P, Fox Leslie E, Musser Margaret L
Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa.
Department of Microbiology, Immunology & Pathology, Colorado State University, Fort Collins, Colorado.
J Vet Intern Med. 2018 Nov;32(6):2045-2053. doi: 10.1111/jvim.15335. Epub 2018 Oct 11.
Gastrointestinal stromal tumors (GISTs) are uncommon intestinal neoplasms in the dog. Literature regarding adjunctive therapy for GISTs in dogs is sparse. High-risk GISTs in humans respond to tyrosine kinase inhibition in the adjuvant setting.
To review cases of toceranib phosphate use in dogs with GISTs and provide initial assessment of possible biological activity. A secondary aim was to evaluate patient and tumor characteristics for possible prognostic value.
Twenty-seven dogs with confirmed GISTs based on histopathology and immunohistochemistry treated with toceranib.
Retrospective study in which cases of toceranib use in dogs with GIST were solicited using the American College of Veterinary Internal Medicine Oncology and Small Animal Internal Medicine listservs.
Five of 7 dogs with gross disease experienced clinical benefit (71%; 3 complete responses, 1 partial response, 1 stable disease). These included 2 dogs with durable responses after toceranib discontinuation. Median progression-free interval (PFI) in dogs with gross disease was 110 weeks (range, 36-155 weeks). Median PFI in dogs with microscopic disease was 67 weeks (range, 9-257 weeks). Metastasis at diagnosis (P = 0.04) and high mitotic index (P < 0.001) were associated with shorter PFI in toceranib-treated dogs.
Biological activity of toceranib is evident in dogs with gross disease. Metastasis of GIST at diagnosis, as well as high tumor mitotic index, was associated with shorter PFI in toceranib-treated dogs. Larger studies are needed to define postsurgical risk and refine the use of toceranib in dogs with gross and microscopic GIST.
胃肠道间质瘤(GIST)是犬类中罕见的肠道肿瘤。关于犬类GIST辅助治疗的文献稀少。人类高危GIST在辅助治疗中对酪氨酸激酶抑制有反应。
回顾磷酸托西拉尼用于犬类GIST的病例,并对可能的生物学活性进行初步评估。次要目的是评估患者和肿瘤特征的可能预后价值。
27只经组织病理学和免疫组织化学确诊为GIST并接受磷酸托西拉尼治疗的犬。
回顾性研究,通过美国兽医内科学会肿瘤学和小动物内科学邮件列表征集磷酸托西拉尼用于犬类GIST的病例。
7只患有肉眼可见疾病的犬中有5只获得临床益处(71%;3例完全缓解,1例部分缓解,1例病情稳定)。其中包括2只在停用磷酸托西拉尼后有持久反应的犬。患有肉眼可见疾病的犬的无进展生存期(PFI)中位数为110周(范围为36 - 155周)。患有微小疾病的犬的PFI中位数为67周(范围为9 - 257周)。诊断时发生转移(P = 0.04)和高有丝分裂指数(P < 0.001)与磷酸托西拉尼治疗的犬的较短PFI相关。
磷酸托西拉尼对患有肉眼可见疾病的犬具有明显的生物学活性。GIST诊断时的转移以及高肿瘤有丝分裂指数与磷酸托西拉尼治疗的犬的较短PFI相关。需要开展更大规模的研究来确定术后风险,并优化磷酸托西拉尼在患有肉眼可见和微小GIST的犬中的使用。