CNS, Pulmonary, TCC, Misc Flashcards
When would treatment with a c-kit inhibitor be beneficial for canine glioma?
Potentially useful in high grade tumors for anti-angiogenic properties
**only vascular endothelium was positive in high-grade gliomas; no tumor immunostaining for c-kit
C-kit and COX overexpression are negative prognostic indicators in human glioma. What percentage of canine gliomas express c-kit and COX2?
NONE
only tumor vasculature of high grade tumors was c-kit+
What are the two most common metastatic intramedullary spinal cord tumors?
HSA
TCC
What is the most common region for spinal meningiomas to occur?
Cervical (cranial to C3)
What are the most common grades of spinal meningiomas found in the cervical, thoracic, and lumbar spine, respectively?
Cervical - Grade 1
Thoracic - Grade 2
Lumbar - Grade 3
What is the most common metastatic brain tumor in dogs? In cats?
Dogs - HSA
Cats - LSA
What characteristics do TVT and devil facial tumor share in regards to karyotype and MHC expression?
Both have stable karyotypes
Both downregulate MHC
Canine TVTs have been shown to have long interspersed nuclear elements (LINE) upstream of the coding region for what oncogene?
c-myc
LINE insertion at the 5’ end of the c-myc gene can be used as a molecular marker for TVT
What is the recurrence rate following surgery for TVT?
30-75%
Name negative prognostic factors for feline ocular melanoma?
Extension into ciliary body
High MI
Large tumor
Involvement of scleral venous plexus
What type of trial would you use to determine quickly and with few patients whether flea medications cause lymphoma?
Case-control
What percentage of cases undergo a revision of diagnosis, treatment, or prognosis following second opinion pathology?
17%
Does intracavitary chemotherapy improve survival in cases of neoplastic effusion?
Yes - improves survival for carcinomatosis/sarcomatsosis/mesothelioma regardless of presence of effusion
What paraneoplastic syndromes have been associated with pulmonary neoplasia in dogs?
ectopic ACTH production
hypertrophic osteopathy
What are the vimentin and cytokeratin staining characteristics of mesothelioma?
positive for both
In which disease state is circulating plasma free DNA highest?
Lymphoid malignancy
> 25ng/mL = shorter remission
What is the most common ear canal tumor in dogs? In cats?
Ceruminous gland adenocarcinoma
What is the metastatic rate of digital SCC following surgery?
26%
In which digital tumor is subungual location a positive prognostic factor?
SCC
Basal cell tumors comprise what % of feline skin tumors?
25%
Head is most common location
What IHC markers can distinguish lymphangiosarcoma from HSA?
PROX-1
LYVE-1
Are EPO and PaO2 levels expected to be high or low in polycythemia vera?
PaO2 - low (thrombosis, poor perfusion)
EPO - low
What toxic plant can cause transformation of BPV-induced papilloma to carcinoma in the intestine of cattle?
Bracken fern
What is the most common gastric tumor in horses?
SCC
Is a young calf (4mo) with lymphoma more likely to have BLV-induced lymphoma or sporadic?
Sporadic - BLV only seen in adults
What % of BLV-infected cows have persistent lymphocytosis? What % develop lymphoma?
30%
1-3% lymphoma
What is the survival time in cats with well- and poorly-differentiated lung tumors, respectively?
Well-dif: 23mo
Poorly-dif: 2.5mo
In dogs with nasal tumors treated with piroxicam only, what is the MST?
3mo
What is the most common complication to urethral stenting?
Incontinence
What is the response rate of TCC to firocoxib?
20% PR
no CR, 33% SD
Which canine breeds are at a 5X increased risk of Sertoli cell tumors?
Shelties, collies
Which factors increase the likelihood of late complications associated with pelvic radiation?
> 3Gy/fraction
Use of platinum as radiation sensitizer
Which drugs act as potent (3+ or 4+) radiation sensitizers?
Gemcitabine, DOX (4+)
Dacarbazine, bleomycin, dactinomycin, mitomycin (3+)
Which drugs act as moderate (1+ or 2+) radiation sensitizers?
Carbo/cisplatin, 5FU, capecitabine (2+)
CCNU, hydroxyurea, methotrexate, paclitaxel (1+)
What is the metastatic rate of TCC at diagnosis? At euth?
