Recurrence‐free interval 12 months after local treatment of mast cell tumors in dogs using intratumoral injection of tigilanol tiglate

Jones, Pamela D; Campbell, Justine; Brown, Graham; Johannes, Chad M.; Reddell, Paul

doi:10.1111/jvim.16018

Cited by 13 publications

(15 citation statements)

References 27 publications

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“…The lesion must have a diameter greater than 1 cm, and a volume ≤ 10 cm 3 , without ulceration, so that the drug does not escape after its application. TT causes vascular rupture and acute local inflammatory response within 4 h, followed by necrosis within 1–4 days and tumor destruction for a period of 4–7 days, with subsequent resolution of the wound within a period varying from 28 to 35 days [ 189 , 190 , 191 , 192 ].…”

Section: Therapeutic Approachmentioning

confidence: 99%

Diagnosis, Prognosis and Treatment of Canine Cutaneous and Subcutaneous Mast Cell Tumors

Nardi

Horta

Fonseca-Alves

et al. 2022

Cells

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Mast cell tumors (MCTs) are hematopoietic neoplasms composed of mast cells. It is highly common in dogs and is extremely important in the veterinary oncology field. It represents the third most common tumor subtype, and is the most common malignant skin tumor in dogs, corresponding to 11% of skin cancer cases. The objective of this critical review was to present the report of the 2nd Consensus meeting on the Diagnosis, Prognosis, and Treatment of Canine Cutaneous and Subcutaneous Mast Cell Tumors, which was organized by the Brazilian Association of Veterinary Oncology (ABROVET) in August 2021. The most recent information on cutaneous and subcutaneous mast cell tumors in dogs is presented and discussed.

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Section: Therapeutic Approachmentioning

confidence: 99%

Diagnosis, Prognosis and Treatment of Canine Cutaneous and Subcutaneous Mast Cell Tumors

Nardi

Horta

Fonseca-Alves

et al. 2022

Cells

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“…Fifty-seven dogs from the US MCT trial that had a single TT treatment of a single target tumour were recurrence free and available for evaluation at 12 months ( 21 ). Of these, 51 dogs had originally developed a single tissue deficit at the treatment site, while six dogs had developed more than one localised tissue deficit at either 7 or 14 days after treatment ( Figure 1 and Supplementary Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Tigilanol Tiglate-Mediated Margins: A Comparison With Surgical Margins in Successful Treatment of Canine Mast Cell Tumours

Ridder¹,

Reddell²,

Jones³

et al. 2021

Front. Vet. Sci.

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Tigilanol tiglate (TT) is a novel small molecule registered as a veterinary pharmaceutical for intratumoural treatment of canine mast cell tumours (MCTs). The drug has a multifactorial mode of action resulting in rapid destruction of the treated tumour by haemorrhagic necrosis and subsequent slough of the necrotic tumour to reveal a tissue deficit that is left to heal by second intention with minimal to no veterinary intervention. Here we introduce the concept of TT-mediated margins, the calculated margin of tissue loss analogous to surgically applied margins to help clinicians conceptualise tissue deficits formed following tumour destruction by TT relative to surgical excision. We used data from 51 dogs that were recurrence-free 12 months after a single administered TT dose into a single target MCT <10 cm3 in volume in a randomised, controlled clinical trial in the USA. We calculated TT-mediated margins based on length of the longest axis of (i) the tumour prior to treatment and (ii) the maximum tissue deficit formed 7–14 days after TT treatment. We compared these TT-mediated margins for each tumour to two surgical approaches to MCT excision in general practise: modified proportional margins (with 2 cm upper limit) and 3 cm fixed margins. For most dogs, TT-mediated margins were less than half the length of the margins calculated for the two surgical approaches in removing the same tumour. There was a trend for TT-mediated margins to increase with increasing tumour volume. Nonetheless, even for the larger tumours in this study (>2 cm3 volume), 50% of TT-mediated margins were less than half the length of the two surgical margins. Eighteen cases were lower limb MCTs, sites often surgically challenging in veterinary practise. On these lower limbs, TT-mediated margins were less than half the length of the corresponding proportional margins in 56% of cases and larger than proportional margins in only two cases. This study suggests that, in many cases, smaller and more targeted margins could be expected when treating MCTs <10 cm3 volume with TT compared with surgical excision. TT-mediated margins are a novel approach to conceptualise tissue deficits after intratumoural TT treatment.

