Elliott James W
J Am Vet Med Assoc. 2019 Apr 15;254(8):960-966. doi: 10.2460/javma.254.8.960.
To assess response and outcome in dogs with stage 4 anal sac apocrine gland adenocarcinoma (ASAGA) treated with toceranib phosphate as the sole chemotherapeutic agent.
Retrospective case series.
15 client-owned dogs with stage 4 ASAGA treated with toceranib phosphate between March 2013 and June 2017.
Medical records were reviewed, and data collected included signalment, clinical signs, results of physical examinations and diagnostic procedures, treatments, response, follow-up information, and outcomes. Adverse events and response to treatment were assessed according to standard guidelines, and the Kaplan-Meier product limit method was used for analyses of progression-free interval and survival time.
No dogs had a complete or partial response to treatment with toceranib; however, 13 dogs had signs of clinical benefit. No dogs had signs of toxic effects related to toceranib or were withdrawn completely from treatment because of adverse events. Median progression-free interval and median survival time were 354 and 356 days, respectively.
Results of the present study indicated that dogs with stage 4 ASAGA treated with toceranib had improved outcomes, compared with outcomes previously reported for dogs with ASAGA that had received non-tyrosine kinase inhibitor treatments. Some dogs had improvement in clinical signs, but euthanasia was often performed because of signs of locoregional failure; therefore, toceranib alone may not be an appropriate treatment for dogs with marked clinical signs attributed to ASAGA, particularly when signs suggest limited quality of life. Further study of toceranib in multimodality treatments for dogs with advanced ASAGA is warranted.
评估以磷酸托西替尼作为唯一化疗药物治疗的4期肛门囊顶泌汗腺腺癌(ASAGA)犬的反应和结局。
回顾性病例系列。
2013年3月至2017年6月间15只接受磷酸托西替尼治疗的4期ASAGA客户拥有犬。
查阅病历,收集的数据包括特征、临床症状、体格检查和诊断程序结果、治疗、反应、随访信息和结局。根据标准指南评估不良事件和治疗反应,采用Kaplan-Meier乘积限界法分析无进展生存期和生存时间。
没有犬对磷酸托西替尼治疗有完全或部分反应;然而,13只犬有临床获益迹象。没有犬有与磷酸托西替尼相关的毒性作用迹象,也没有犬因不良事件而完全停止治疗。中位无进展生存期和中位生存时间分别为354天和356天。
本研究结果表明,与先前报道的接受非酪氨酸激酶抑制剂治疗的ASAGA犬的结局相比,接受磷酸托西替尼治疗的4期ASAGA犬的结局有所改善。一些犬的临床症状有所改善,但常因局部区域衰竭迹象而实施安乐死;因此,单独使用磷酸托西替尼可能不是ASAGA所致明显临床症状犬的合适治疗方法,尤其是当症状提示生活质量有限时。有必要进一步研究磷酸托西替尼在晚期ASAGA犬多模式治疗中的应用。