Oral tumors/OSCC Flashcards by Megan S

What is the increased risk for OSCC in cats wearing flea collars? What is another risk factor?

over 3.5x

Another risk factor = canned food/tuna

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T/F: Gemcitabine is the preferred radiosensitizer in cats?

False - not recommended due to significant hematologic and local tissue toxicity

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What is the MST for OMM without treatment?

65d (2.2 months)

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What is the MST for lip melanoma after surgery? Tongue melanoma?

Lip - 580d (19 months)

Tongue - >551d (18 months)

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Which sites of canine OSCC are associated with high metastatic potential?

tonsils

base of tongue

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What is the prognosis for canine OSCC with dRT alone?

15-16 months

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What is the RR of canine OSCC to piroxicam alone? (Schmidt 2001 - good paper to know)

17%

1/17 CR, 2/17 PR; PFS of responders 180d (6 months)

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What % of dogs with OSCC treated with piroxicam and carboplatin had a CR?

57%

T3 tumors - only 7 dogs

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T/F: Canine oral fibrosarcomas are highly responsive to RT?

False

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What is the MST for mandibular OSA treated with surgery alone?

14-18 months

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What is the 3 year PFS for acanthomatous ameloblastoma with RT alone? T1/2 vs. T3

T1/2: 86%

T3: 30%

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What is the 1 year survival rate for canine tonsillar SCC?

10%

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Which breeds are predisposed to lingual HSA and FSA?

Border Collie, Golden Retriever

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What is the most common tumor of the canine tongue?

SCC

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What is the MST for canine oral fibrosarcomas for RT alone vs. RT + Sx?

RT - 7 months (tumor size matters - T1 45 mo, T2 31 mo, T3 7 mo)
RT + Sx: MST 18-26 mo; recurrence 32%

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What is the local recurrence rate for a grade III MLTOB (MLO)?

78%

grade I 30%, grade II 47%

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What is the metastatic rate of a grade I MLTOB (MLO)?

30%

grade II 60%, grade III 78%

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Where does an eosinophilic granuloma develop in a dog vs. cat?

Dog - tongue

Cat - lip

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What is the MST for salivary gland carcinomas treated with sx +/- RT for dogs and cats?

Dogs - 550d (18 months)

Cats - 516d (17 months)

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What was the recurrence rate for oral fibrosarcomas in a recent study? (Sarowitz 2017)

54.2%

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What was the ORR and control time (PFS) for feline OSCC treated with PDT using liposomal phosphorylated meta-tetra (hydroxylphenyl) chlorine?

ORR 84% (61% CR)
PFS 35 months
Not great for invasive, advanced lesions

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What is % metastasis for canine oral fibrosarcoma? (Martano 2018 - review article)

10-14%

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What were the conclusions regarding efficacy and bioavailability of buccal buprenorphine? (Stathopoulou J Feline Med Surg 2018)

Pain scores improved
Lower bioavailability and shorter half-life in cats with stomatitis compared to previous studies
Concluded that it helped with pain and there was low inter-individual variability in plasma concentration, good option for oral pain

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What was the MST for dogs with SCC that had incomplete excision and underwent hypofx RT in a recent study? Was post-operative RT useful for fibrosarcomas? (Riggs 2018)

SCC - 2051d (5.6 years)

Fibrosarcoma - post-op RT did not appear to have protective value (retrospective study, RT may have been worse cases)

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What was the ORR to accelerated hypofx RT for feline OSCC? (Poirier VRU 2013)

71% (41% CR) Tx with 10 daily fractions of 4.8 Gy Acute toxicity was grade 2 mucositis - managed with feeding tubes and supportive care

What % of cats with OSCC developed metastasis after accelerated hypofx RT? (Poirier VRU 2013)

19% | did not have evidence of local progression

For feline OSCC, tumor expression of ___ was inversely proportional to survival. (Yoshikawa/Thamm 2012)

EGFR | In Sabattini 2010 74% of 19 tumors positive for EGFR, associated with decreased DFI and MST

How did the GTV on PET CT (with 18F-FDG) compare to regular CT? (Yoshikawa/Larue VRU 2013)

Mean GTV on PET was significantly smaller than CT for mandible/maxilla but not in lingual/laryngeal group

What was the rate of local (mand LN) and distant mets in feline OSCC? (Soltero-Rivera 2014)

mand LN - 31% | distant - 10%

What two toxicities were seen with polyamine inhibitors for feline OSCC? (Lewis J Vet Den 2013)

ototoxicity (5/6) and subclinical thrombocytopenia (6/14)

T/F: STAT3 expression is present in feline OSCC and may be a therapeutic target.

