• Journal of Veterinary Science
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• v.24 no.6
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• pp.76.1-76.6
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• 2023

An 11-year-old neutered male Miniature Poodle with a stage 3 apocrine gland adenocarcinoma was started on chemotherapy with toceranib phosphate after surgery. Beginning on day 10 of toceranib, the dog's foot pads became erythematous and hyperkeratinized. The dog complained of pain, inability to walk, depression, and loss of appetite. The symptoms resolved when toceranib was discontinued and reappeared when toceranib was resumed. Grade 3 palmar-plantar erythrodysesthesia was identified as an adverse event of toceranib based on the VCOG-CTCAE and Naranjo scale. Although very rare in veterinary medicine, clinicians should consider that palmar-plantar erythrodysesthesia can occur after toceranib administration.

• Journal of Veterinary Clinics
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• v.35 no.5
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• pp.211-214
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• 2018

A 14-year-old intact female Yorkshire terrier was presented with a 2-month history of shivering, intermittent pelvic limb weakness and collapse. Biochemical abnormalities revealed inappropriately increased serum insulin concentration with persistent hypoglycemia. Abdominal ultrasound revealed multiple various sized nodules in liver and fine-needle aspirates of the nodule showed typical neuroendocrine cells with high cellularity. Computed tomography (CT) revealed well-defined hyperattenuating mass in the right pancreatic lobe with homogenous enhancement. CT findings were consistent with a pancreatic tumor with malignant metastasis. Treatment was initiated with low-dose prednisolone and toceranib phosphate. The dog was maintained stable with no more progression of clinical signs and it is worth to try toceranib phosphate in a dog with metastatic insulinoma for improving the quality of life.

• Journal of Veterinary Clinics
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• v.34 no.1
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• pp.43-46
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• 2017

A 10-year-old, spayed, female Cocker Spaniel was referred to our hospital with a history of a cough and dyspnea. The patient was tentatively diagnosed with a chemodectoma based on clinical features evident on echocardiography and computed tomography. Metronomic chemotherapy utilizing toceranib phosphate as well as medications for congestive heart failure were administered. During the period chemotherapy was administered (nine months from the time of diagnosis), clinical improvement was noted without the development of any adverse effects. However, clinical signs recurred after chemotherapy was discontinued at the owner's request. When the patient was reevaluated via computed tomography, it was found that the size of the mass had increased. The patient developed severe dyspnea secondary to recurrent pleural effusion and was euthanized 65 days after clinical signs reappeared. A necropsy was performed and the patient was definitively diagnosed with a chemodectoma based on histopathologic and immunohistochemical analysis. This case report describes the clinical application of metronomic chemotherapy with toceranib phosphate, which is a tyrosine kinase inhibitor, in the treatment of a chemodectoma. We propose that this treatment may improve the quality of life and result in a prolonged survival time compared to treatment with medications for congestive heart failure alone.

• Korean Journal of Veterinary Research
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• v.61 no.1
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• pp.10.1-10.11
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• 2021

The purpose of this retrospective study was to provide additional data on the use of toceranib in a wide variety of tumor types in small breed dogs, especially < 8 kg (except 5 dogs). This was a retrospective study of 31 dogs with malignant tumors treated with a 2.5 mg/kg median dose of toceranib (Palladia; Zoetis, USA) on a Monday-Wednesday-Friday schedule. Clinical benefit was observed in 13 of 15 dogs (86.7%, 3 with complete response, 4 with partial response, 6 with stable disease) with gross disease. Distant metastasis, response to treatment, and treatment setting were significantly associated with survival time. Negative prognostic factors were multiple chemotherapy and distant metastasis (affecting progression-free survival [PFS]), surgery, regional enlarged lymph nodes, underlying disease, and toxicity (affecting median survival time [MST]). Positive prognostic factors were epithelial and round cell tumor (affecting PFS), epithelial tumor, microscopic disease, no evidence of disease response, and stable disease (MST). In conclusion, a clinical benefit from toceranib treatment was noted in most of the dogs with gross disease in our study. This study suggested that the toceranib is probably selective treatment to various tumor types in small breed dogs.

