Skeletal

Question 1

T/F: Giving doxorubicin q 21 days instead of q 14 days preserves its anti-neoplastic activity while improving cardioprotection.

Answer 1

False: anti-metastatic effects are better when given every 2 weeks

Question 2

What is the general class/MOA of BAY 12-9566?

Answer 2

MMP inhibitor

Question 3

T/F: When doxo was given concurrent with cisplatin (same day) as adjuvant tx for dogs with OSA, treatment was well tolerated but outcomes weren’t superior to either drug as a single agent.

Answer 3

False: 10% treatment-related mortality

Question 4

T/F: When doxo was given concurrent with carbo (24 hrs apart) as adjuvant tx for dogs with OSA, outcomes were superior to single-agent therapy but the protocol had an unacceptable rate of side effects.

Answer 4

False: well tolerated but not superior to single-agent.

Question 5

What were the DFI and OS of dogs (6 micromets and 6 gross dz) with OSA receiving satraplatin?

Answer 5

DFI 456 days, MST 659 days

Question 6

What is L-MTP-PE?

Answer 6

A synthetic analog of Mycobacterium cell wall, acts as a non-specific immune stimulant.

Question 7

Summarize the studies using L-MTP-PE in dogs with OSA?

Answer 7

L-MTP-PE alone post-op: improved outcome relative to placebo (168 days vs 58).
L-MTP-PE follwing completion of cisplatin tx: improved outcome relative to placebo (14.4 vs 9.8 months).
L-MTP-PE given concurrently with cisplatin: no improvement in outcomes compared to control.

Question 8

What is the MST for dogs with OSA following metastatectomy?

Answer 8

176 days (overall MST 487 days)

Question 9

List 4 criteria for metastatectomy?

Answer 9

1. Primary tumor in remission, ideally >300 days
2. Only 1 or 2 lung nodules on thoracic films
3. No metastatic lesions elsewhere (neg bone scan)
   +/-4. Long doubling tume of mets (>30 days) with no new lesions during that time

Question 10

What would be a reason to consider metastatectomy when the traditional 4 criteria are not met?

Answer 10

Palliative for hypertrophic osteopathy

Question 11

What is the BRR for dogs with metastatic OSA receiving Palladia?

Answer 11

47.8%
PR 4.3%
SD 43.5%

Question 12

What range of OSA patients experience alleviation of pain after palliative RT?

Answer 12

74-93%

Question 13

What is the median duration of pain control with palliative RT?

Answer 13

53-130 days (1.75 - 4.3 months)

Question 14

What type of radiation does Samarium emit?

Answer 14

gamma and beta

Question 15

What % of dogs experience pain palliation with Samarium treatment?

Answer 15

63-83%

Question 16

What is the primary side effect of Samarium tx?

Answer 16

Marrow suppression (plts and segs)

Question 17

What is the MOA of aminobisphosphonates?

Answer 17

Induction of osteoclast apoptosis
Specifically prenylation of GTP-binding proteins, causing failure of normal intracellular signalling and interaction with the extracellular matrix.

Question 18

T/F: in addition to pain palliation, pamidronate and zoledronate both demonstrated dose-dependent cytotoxicity against OSA cell lines.

Answer 18

True

Question 19

What % of dogs with OSA experience durable (>4 months) pain control with single agent pamidronate?

Answer 19

28%

Question 20

What is the most potent aminobisphosphonate that is commonly used clinically?

Answer 20

Zoledronate

Question 21

Zoledronate is how many times more potent than pamidronate?

Answer 21

100

Question 22

What % of dogs with OSA experience durable (>4 months) pain control with single agent zoledronate?

Answer 22

50%

Question 23

Which form of OSA is thought to have a less aggressive biological behavior: periosteal or parosteal?

Answer 23

Parosteal

Question 24

What breed of dog is at increased risk of chondrosarcoma?

Answer 24

Golden retriever

Question 25

What % of CSA occur in flat bones?

Answer 25

61%

Question 26

What is the most common anatomic site for CSA in dogs?

Answer 26

nasal cavity

Question 27

T/F: metastatic disease has been rarely reported with canine nasal CSA?

Answer 27

False: not reported

Question 28

What are the most common sites of metastasis from primary bone fibrosarcoma in dogs?

Answer 28

heart, pericardium, skin, bones

lung less common

Question 29

What is the medium time to metatstasis with MLO?

Answer 29

542 days

Question 30

Cat OSA vs dogs: what is the primary difference in anatomic site?

Answer 30

More often in the rear limbs

Question 31

What is the metastatic rate of feline OSA?

Answer 31

5-10%

Question 32

For the “boom boom” palliative RT protocol (10 Gy x 2 on consecutive days), what was the % response rate? Pathologic fracture rate?

Answer 32

92. 8% improved pain control

35. 7% pathologic fracture

Question 33

What is a potential adverse effect of chronic zoledronate administration - reported commonly in humans as well as one canine case report?

Answer 33

osteonecrosis of the jaw

Question 34

What CT finding suggests increased likelihood of pathologic fracture?

Answer 34

Subchondral bone involvement - med time to fx 4.2 mos; without subchondral 16.3 mos

Question 35

Describe the risk of pathologic fracture in the radius versus other long bones.

Answer 35

Other bones are 5X more likely to fracture than the radius.

Question 36

In a study of 33 dogs with extra-skeletal OSA, what was the most common tumor location? Was there anything that influenced survival time?

Answer 36

Spleen

Yes - wide/radical excision (MST 90 days vs 13)

Question 37

In a study of owner satisfaction with QOL following amputation, how many would decide again to amputate if faced with the same scenario?

Answer 37

86%

Question 38

For canine mandibular OSA, what is the MFI, MST, and metastatic rate?

Answer 38

MFI 627 days
MST 525 days
Met rate 58%