True (Brown 2015)

What was the overall biologic response of feline OSCC to Palladia? Most common side effect? (Wiles 2017)

56.5% Mild GI most common side effect many had NSAIDs concurrently

How did survival time differ in Palladia treated cats with OSCC vs. those without Palladia? (Wiles 2017)

Palladia - MST 123d | No Palladia - MST 45d

What was % AE experienced in cats with Palladia in conjunction with other therapies for OSCC? (Olmsted 2017)

17% toxicity - most grade 1-2 GI, one grade 4 metabolic (liver enzyme elevation)

CD1, FRA1, and c-myc were increased in feline OSCC - these are targets of what pathway? (Giullano 2016)

Wnt

What protein was upregulated in feline OSCC in JZ's study? (Walz 2017)

FASN

What are negative prognostic factors for canine tonsillar SCC? (Grant 2016)

bilateral tonsil involvement, local mets, distant mets | prolonged survival for dogs with one tonsil and no mets - 637d

Mutations of ___ may be involved in the development and progression of smoke-related OSCC in cats.

p53

What is the metastatic rate of oral SCC vs. tonsillar in dogs?

oral - RLN 10%, lungs 3-36% | tonsillar - 73%

What is MST for cats with OSCC treated with mandibulectomy +/- RT?

11-14 months mandibulectomy + RT - 14 months in one study mandibulectomy alone - 11.3 months in another

What was the MST when carbo was added to the accelerated RT protocol for feline OSCC? (Withrow p.390)

163d (5.4 months) 14 cats

What CR was observed with combination RT and gemcitabine for feline OSCC? (Withrow p. 390)

73% | MST 184d

What is the MST for canine OSCC with mandibulectomy? maxillectomy? (Withrow)

mand - 19-26 months (91% 1 yr survival) | max - 10-19 months (57% 1 yr survival)

What is the local recurrence rate for canine OSCC after mandibulectomy? After maxillectomy? (Withrow)

mand - 10% | max - 29%

What is the metastatic rate of canine oral fibrosarcoma?

RLN 19-22% | lungs 27%

What is the local recurrence of fibrosarcoma following mandibulectomy and maxillectomy in dogs?

mand - 59% (MST 11 months) | max - 40% (MST 12 months)

What breeds were overrepresented with acanthomatous ameloblastoma? (Goldschmidt 2017)

Golden retrievers | Also maybe Cocker Spaniels

What location did CAA occur in most frequently? (Goldschmidt 2017)

rostral mandible - represented 51.1% of cases

What was the % recurrence in Goldschmidt's paper with narrow and incomplete margins for CAA?

No recurrence (only evaluated with PE, 2 patients had repeat imaging -- it was a retrospective study) 34.8% of patients had complete margins (>5mm), 43.5% had narrow margins (1-5mm), and 21.7% had incomplete (<1 mm) margins

Which TKI targets were expressed in canine oral fibrosarcoma? (Milovancev 2016)

PDGFR-a and B

Doxorubicin had synergistic effects with what two TKIs against canine oral fibrosarcoma cell lines? (Milovancev 2016)

masitinib and Imatinib

Does papilloma virus play a role in canine OSCC development? (Munday 2015)

No - PV DNA not detected in the tumors

Does palliative RT extend life for feline OSCC? Does it improve QOL? (Sabhlock 2015)

Doesn't extend life but did improve QOL in 65%

How does sublingual thyroid carcinoma compare with other locations? (Broome 2014)

Better px - many dogs had prolonged survival even without treatment

What % of dogs with oral mucosal MCT had local mets at dx? (Elliot 2016)

55%

T/F: Zoledronate and meloxicam are synergistic in a mouse model of bone invasive OSCC.

False - they were tolerated but not synergistic

T/F: Tumor location, clinical stage, and histologic subtype were NOT associated with survival time for canine nontonsillar OSCC.

True

What % of dogs with high-low FSA were GR? (Ciekot 1994)

52%

What % of dogs with oral fibrosarcomas developed local recurrence and metastasis with surgery +/- RT? (Frazier 2012)

Recurrence - 24%, metastasis - 24% MST 743d

What is the relative risk for developing feline OSCC for cats that eat canned food? (Bertone 2003)

RR = 3.6 | not that this study also says 5x the risk of OSCC for flea collars and Withrow just says >3.5

What was the response rate of feline OSCC to SBRT? What two factors were associated with shorter survival? (Yoshikawa 2016)

38.5% | Shorter survival: keratinization and increased MVD