20% dx, 50% euth
What is the RR of TCC to mitoxantrone/piroxicam?
35% RR
46% SD
The RR of TCC to cisplatin/piroxicam is 77%. Why is this combination not recommended?
Renal toxicosis
Is piroxicam a selective or nonselective COX inhibitor? What is the RR of TCC to piroxicam?
nonselective
18% RR
What % of patients were excluded from DOX administration based on cardiac screening?
6% - most due to VPCs
What was the ORR to DOX for dogs with presumed cardiac hemangio?
41%
PFS = 66d
What were negative prognostic factors for dogs with presumed cardiac hemangio treated with DOX?
tumor size >median
thrombocytopenia
What was the MST of dogs with right atrial masses and pericardial effusion treated with DOX?
139.5d
What was the MST following thoracoscopic resection of right atrial masses in dogs?
90d
What % of feline renal transplant patients developed neoplasia, and what odds did this correspond to compared to controls?
- 5% (lymphoma = 56% of these)
6. 6x higher odds than control
What is the sequence homogeneity between canine and human carcinoembryonic antigen, TGFB, and NFkB?
> 90% homology
In a series of dogs with hypercalcemia, what % of cases were neoplastic?
63% neoplasia
49% (overall) lymphoma
What was the MST and prognostic factors for splenic liposarcoma?
MST = 623d
prognostic - mets at diagnosis, > grade I tumors (MST grade I >1000d)
What was the most common tumor underlying metastatic cancer of unknown primary?
carcinoma - 57%
MST = 30d
What was the PFS following streptozotocin administration in 19 dogs with insulinoma?
196d (6.5mo)
What was the sensitivity and specificity of CXR for pulmonary nodules detected by CT?
71-95% Sn
83-94% Sp
How is sensitivity calculated?
True Positive/(True Positive + False Negative)
How is specificity calculated?
True Negative/(True Negative + False Positive)
What was the interobserver variability in radiographic diameter measurement for pulmonary nodules?
16%
In dogs undergoing AUS and CXR for staging of primary brain tumors, STS, or nasal tumors, what was the rate of serious comorbidity detection?
9%
3% had a second malignancy
What is the diagnostic utility of dual-phase contrast CT in distinguishing malignant and nonmalignant hepatic and splenic masses?
Very poor
In a small pilot study of FDG PET-CT in dogs, treatment protocol and prognosis were significantly changed due to the results in what % of patients?
70%
Why is FLT a useful PET marker?
18F-L-thymidine is converted by TK1 to 18F-FLT-monophosphate and trapped in the cell
TK1 activity is higher in cancer
In which regions is physiologic uptake of 18F-FLT and -FDG expected?
FDG - brain, muscle, myocarium
FLT - bone marrow, liver/gall bladder, urinary tract
Why do nitromidazoles accumulate in hypoxic cells?
Once they enter, they are reduced to radicals; they cannot be reoxidized in the absence of oxygen.
Which PET markers can be used to detect hypoxia?
18F-fluoromisonidazole (FMISO)
18F-fluoroazomycin arabinoside (FAZA)
[60,62,64Cu]diacetyl-bis-N4- methylthiosemicarbazone (Cu-ATSM)
**FMISO and FAZA are limited by high background uptake
What is the advantage to 18F-sodium fluoride (NaF) vs. 99m-Tc imaging for detection of bone metastases?
18F-NaF is less protein bound = less background staining
Replaces -OH and binds to hydroxyappetite
The intraoperative imaging agent LUM015 is cleaved by proteases in vivo allowing fluorescent imaging that distinguishes neoplastic tissue. What was the accuracy of this system in distinguishing neoplastic from normal tissue (using bx as reference)?
92% !
53% of dogs developed facial erythemia after injection
How did the serum concentrations of TK1 and CRP in dogs with cancer compare to control dogs?
Significantly higher in dogs with cancer
What is the neoplasia index (NI)? When using the NI to screen clinically healthy dogs, what was the specificity of a positive NI for development of cancer within 6mo?
91% (>5.8) Sensitivity = 100%
“high positive” = 98% (>9), but lower sensitivity (48%)
Can serum TK help rule out HSA vs benign splenic disease?
