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Oncology Boards > Skeletal - OSA, Chondro, etc. > Flashcards

Skeletal - OSA, Chondro, etc. Flashcards

1
Q

Where do the majority of feline chondrosarcomas occur? (Durham JAAHA 2008)

A

70% bone - 63% long, 37% flat

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2
Q

What is the outcome for cats treated with radical surgery for chondrosarcoma? (Durham JAAHA 2008)

A

Long term control/cure, no mets reported

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3
Q

What is the rate of pulmonary mets from a gradce 1 chondrosarcoma in dogs? ( Farese vet surg 2009)

A

0%

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4
Q

What is the rate of pulmonary mets from a grade 2 chondrosarcoma in dogs? ( Farese vet surg 2009)

A

31%

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5
Q

What is the rate of pulmonary mets from a grade 3 chondrosarcoma in dogs? ( Farese vet surg 2009)

A

50%

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6
Q

What is the MST for grade 1 chondrosarcoma treated with amputation in dogs (Farese Vet Surg 2009)

A

6yrs

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7
Q

What is the MST for grade 2 chondrosarcoma treated with amputation in dogs (Farese Vet Surg 2009)

A

2.7yrs

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8
Q

What is the MST for grade 3 chondrosarcoma treated with amputation in dogs (Farese Vet Surg 2009)

A

0.9yrsd

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9
Q

What was the overall MST for all canine chondrosarcomas treated with limb amputation? (Farese Vet Surg 2009)

A

MST 979d

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10
Q

What was the MST for non-nasal chondrosarcoma that was not treated in dogs (Waltman Vet Surg 2007)

A

MST 495d

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11
Q

Has nodal metastasis been reported for dogs with chondrosarcoma?

A

Yes **Comittee member**

Case report of a dog with humeral chondro + axillary LN met

Treatment: dox x5, alive w/o additional mets 8mo post-tx

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12
Q

MST and metastasis-free interval (MFI) for 45 dogs getting limb amp + single SQ dose of carbo for OSA? (Santamaria JAVMA 2019)

A

MST 196d, MFI 197d - authors don’t recommend this approach because similar to amp alone numbers

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13
Q

AEs from single SQ dose of carbo for dogs with OSA ((Santamaria JAVMA 2019)

A

6.6% grade 4 neutropenia, 8.8% grade 4 thrombocytopenia, 6.6% hospitalized for GI tox.

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14
Q

What was mPFS and MST for dogs with MLO treated with 3x10Gy SBRT (2 histo dx, 8 imaging dx) (Sweet VCO 2019)

A

PFS 223d, MST 329d

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15
Q

What was the rate of pulmonary metastasis in dogs with MLO treated with SBRT? (Sweet VCO 2019)

A

None at dx, 2/10 (20%) developed at 90 and 315d post treatment

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16
Q

What are AZD1152 and VX680 and were they effective against canine OSA cell lines? (Cannon VCO 2015) **Committee member**

A

aurora kinase inhibitors

cytotoxicity noted in all but half-maximal inhibitor concentration significantly higher than piror studies

take home: OSA generally resistant to these drugs and unlikely useful

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17
Q

What was the effect from treating OSA cells with amiloride + chemo? Sidebar - what is amiloride? (Poon JVIM 2019)

A

Amiloride = potassium sparing diuretic

Dox + amiloride –> synergism

Induced early and late apoptosis, upregulated p53 –> upreg Bax and downreg Bcl-xl and akt phosphorylation

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18
Q

What is auranofin and what was its effect in dogs with OSA? (Endo-Munoz VCO 2019)

A

auranofin inhibits thioredoxin reductase 2 (driver of metastasis in OSA)

Auranofin + amp + carbo improved outcome specifically in male dogs (10 dogs w/o disease b/w 800-1500d)

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19
Q

What was the response to TOC in dogs with metastatic OSA? (Laver VCO 2018)

A

17% SD, remainder PD at wk 8 or earlier

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20
Q

Did metronomic CTX (15mg/m2 PO q24) + meloxicam improve PFS or OST in dogs with appendicular OSA following tx with amp+carbo? What was an interesting finding of this study? (Matsuyama JAVMA 2018)

A

Nope

SHC was common (58%)

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21
Q

What was the protocol for sequential accelerated dox/carbo post-amp for dogs with OSA and what was the MST/1 and 2-yr survival? What was prognostic for ST? (Frimberger JAAHA 2016)

A

doxo 30mg/m2 q2 x 3wks then carbo 300mg/m2 q3wk

MST 317d (10.6mo) 1yr = 43%, 2 yr = 14%

ALP level and completion of chemo = significant on ST

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22
Q

What was the effect of TOC/pirox/CTX maintenance therapy for dogs with appendicular OSA following amp + carbo? (London Plos 2015) **Committee Member**

A

No impact of mDFI, OS or 1yr survival rate

dogs with palladia had more diarrhea, neutropenia and weight loss vs. no palladia

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23
Q

Genetically engineered Salmonella enterica serovar typhimurium encoding what has been shown to improve DFI in dogs with OSA? What dosing was better? (Fritz Vet Med Sci 2016) **Committee member**

A

IL-2

Dogs at lower doses of drug had longer DFI than higher doses

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24
Q

What was the difference in DFI and MST for dogs treated with amputation and combined metronomic and MTD chemo for OSA? (Bracha JSAP 2014)

