Retrospective evaluation of toceranib phosphate (Palladia®) toxicity in cats

Abstract

The purpose of this study was to describe the toxicity profile of toceranib phosphate in tumour bearing cats. Medical records were reviewed from seven institutions. Patients with incomplete medical records and those receiving concurrent chemotherapy or NSAIDs (non-steroidal anti-inflammatory) were excluded. Fifty-five cats met the inclusion criteria. Carcinoma was diagnosed in 55% of cases. Median oral toceranib dose was 2.7 mg kg and was most commonly administered on Monday, Wednesday and Friday. Thrombocytopenia (16.3%) and neutropenia (9.1%) were the most common haematologic toxicities. Azotemia (14.5%) and alanine aminotransferase (ALT) elevations (7.2%) were the most frequently encountered biochemical alterations. Gastrointestinal (GI) toxicity was seen in 21.8% of cats, and was lower than previously reported in dogs. The results of this study showed that treatment of cats with toceranib is well-tolerated and toxicity is uncommon. Additional studies to define a more structured dosing schedule and to evaluate the efficacy of toceranib in the treatment of feline cancers are needed.

Management of a feline gastric stromal cell tumour with toceranib phosphate: a case study

“…Another study showed although 60% of cats had some side effects, nearly 90% were low grade and resolved without direct intervention . In another study, the most common toxicity was gastrointestinal, documented in 22% of cats . These most common adverse effects were not noted in this case, although whether the weight loss seen after week 66 was related to toceranib or neoplasia could not be determined.…”

“…Toceranib (Palladia; Zoetis) is licensed for the treatment of cutaneous mast cell tumours in dogs. Off‐label usage in cats has been described for a variety of tumour types including oral squamous cell carcinoma, injection site sarcoma, mast cell neoplasia and pancreatic carcinoma . In cats, the most common toxicities of toceranib include mild gastrointestinal signs and myelosuppression which are self‐limiting or resolve with a dose adjustment or treatment break.…”

“…In cats, the most common toxicities of toceranib include mild gastrointestinal signs and myelosuppression which are self‐limiting or resolve with a dose adjustment or treatment break. Other reported adverse effects include elevations in alkaline phosphatase and alanine transaminase …”

Tumour angiogenesis, anti‐angiogenic therapy and chemotherapeutic resistance

“…Toceranib and masitinib have been approved for veterinary use in dogs, particularly for mast cell tumours . However, a range of anti‐angiogenic drugs, either alone or in combination, has been used to treat a wide variety of canine and feline neoplasms, including osteosarcomas, melanomas, fibrosarcomas, histiocytic sarcomas, haemangiosarcomas, lymphomas and prostatic, thyroid, nasal, gastric, mammary, pulmonary, biliary, salivary, anal sac and urinary bladder carcinomas …”

“…In the majority of these veterinary studies, tocerinab was used, sometimes alone [29][30][31][32][33][34][35][36][37] or, more commonly, in combination with other drugs such as cyclophosphamide (belonging to the nitrogen mustard group of alkylating agents), 38,39 vinblastine (an antimitotic alkaloid), 40,41 carboplatin (a platinum-containing complex), 42,43 lomustine (1-(2-chloroethyl)-3-cyclohexyl-1-nitrosurea (or CCNU), which belongs to the nitrosurea group of alkylating agents), [44][45][46] doxorubicin (an anthracycline antibiotic) [47][48][49] and piroxicam (a nonsteroidal anti-inflammatory drug (NSAID) with cyclooxygenase (COX)-2 inhibiting properties). 38,[50][51][52] Masitinib has also been evaluated in dogs.…”