Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, UK.
Departamento de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, Alfara del Patriarca, Valencia, Spain.
J Feline Med Surg. 2024 Aug;26(8):1098612X241256473. doi: 10.1177/1098612X241256473.
Mammary tumours in cats are biologically aggressive. The standard of care relies upon wide surgical resection. Chemotherapy has been described in the macroscopic disease setting; however, limited efficacy has been shown. The aim of this study was to assess the efficacy of toceranib phosphate in macroscopic feline mammary tumours (FMTs).
A total of 17 cats with cytologically or histopathologically confirmed mammary adenocarcinoma (gross disease) were prospectively enrolled. Toceranib phosphate was administered at a median dose of 2.77 mg/kg (range 2.3-3.2) PO q48 h. No corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs) were administered. Toxicity was graded according to Veterinary Cooperative Oncology Group-Common Terminology Criteria for Adverse Events (VCOG-CTCAE) v1.1 criteria. The response was assessed after 1 month, following Response Evaluation Criteria In Solid Tumours (RECIST) criteria.
Toxicity was observed in eight cats, with most instances being grade 1 or 2, which were managed with supportive care. Only one cat experienced grade 3 toxicity (anorexia), which resolved after a dose reduction. Clinical benefit was seen in 12 (64.7%) cats and an objective response was seen in six (35.2%) cats. One cat experienced complete response, five had partial response, six had stable disease and five had progressive disease. One cat showed distant progression (malignant pleural effusion) despite continued partial remission of the primary tumour. The median progression-free survival and median overall survival time were 91 days (range 30-158) and 145 days (range 31-234), respectively.
Toceranib phosphate showed clinical benefit and a good safety profile in advanced or recurrent FMTs, offering a new alternative in the treatment of this disease; however, further prospective and randomised studies are required to further assess its efficacy. Interestingly, one cat developed distant metastases while the primary tumour showed partial response, suggesting that primary tumour and metastatic disease may not sustain the same sensitivity to toceranib.
猫的乳腺肿瘤具有很强的生物侵袭性。目前的治疗标准依赖于广泛的手术切除。已经在宏观疾病环境中描述了化疗，但疗效有限。本研究旨在评估磷酸托昔替尼在猫的乳腺肿瘤（FMT）中的疗效。
共纳入 17 只经细胞学或组织病理学证实患有乳腺腺癌（大体疾病）的猫。磷酸托昔替尼的中位剂量为 2.77mg/kg（范围 2.3-3.2），PO q48h。未给予皮质类固醇或非甾体抗炎药（NSAIDs）。毒性根据兽医合作肿瘤学组-常见不良事件术语标准（VCOG-CTCAE）v1.1 标准进行分级。根据实体瘤反应评估标准（RECIST）标准，在 1 个月后评估反应。
8 只猫出现毒性，大多数为 1 级或 2 级，通过支持性治疗即可控制。只有 1 只猫出现 3 级毒性（厌食），剂量减少后得到缓解。12 只（64.7%）猫表现出临床获益，6 只（35.2%）猫出现客观反应。1 只猫完全缓解，5 只部分缓解，6 只稳定，5 只进展。1 只猫尽管原发肿瘤持续部分缓解，但出现远处进展（恶性胸腔积液）。无进展生存期和总生存期的中位数分别为 91 天（范围 30-158）和 145 天（范围 31-234）。
磷酸托昔替尼在晚期或复发性 FMT 中显示出临床获益和良好的安全性，为治疗这种疾病提供了新的选择；然而，需要进一步的前瞻性和随机研究来进一步评估其疗效。有趣的是，一只猫在原发肿瘤出现部分缓解的同时发生远处转移，这表明原发肿瘤和转移疾病可能对托昔替尼的敏感性不同。