Not really, it was not significantly higher in pts with HSA than benign splenic disease
At a cutoff of 6.55 U/L, sensitivity = 52% and specificity = 93%
Which 3 diseases caused elevated serum and urine neutrophil gelatinase-associated lipocalin (NGAL) compared to normal controls?
CKD
Carcinoma
Lymphoma
How did the serum concentration of 25-OH-Vit D impact risk of cancer?
RR of cancer increased as Vit D decreased
RR = 3.9X below 40ng/mL
What serum concentration of 25-OH-Vit D is considered sufficient to decrease RR of cancer?
100ng/mL
What are the most common chromosomal aberrations in canine TCC?
Gain of CFA 13 (97%)
Gain of CFA 36 (84%)
Loss of CFA 19 (77%)
How did the staining scores for p63 and B-catenin in TCC compare to normal urothelium? Did this impact outcome?
Both p63 and B-catenin were LOWER in TCC
**low p63 was significantly related to shorter survival
Which ultrasonographic findings in TCC were associated with shorter survival?
Wall involvement, heterogenous mass, and trigonal location
What was the RR and side effect rate in dogs with TCC treated with 10x2.7Gy
61% RR (7.6% CR, 54% PR – 100% CB rate)
31% had Gr I-II acute efx
What was the subjective response rate and median event-free survival in dogs with urogenital tumors treated with IMRT?
SRR = 60% mEFS = 317 days
What was the RR to mitoxantrone + piroxicam vs carbo + piroxicam in a phase III trial?
MTX-P - 8% CR; MST 106d
Carbo - 13% PR; MST 73d
**NSD between both in RR or ST
What was the RR and MTTP for dogs with TCC treated with vinorelbine rescue therapy?
14% PR; subjective improvement in 78%
MTTP = 93d
What was the RR of TCC to DOX + piroxicam as first line therapy?
9% mPFS 103d (including pts who had surgery)
What was the ORR of TCC to metronomic chlorambucil?
3% PR
67% SD
mPFI 119d
What were the ORRs of TCC to cisplatin, firocoxib, and a combination in a randomized trial?
Cisplatin - 13%
Firocoxib - 20%
Cis/Firocox - 57% !! - signficantly higher than cis alone
mPFI 186d
What was the ORR of TCC to deracoxib?
17% RR
71% SD, mTTP - 133d
What was the ORR of TCC to VBL 3.0mg/m2 q2wk?
36% PR
50% SD
What procedure was associated with TCC of the body wall?
Cystotomy
MST = 57d
Do tumor PGE2 concentration or COX2 expression predict response to piroxicam in TCC?
no
RR was 33% in this study
What % of patients with TCC had a positive UCS during tx?
45% (80% female, 29% male)
most common = staph, e. coli
What proportion of feline TCC were + for COX2? What was the RR to meloxicam?
71% COX2+ – correlated with decreased survival
91% showed improvement in clinical signs
What was the most common tumor in domestic snakes?
STS
What was the sensitivity and specificity of cytologic detection of neoplasia in LNs compared to histopath? What tumors/LNs had the highest false negative rate?
67% Sn, 92% Sp; accuracy = 77%
highest false negative rate in mesenteric T-cell LSA, metastatic sarcoma, and metastatic MCT
What was the rate and pattern of lymph node metastasis in dogs with tumors of the head undergoing bilateral lymphadenectomy?
45% metastatic rate - 62% were contralateral
100% had mets in mandibular, 78% retropharyngeal
-ie, no dogs had retropharyngeal but not mandibular
In the most recent prospective evaluation of second-opinion histopath, what was the rate of complete agreement, and what % of disagreements affected treatement or prognosis?
52% agreement
37% major disagreements affecting either tx or prx
What is EpCAM? In which canine tumor type was this molecule expressed most highly?
- EpCAM = epithelial cell adhesion molecule; upregulation is associated with loss of E-cadherin and EMT
- higher expression in carcinoma cell lines
In which canine tumors was BRAF most frequently mutated?
prostatic CA - 80%
TCC - 67%
In what % of canine melanomas and melanocytomas was BRAF mutated?
6% melanoma
7% melanocytoma
What is the key to Devil Facial Tumor immune evasion?
downregulation of MHC Class II