• Journal of Veterinary Clinics
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• v.34 no.6
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• pp.441-444
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• 2017

A 15-year-old spayed female Miniature Schnauzer was presented for unilateral foreleg lameness and pain. On physical examination, left elbow joint swelling and stiffness were identified. On a computed tomography (CT) scan, a periosteal reaction of the left humerus from the distal metaphysis to the epiphysis and cortical destruction of the medial condyle was observed. Based on blood tests, histopathology, and immunohistochemistry, it was concluded as a skeletal histiocytic sarcoma. Since the patient's pain was not controlled despite application of a fentanyl patch, a left forelimb amputation was decided upon as part of the palliative therapy. Metronomic chemotherapy with toceranib phosphate and pamidronate was initiated. Toceranib was administered for 3 months without the development of any adverse effects except mild neutropenia. However, 3 months after initiating treatment, the toceranib was discontinued due to moderate gastrointestinal disturbances. Over the next 2 months, a left mandibular bone mass and cortical bone destruction in the bilateral tibia and tarsal joint were identified on CT. The patient became unwilling to eat and was noted to have severe skeletal pain. The anorexia and lethargy were progressively worsening and the owner decided to euthanize the patient. A necropsy was performed and the patient was definitively diagnosed with disseminated histiocytic sarcoma based on histopathologic and immunohistochemical analyses. This report describes a Miniature Schnauzer dog with DHS managed with surgical removal and metronomic chemotherapy with toceranib that survived with an improved quality of life for 7 months.

• Korean Journal of Veterinary Service
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• v.46 no.3
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• pp.249-253
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• 2023

A 12-year-old neutered male Maltese was brought to our hospital with loss of appetite, generalized alopecia, anemia, and a palpable abdominal mass. Ultrasonography revealed multiple abdominal masses in the liver and spleen. Subsequently, splenectomy and liver biopsy were performed, and the masses were histologically diagnosed as metastatic fibrosarcomas of unknown primary origin. The owner refused further investigations such as computed tomography and hepatectomy, therefore, we decided to initiate chemotherapy in the form of metronomic therapy with toceranib phosphate, which has several advantages, such as better tolerability, low cost, and convenience. The size and number of hepatic fibrosarcomas continued to increase despite continued administration of toceranib (10 mg/dog, PO, q48h). The dog died approximately 43 days after initiation of the toceranib treatment. To the best of our knowledge, this is the first report on toceranib therapy for metastatic hepatic fibrosarcoma in a dog.

• Journal of Veterinary Clinics
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• v.39 no.2
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• pp.87-92
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• 2022

A 14-year-old castrated male Persian cat presented with a 2-week history of respiratory difficulty. On physical examination, the patient showed intermittent open-mouth breathing and thoracic auscultation revealed wheezing. Thoracic radiographs revealed a narrowed upper airway and pulmonary infiltration. Computed tomography detected a mass occluding the lumen of the trachea at the level of the entrance to the thorax, a mass causing right main bronchus stenosis, and a nodule on the right caudal lung lobe. Bronchoalveolar lavage cytology tentatively diagnosed a carcinoma. Tracheal mass resection was performed through tracheostomy. Histopathology confirmed the presence of tracheobronchial carcinoma. The survival time after diagnosis was 10 months, during which time the cat underwent tracheostomy, debulking by endotracheal tube, and tracheal stent placement procedures in combination with toceranib phosphate adjuvant chemotherapy.

• Journal of Veterinary Clinics
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• v.32 no.2
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• pp.183-186
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• 2015

A four-year-old spayed female Maltese dog weighing 3 kg was referred with reverse sneezing and fourmonth history of unilateral nasal discharge. She was diagnosed as nasal transitional carcinoma which in bilateral nasal cavity and extending into the frontal sinus by biopsy with rhinoscopy. Metronomic chemotherapy with cyclophosphamide ($12.5mg/m^2$) and toceranib phosphate (2.5 mg/kg) was initiated following after surgical treatment of nasal mass debulking. Clinical response was good and had no side effects during the chemotherapy period (11 months after diagnosis). This is a case report describing adjuvant metronomic chemotherapy in nasal transitional carcinoma in Korea.