Purpose
Examine the efficacy of toceranib phosphate (Palladia) as a primary and/or adjuvant agent in the treatment of canine nasal carcinoma
Canine nasal carcinomas are common, locally aggressive tumors. Untreated patients survive an average of 3-5 months. Radiation therapy is currently the treatment of choice as it extends median survival times to 8-25 months, with a maximum tumor response approximately 3 months after completion of treatment. Long-term control of this tumor is rarely achieved, so new approaches to this uniformly fatal tumor are needed.
All tumors must develop new blood vessels in order to grow. Palladia is a tyrosine kinase inhibitor that inhibits the development of new blood vessels by targeting receptors called vascular endothelial growth factor receptors. These receptors have been documented to occur in canine nasal tumors and early reports indicate that Palladia has primary activity in these tumors. Palladia has also been shown to sensitize tumor tissues to the effects of radiation therapy. Because of these findings, clinical investigation of Palladia as therapy for nasal carcinomas, alone or in combination with radiation therapy is needed to know if we can increase our efficacy in controlling these tumors in comparison to radiation therapy alone. We also need to monitor for any side effects.
Dogs deemed eligible based on prior evaluation will be treated with Palladia. Whether or not to include radiation therapy in your pet’s treatment plan is your decision. If radiation is chosen, your dog will receive 10 radiation treatments Monday through Friday over two weeks with a total dose of 42 Gy.
Your dog will receive monitoring tests including a physical examination, a complete blood count, toxicity assessment through review of blood work results and review of your diary, and pill counts to confirm administration compliance weekly for the first two weeks, then at week 4, and then at four-week intervals. Three months after starting Palladia (or after completion of radiation therapy with Palladia) a CT scan will be performed and the response to treatment will be evaluated.
Your dog will receive free drug and monitoring tests (as outlined above) for adverse effects, as well as a follow-up CT scan at 90 days post-treatment (overall cost savings of approximately $3300). We expect treatment with Palladia will benefit dogs with nasal carcinoma by increasing response rates and prolonging disease free-intervals and overall survival times.