Prospective Clinical Trial to Compare Vincristine and Vinblastine in aCOP‐Based Protocol for Lymphoma in Cats

Abstract

Background: Current standard chemotherapy protocols for lymphoma in cats carry risks of gastrointestinal toxicity, which can decrease quality of life and complicate response assessment. Protocols with less gastrointestinal toxicity may improve treatment tolerance.Hypothesis/Objectives: The study purpose was to compare response rate, outcome, and toxicity between cats that received vincristine or vinblastine as part of combination chemotherapy for lymphoma. We hypothesized that vinblastine would have similar efficacy, but less gastrointestinal toxicity, compared with vincristine.Animals: Forty client-owned cats with confirmed diagnosis of lymphoma. Methods: Cats were randomized to 1 of 2 treatment arms and received weekly COP-based chemotherapy for 6 months or until disease progression. Response rate, progression-free survival (PFS), lymphoma-specific survival (LSS), and incidence and severity of gastrointestinal and hematologic toxicity were compared between arms. Arm cross-over occurred if specific gastrointestinal toxicity criteria were noted.Results: Cats in both arms had similar response rates, PFS, and LSS (48 versus 64 days, P = .87; 139 versus 136 days, P = .96). Cats that received vincristine were significantly more likely to switch arms based on gastrointestinal toxicity than cats that received vinblastine (44.4 versus 10.5%, P = .02). Lower baseline weight was significantly negatively associated with PFS and LSS (P = .01, P = .003, respectively). Baseline anemia was significantly negatively associated with LSS (P = .04).Conclusions and Clinical Importance: Results suggest that vinblastine is a reasonable alternative to vincristine in the treatment of some cats with lymphoma. Baseline body weight remains a significant prognostic factor for cats with lymphoma.

Treatment of feline intermediate‐ to high‐grade lymphoma with a modified university of Wisconsin–Madison protocol: 119 cases (2004–2012)

“…Although no distinction was made between histologic types in the studies in the immediate post‐FeLV era, the alimentary form of lymphoma has historically accounted for the minority of cases, accounting for only 13–35% of the cases in studies published prior to 2005 . However, in studies published after 2005, there has been a steady increase in the intermediate‐ to high‐grade alimentary form, and it now accounts for 42–57% of the feline lymphoma cases seen . The study reported herein also has one of the highest reported percentages (63%) of the alimentary form of lymphoma, despite having excluded any small cell or low grade lymphoma cases.…”

Esophageal feeding tube placement and the associated complications in 248 cats

“…Those with a lower body weight had an increased odds ratio of dying of their disease. Lower body weight has been previously shown to be associated with a poorer prognosis in a number of conditions . Unfortunately, the BCS was not available for a large number of the cats in the current study, so it is difficult to identify whether it was the thinner cats that had the poorer prognosis or just those with a smaller stature.…”

Treatment of feline lymphoma using a 12‐week, maintenance‐free combination chemotherapy protocol in 26 cats

“…However, a negative association between weight loss before starting chemotherapy and the likelihood to achieve CR has previously been reported in cats . Additionally, two recent studies have shown the prognostic significance of baseline body weight and weight changes during the course of treatment of feline lymphoma . Exact reasons for the occurrence of anorexia not accompanied by vomiting in cats undergoing chemotherapy are difficult to elucidate; however, they may probably – as in humans – be associated with sustained nausea and with that considerably impact the individual's quality of life.…”