A Multi-Institutional Retrospective Analysis of Toceranib Phosphate for Presumed or Confirmed Canine Aortic Body Chemodectomas

Abstract

Aortic body tumors, specifically chemodectomas, are the second most common type of canine cardiac tumor; however, information about treatment is currently lacking. This study included dogs with a presumptive or definitive diagnosis of an aortic body chemodectoma that underwent treatment with toceranib phosphate. Cases were solicited via the American College of Veterinary Internal Medicine Cardiology, Internal Medicine, and Oncology listservs using an electronic survey. Cox multivariate analysis of factors potentially impacting survival time was completed. Twenty-seven (27) cases were included in analysis. The clinical benefit rate (complete remission, partial remission, or stable disease >10 weeks) was 89%. A median survival time of 478 days was found for those receiving toceranib alone (n = 14), which was not statistically different from those treated with additional modalities (521 days). No factors evaluated statistically impacted outcome. Further, prospective studies are warranted to evaluate the use of toceranib for the treatment of canine aortic body chemodectomas.

The role of toceranib phosphate in dogs with non‐mast cell neoplasia: A systematic review

“…Therefore, the overall survival (823 days) is also difficult to be attributed solely to toceranib 46 . On the other hand, Coto et al reported a clinical benefit (CR, PR, SD) in 89% of the cases and a toceranib‐specific survival time of 478 days 47 . Dogs that received other forms of treatment in addition to toceranib had a MST of 521 days, which was not statistically different to the toceranib‐only group 47 In both studies, the majority of dogs did not have a histological diagnosis and NET was assumed based on echocardiographic findings.…”

“…Sunitinib has been licensed for the treatment of neuroendocrine pancreatic cancer in people 85 while promising findings have been described in some case reports and retrospective studies in dogs with thyroid carcinoma, insulinoma, phaechromocytoma and heart base tumours treated with toceranib. 46,47,50,51,53 In addition, dogs with ASAC, that is considered a neuroendocrine tumour, showed benefit when treated with toceranib. [28][29][30][31][32] One of the challenges is to accurately assess tumour response when some NET are slow to progress.…”

“…[43][44][45] Two retrospective studies (with a total of 54 cases) and one case report on the use of toceranib in heart base tumours (suspected chemodectomas) were identified. [46][47][48] In the study by Lew et al, 27 dogs were included in the study, though nine cases had received other forms of treatment prior to toceranib initiation. The authors reported a low overall response rate (PR in 10% of the cases) in 20 dogs that had restaging.…”

Ultrasound-Guided Radiofrequency Ablation of Chemodectomas in Five Dogs

“…In dogs CDs are low prevalence tumors with a complex clinical management. Several approaches have been described to treat these tumors, ranging from surgery [17], radiotherapy [8,21,22], stent placement [23,24] and chemotherapy [19,20]. There are currently no guidelines indicating which treatment option is best suited for canine CDs however, pericardiectomy and/or surgical excision of masses that are not locally invasive, can be considered the first choice treatment [16,17,55].…”

“…The complex approach to this tumor is reflected in the multitude of treatment modalities described in the literature, as well as the potential use of several different modalities in the same dog as part of a multimodal approach. Toceranib phosphate [19,20], stereotactic radiotherapy [8,15,21,22] and stent placement to alleviate local vascular compression have been described [23,24].…”