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“…This is not the case for low grade MCT, where lesions up to 10 cm 3 in volume can be treated efficaciously with TT (29). Lower recurrence rates have been observed in Australian studies with low grade MCT, but the same principal of retreatment can be applied (30,51). A retreatment strategy, wherever a TSR is diagnosed, after 28 days should be implemented to prolong response durability and this should be a straight-forward consideration if pretreatment criteria are still met.…”

Section: Discussionmentioning

confidence: 99%

“…A second intratumoural TT treatment for dogs that did not achieve a CR by Day 28 increased the CR rate to 88% (29). Longer term response durability was assessed for that study and at 12 months, 89% (57 out of 64) of patients that had a CR at Day 28 following a single treatment and were available for evaluation were still recurrence free at the treatment site (30).…”

Section: Introductionmentioning

confidence: 99%

“…It must be observed that although referral for these treatments may be offered, many owners may choose to not pursue such therapy for several reasons including cost, required time commitment, the need to regularly travel to a geographically distant specialist centre, or their pet's prognosis. For these situations an opportunity exists for an efficacious alternative to surgery that may provide local palliation of the tumour or longer durability of local tumour control (30).…”

Section: Introductionmentioning

confidence: 99%

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Intratumoural Treatment of 18 Cytologically Diagnosed Canine High-Grade Mast Cell Tumours With Tigilanol Tiglate

Brown¹,

Campbell²,

Jones³

et al. 2021

Front. Vet. Sci.

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Canine high-grade mast cell tumours (HGMCT) are associated with a poor prognosis, are inherently more invasive, and have higher rates of local recurrence. The primary aim of this retrospective study was to assess the efficacy of intratumoural tigilanol tiglate (TT) as a local treatment option. Eighteen dogs with mast cell tumours (MCT) cytologically diagnosed by veterinary pathologists as either high-grade or suspected high-grade MCT were treated with TT. The TT dose was based on tumour volume (0.5 mg TT/cm3 tumour volume) and delivered intratumourally using a Luer lock syringe and a fanning technique to maximise distribution throughout the tumour mass. Efficacy was assessed on the presence/absence of a complete response (CR) to therapy at days 28 and 84 using response evaluation criteria in solid tumours (RECIST). For dogs not achieving a CR after 28 days, the protocol was repeated with a second intratumoural TT injection. Ten out of 18 dogs (56%) in this study achieved and maintained a CR to at least 84 days after their first or second treatment. Six patients were alive and available for evaluation at 2 years, three of those were recurrence free, and a further three patients were recurrence free following a second treatment cycle. Tigilanol tiglate shows efficacy for local treatment of HGMCT, with higher efficacy noted with a second injection if a CR was not achieved following the first treatment. In the event of treatment site recurrence (TSR), the tumour may be controlled with additional treatment cycles. Tigilanol tiglate provides an alternative local treatment approach to dogs with HGMCT that would either pose an unacceptable anaesthetic risk or the tumour location provides a challenge when attempting surgical excision.

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Recurrence‐free interval 12 months after local treatment of mast cell tumors in dogs using intratumoral injection of tigilanol tiglate

Cited by 13 publications

References 27 publications

Diagnosis, Prognosis and Treatment of Canine Cutaneous and Subcutaneous Mast Cell Tumors

Diagnosis, Prognosis and Treatment of Canine Cutaneous and Subcutaneous Mast Cell Tumors

Tigilanol Tiglate-Mediated Margins: A Comparison With Surgical Margins in Successful Treatment of Canine Mast Cell Tumours

Intratumoural Treatment of 18 Cytologically Diagnosed Canine High-Grade Mast Cell Tumours With Tigilanol Tiglate

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