Alonso-Miguel D, García-San José P, González Sanz S, Clarés Moral I, Pérez-Alenza M D
Department of Animal Medicine and Surgery, School of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain.
N Z Vet J. 2021 Jul;69(4):234-239. doi: 10.1080/00480169.2021.1905569. Epub 2021 May 4.
To compare survival in dogs with recurrent or metastatic insulinomas that were treated with palliative therapy, alone or in combination with toceranib phosphate and to assess tolerability of the combined therapy in dogs.
Dogs diagnosed with insulinoma were retrospectively identified in the records of the Veterinary Teaching Hospital Complutense (Madrid, Spain). Diagnosis of insulinoma was based on clinical signs of hypoglycaemia, concentrations in serum of glucose <3.3 mmol/L and insulin >10 μIU/mL and presence of a pancreatic mass on diagnostic imaging. Dogs were treated surgically or medically, according to clinical stage established by imaging techniques, and monitored with blood and urine analyses monthly and abdominal ultrasonography every 3 months until death. Dogs that presented with metastatic disease at diagnosis or with recurrent hypoglycaemia after surgery were treated, according to the owner's decision, with one of two treatment protocols: palliative therapy alone (control group, n=7: diet, prednisone, famotidine or omeprazole, ±octreotide) or palliative therapy in combination with toceranib (treatment group, n=5; median dose of toceranib 2.52 mg/kg). Overall survival time (OST) and adverse events were compared between the two treatment groups.
The OST was longer in the treatment group (median 399, min 125, max 476 days) compared to the control group (median 67, min 23, max 387 days; p=0.042). Dogs in the treatment group had a higher incidence of grade 1-2 gastrointestinal toxicity (diarrhoea) than dogs in the control group (p=0.010). In all cases, gastrointestinal toxicity was solved by temporarily discontinuing toceranib.
The use of toceranib combined with palliative treatment in dogs with suspect metastatic or recurrent insulinomas increased survival time and was adequate tolerated.
比较接受姑息治疗、单独使用或联合使用磷酸托西拉尼治疗的复发性或转移性胰岛素瘤犬的生存率，并评估联合治疗对犬的耐受性。
在Complutense兽医教学医院（西班牙马德里）的记录中回顾性识别诊断为胰岛素瘤的犬。胰岛素瘤的诊断基于低血糖的临床症状、血清葡萄糖浓度<3.3 mmol/L和胰岛素>10 μIU/mL以及诊断性成像中胰腺肿块的存在。根据成像技术确定的临床分期，对犬进行手术或药物治疗，并每月进行血液和尿液分析监测，每3个月进行腹部超声检查直至死亡。根据主人的决定，对诊断时出现转移性疾病或手术后复发性低血糖的犬采用两种治疗方案之一进行治疗：单独姑息治疗（对照组，n = 7：饮食、泼尼松、法莫替丁或奥美拉唑，±奥曲肽）或姑息治疗联合托西拉尼（治疗组，n = 5；托西拉尼中位剂量2.52 mg/kg）。比较两个治疗组的总生存时间（OST）和不良事件。
与对照组（中位67天，最小值2 3天，最大值387天；p = 0.042）相比，治疗组的OST更长（中位399天，最小值125天，最大值476天）。治疗组犬的1-2级胃肠道毒性（腹泻）发生率高于对照组犬（p = 0.010）。在所有情况下，通过暂时停用托西拉尼解决了胃肠道毒性。
在疑似转移性或复发性胰岛素瘤犬中，使用托西拉尼联合姑息治疗可延长生存时间，且耐受性良好。
