Phase I dose escalating study of oral cyclophosphamide in tumour-bearing cats

Chan, Catherine M.; Rassnick, Kenneth M.; Frimberger, Angela E.; Nguyen, Sandra; Moore, Antony S.

doi:10.1016/j.tvjl.2020.105450

Cited by 3 publications

(9 citation statements)

References 15 publications

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“…The likelihood that the constitutional and gastrointestinal AEs were an effect of therapy is low, however, given the low frequency of such AEs in cats receiving even over double the median dose of cyclophosphamide utilized in this study. 42 However, the challenges associated with clinically deciding response and relapse means that it is possible that the PFS was under- or overestimated if AEs were erroneously attributed to PD or AEs, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Cyclophosphamide is an alkylating agent commonly employed in the management of various types of lymphoma in cats, 28–37 as well as other feline malignancies. 38–41 Until recently, 42,43 the maximum tolerated dose of cyclophosphamide in cats was not well established, and the spectrum of published dosage regimens was diverse. 28–41 Even so, cyclophosphamide appeared to be well-tolerated, with adverse events (AEs) uncommonly reported.…”

Section: Introductionmentioning

confidence: 99%

“…28–41 Even so, cyclophosphamide appeared to be well-tolerated, with adverse events (AEs) uncommonly reported. 28–42 The principal dose-limiting toxicity in cats is myelosuppression, primarily affecting neutrophils. 42–44 Additional clinically significant toxicities, including gastrointestinal and neurologic toxicities, are rarely reported, even with very high doses.…”

Section: Introductionmentioning

confidence: 99%

“…28–42 The principal dose-limiting toxicity in cats is myelosuppression, primarily affecting neutrophils. 42–44 Additional clinically significant toxicities, including gastrointestinal and neurologic toxicities, are rarely reported, even with very high doses. 42,45,46 In conjunction with this negligible AE profile, and similar to chlorambucil, cyclophosphamide may be preferred over alternative rescue agents because it is conveniently available as an oral formulation that can be administered by the client at home, sparing the cats and clients from hospital-associated stress and costs, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Cyclophosphamide rescue therapy for relapsed low-grade alimentary lymphoma after chlorambucil treatment in cats

Kim

Wouda

Borrego³

et al. 2021

Journal of Feline Medicine and Surgery

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Objectives The aims of this study were to evaluate the response, outcome and prognostic factors in cats with clinically presumed relapsed low-grade alimentary lymphoma (LGAL) receiving cyclophosphamide as a first-line rescue therapy after failing chlorambucil treatment. Methods The medical records of 20 cats (from three institutions, between 2002 and 2017) treated with cyclophosphamide for relapsed LGAL after initial treatment with chlorambucil were retrospectively reviewed. Progression-free survival (PFS), overall survival time (OST) and the association of select variables with measures of outcome were assessed. Adverse events (AEs) were also described. Results Eighteen cats (90%) achieved a complete clinical response (CR) for a median duration of 239 days. The median PFS was 215 days. The median OST was 1065 days. The only clinical factor associated with a longer PFS was achievement of a CR with cyclophosphamide treatment. Cyclophosphamide was associated with few and reversible constitutional, gastrointestinal and hematologic AEs. Conclusions and relevance Cyclophosphamide appears to be a safe and effective first-rescue therapeutic option for cats with relapsed LGAL.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cyclophosphamide rescue therapy for relapsed low-grade alimentary lymphoma after chlorambucil treatment in cats

Kim

Wouda

Borrego³

et al. 2021

Journal of Feline Medicine and Surgery

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“…15 Cats have been shown to tolerate higher cyclophosphamide dosages than dogs; an appropriate dosage is 460 mg/m 2 . 16,17 Although this dosage of cyclophosphamide has been shown to be safe in cats, it is unclear whether incorporating this dosage, and incorporating other drugs as suggested above, into combination chemotherapy protocols would provide better outcomes (improved remission rates and lower toxicity risk) for cats with alimentary lymphoma. The intent of this study was to retrospectively evaluate such a protocol (VACP protocol) for efficacy and toxicity and to identify prognostic factors that predict patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Treatment of feline intermediate to high‐grade alimentary lymphoma: A retrospective evaluation of 55 cats treated with the VAPC combination chemotherapy protocol (2017–2021)

