Early Tumor Response to Intraarterial or Intravenous Administration of Carboplatin to Treat Naturally Occurring Lower Urinary Tract Carcinoma in Dogs

Abstract

BackgroundSurvival times and tumor responses associated with malignant neoplasia of the lower urinary tract are poor despite the vast array of current treatments. Therefore, the evaluation of alternative treatments, such as intraarterial administration of chemotherapy (IAC) should be considered.ObjectiveTo describe a technique for superselective catheterization for IAC and to evaluate initial tumor response by ultrasonography after both IAC and intravenous administration of chemotherapy (IVC).AnimalsClient‐owned dogs with lower urinary tract neoplasia treated with either IVC (n = 15) or IAC (n = 11).MethodsRetrospective study. An arterial approach via the carotid or femoral artery was utilized to obtain superselective access and administer chemotherapy in the IAC cases. Medical record review was performed, data were recorded, and recorded variables were evaluated statistically.ResultsIntraarterial chemotherapy was successfully administered in all cases. There was a significantly greater decrease in longest unidimensional measurement in the IAC group as compared to the IVC group (P = .013). The IAC group was also significantly more likely to have a tumor response as assessed by modified RECIST guidelines (P = .049). Dogs in the IAC group were significantly less likely to develop anemia (P = .001), lethargy (P = .010) and anorexia (P = .024).Conclusion and Clinical ImportanceThis study demonstrated the feasibility and efficacy of performing IAC for lower urinary tract neoplasia. Further investigation is necessary as the follow‐up time was short and the impact on long‐term outcome and survival was not determined.

Lower Urinary Tract Neoplasia

“…Multiple chemotherapeutic protocols and drugs have been studied (including cisplatin, carboplatin, mitoxantrone, doxorubicin, vinblastine, and gemcitabine), and in general canine TCC is considered relatively resistant to chemotherapy [3,4,5]. Although long-term outcome data is limited, evidence suggests a potential benefit of chemotherapy administration via an intraarterial route [58]. As compared to canine patients that received intravenous carboplatin for treatment of lower urinary tract carcinoma, patients that received intraarterial carboplatin were more likely to have a tumor response and experienced greater decreases in tumor size [58].…”

Palliative care in small animal oncology

“…Additional modifications can be made as necessary in patients in which toxicity is a problem so that quality of life is maintained during treatment. Chemotherapy can be used before (neoadjunctive) or after (adjunctive) surgery for solid tumours and occasionally as a sole agent in the palliative setting (Page and others 1993, Chun and others 1997, Bacon and others 2008, Bailey and others 2008, Bulakowski and others 2008, Grant and others 2008, Kisseberth and others 2008, Rassnick and others 2008, Cooper and others 2009, Dominguez and others 2009, Lori and others 2010, Arnold and others 2011, Fidel and others 2011, Bray and Polton 2014, Selmic and others 2014, Cannon and others 2015, Culp and others 2015, Marconato and others 2015) (Table 5). Intracavitatory chemotherapy can be useful in some patients with neoplastic pleural effusion (Charney and others 2005); permanent pleural ports are well tolerated and facilitate delivery as well as allowing drainage of the effusion.…”

“…These cases are rare, however, as most affected patients have clinical signs that lead to euthanasia before complete obstruction is evident. Chemoembolisation and selective transvessel chemotherapy have also been described (Weisse 2009, 2015, Culp and others 2015). …”

Outcome and prognostic factors in medically treated canine prostatic carcinomas: A multi‐institutional study

“…The high metastatic rate highlights the need for effective systemic treatment. However, the role of cytotoxic chemotherapy in the management of canine PC is unknown, and only anecdotal responses to chemotherapy drugs commonly used to treat other canine urothelial carcinomas exist . When used with NSAIDs to treat urinary bladder TCC, chemotherapy may be associated with improved outcomes compared to NSAIDs alone .…”

“…However, the role of cytotoxic chemotherapy in the management of canine PC is unknown, and only anecdotal responses to chemotherapy drugs commonly used to treat other canine urothelial carcinomas exist. 26,27 When used with NSAIDs to treat urinary bladder TCC, chemotherapy may be associated with improved outcomes compared to NSAIDs alone. 26,28,29 A recent study failed to identify any statistical significant differences between 2 groups of dogs with bladder TCC treated with piroxicam in combination with mitoxantrone or carboplatin.…”