Multicenter prospective trial of hypofractionated radiation treatment, toceranib, and prednisone for measurable canine mast cell tumors

K S Carlsten, C A London, S Haney, R Burnett, A C Avery, D H Thamm
Journal of Veterinary Internal Medicine 2012, 26 (1): 135-41

BACKGROUND: Mast cell tumors (MCT) are common cutaneous tumors in dogs and when not amenable to surgical excision can present a therapeutic challenge. New treatment protocols for unresectable MCT are needed.

HYPOTHESIS: The combination of toceranib, prednisone, and hypofractionated radiation treatment (RT) will be well tolerated and efficacious.

ANIMALS: Seventeen client-owned dogs with measurable MCT amenable to RT.

METHODS: Prospective clinical trial. All dogs received prednisone, omeprazole, diphenhydramine, and toceranib. Toceranib was administered for 1 week before initiating RT, consisting of 24 Gy delivered in 3 or 4 fractions.

RESULTS: On an intent-to-treat basis, the overall response rate was 76.4%, with 58.8% of dogs achieving a complete response and 17.6% a partial response. The median time to best response was 32 days, and the median progression-free interval was 316 days. The overall median survival time was not reached with a median follow-up of 374 days. The most common toxicoses were gastrointestinal and hepatic.

CONCLUSIONS AND CLINICAL IMPORTANCE: The combination of hypofractionated RT, toceranib, and prednisone was tolerated and efficacious in the majority of dogs. Response rates and durations were higher than those reported for toceranib as a single-agent treatment for MCT. This combination is a viable treatment option for unresectable MCT.


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