Moore,

Frimberger

2023

Vet Comparative Oncology

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The most commonly utilized protocols to treat lymphoma in cats employ vincristine, cyclophosphamide and prednisone; with additional drugs sometimes used including L‐asparaginase and doxorubicin. Medical records were reviewed for 55 cats with alimentary lymphoma treated with a novel multiagent protocol using prednisolone, L‐asparaginase, doxorubicin, vinblastine instead of vincristine, a higher dosage of cyclophosphamide and oral procarbazine (VAPC protocol). Outcomes evaluated were response to therapy, toxicity and progression‐free survival (PFS). Grade 3 or 4 neutropenia was the most common treatment‐related reason for chemotherapy dosage adjustment, occurring in 8 of 52 cats receiving vinblastine, 7 of 55 cats receiving cyclophosphamide and 1 of 40 cats receiving doxorubicin, but febrile neutropenia was identified in only two cats. Of 38 cats receiving chemotherapy for measurable disease, 26 (68.4%) achieved complete response (CR). Three cats achieved a partial response and 9 cats failed to achieve a remission. There were no identified factors influencing whether a cat was likely to achieve CR. For all 55 cats (including those receiving chemotherapy and surgery), median PFS was 184 days with 1, 2 and 3‐year survival rates of 35.4%, 26.5% and 26.5%, respectively. On multivariate analysis, 40 cats that achieved CR had a median survival time of 341 days (78 days for PR, 45 days for NR); PFS times were also significantly affected by lymphocyte:monocyte L:M ratio (>3.4 = 700 days vs. ≤3.4 = 126 days) and B‐cell versus T‐cell phenotype (220 days vs. 42 days, respectively).

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Clinical evaluation of the effectiveness of meloxivet in the complex treatment of cats with mammary gland carcinoma

Bilyi,

Herhaulović

2024

Vet. stn. (Online)

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This study presents the results of a clinical administration of meloxivet nonsteroidal anti-inflammatory treatment against the background of the docetaxel + cyclophosphamide regimen chemotherapy following bilateral mastectomy in cats with mammary gland carcinoma. The inclusion of meloxivet in complex chemotherapy against breast carcinomas bilateral mastectomy improved treatment results. In particular, survival was extended in the clinical stages: I and II - by 1.3 times, III - by 1.6 times, and the disease-free period was increased by 1.5, 1.4 and 1.9 times, respectively. Complex treatment of cats including non-steroidal anti-inflammatory therapy reduced the risk of disease progression depending on the clinical stage during the first six months after the end of the course. An increase in the number of patients with subsequent metastasis (after six to twelve months) was also noted. The use of meloxivet made it possible to avoid disease progression in cats up to three years of age, and to reduce its probability and delay the onset of metastasis in all age categories. The proposed scheme of treatment of cats with mammary gland carcinomas reduced side effects, indicating an insignificant risk of negative effects of long-term meloxivet use against the background of a 1.5- fold reduction in the frequency of recurrences in the surgical intervention area.

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Phase I dose escalating study of oral cyclophosphamide in tumour-bearing cats

Cited by 3 publications

References 15 publications

Cyclophosphamide rescue therapy for relapsed low-grade alimentary lymphoma after chlorambucil treatment in cats

Cyclophosphamide rescue therapy for relapsed low-grade alimentary lymphoma after chlorambucil treatment in cats

Treatment of feline intermediate to high‐grade alimentary lymphoma: A retrospective evaluation of 55 cats treated with the VAPC combination chemotherapy protocol (2017–2021)

Clinical evaluation of the effectiveness of meloxivet in the complex treatment of cats with mammary gland carcinoma

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