A

Carbo + CTX/pirox = DFI 192d (6.4mo) MST 217d (7.2mo)

Carbo/dox alt + CTX/pirox = DFI 182d (6mo) MST 189d (6.3mo)

No difference b/w groups

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25
Q

What was the MST and DFI for dogs treated with amp + gem/carbo for OSA? What was prognostic in this study? (McMahon JVIM 2011)

A

DFI 203 d (6.8mo), MST 279d (9mo)

Poor prognosis: prox humeral location

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26
Q

What was the conclusion from comparing carbo vs. doxo (carbo 300mg/m2 q3 x6 vs. q3wk x4) vs. doxo (q2wk x 5 or q3wk x5) vs. carbo/dox alt x 6 total? (Selmic JVIM 2014)

A

No protocols sig different (overall DFI 291 d (9.7mo), OST 284d (9.5mo)

dose intensity not assoc. with outcomes

carbox5 = lower proportion of dogs with AEs

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27
Q

Was carbo x6 or alt carbo/dox superior for treatment of osa after amp in a phase III trial? (Skorupski VCO 2013)

A

carbo x 6 sig longer (425d = 14.2mo) compared to carbo/dox (135d = 4.5mo)

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28
Q

What was the effect of adding pamidronate to a treatment protocol of palliative RT +/- chemo for appendicular OSA? (Oblak Vet Surg 2012)

A

shortest MST for RT + pamid (69d) vs. longest for pRT + chemo (307d = 10mo)

Chemo improved survival, pamid decreased - authors rec. don’t combine pamid with pRT

29
Q

What was the difference in signalment for primary appendicular bone HSA vs. telangiectatic OSA (tOSA)? (Giuffrida Vet Surg 2018)

A

HSA: more males, medium sized and hind limbs (78%) esp. tibia

tOSA: weighed a median of 9.9kg more than HSA

30
Q

What was the difference in OST and 1-yr survival for dogs treated with SOC for appendicular HSA vs. tOSA? (Giuffrida Vet surg 2018)

A

HSA 299d (10mo), 1yr = 28%

tOSA 213d (7mo), 1yr = 7%

not stat sig different

31
Q

In a study of tOSA vs. appendicular HSA, what IHC marker reclassified what % of tOSA to HSA? (Giuffrida Vet Surg 2018)

A

endothelial cell marker FVIII/vWF

20% reclassified from tOSA to HSA

32
Q

What was the accuracy, sensitivity and specificity of cytology for bone lesions in dogs? (Sabattini JVIM 2017)

A

Accuracy 83%, sens 83.3%, spec 80%

33
Q

What was the accuracy, sensitivity and specificity for histopathology for dogs with bone lesions? (Sabattini JVIM 2017)

A

accuracy 82.1%, 72.2% sensitivity, 100% specificity

34
Q

What % of bone tumors were correctly identified cytologically or histologically in dogs with bone lesions? (SWabattini JVIM 2017)

A

cyto = 50%

histo = 55%

35
Q

When comparing CXR to CT, how many dogs had pulmonary mets identified from OSA? (Eberle VCO 2010)

A

CXR = 5%

CT = 28%

36
Q

What histologic prognostic factors have been identified for feline OSA? (Dimopoulou vet surg 2008)

A

histologic grade and MI

37
Q

OSA patients with low levels of both YAP (Hippo pathway) and pSmad2 (marker of active TGF-B signaling) had a significantly (shorter/longer) survival time (Luu BMC 2018)

A

significantly longer

38
Q

What IHC markers evaluated in canine OSA cell lines are similar to human studies suggesting canine OSA cells are a useful model for human studies? (Al-Khan J Comp Path 2017)

A

Vimentin, ALP, Runx2, BPM4 all highly expressed by all tumors

39
Q

What was the effect on OSA cell lines treated with platelts (intact platelets, platelet lysate and platelet releasate) (Bulla J Comp Path 2017)

A

Inhibited migration of canine OSA cell lines

downregulated transcriptional levels of SNAI2 and TWIST1 genes

40
Q

What was the difference in serum 25-hydroxyvitamin D between dogs with OSA vs. controls? (willcox vet J 2016)

A

No difference - vit d might not be important in pathogenesis of canine OSA

41
Q

What was the effect of etoposide in a mouse xenograft OSA model? (Res Vet Sci 2017)

A
  • sig delayed tumor progression w/ marked reduction in Ki-67 immunoreactivity
  • Etoposide + pioxicam down-regulated survivn expression (but was not followed by apoptotic activity)
    • ​piroxicam did not enhance the anti-tumor efficacy of etoposide
42
Q

What is p16 and what is known about it in human and canine OSA? (Murphy BMC 2017)

A

p16 = tumor suppressor gene product

correlated with favorable response to chemo in human osa patients

trend identified in dogs with lack of OSA p16 and shorter DFI

43
Q

What does using a PKC inhibitor do in OSA? (Hong, Khanna VCO 2010)

A

Blocks ezrin phosphorylation and cell migration

(Ezrin, raxixin and moesin = related progeins associated with plasma membrane; crosslink actin filaments to plasma membrane)

all OSA lines tested here (4) expressed ezrin and PKC (PKC phosphorylates ezrin)

44
Q

Describe B-catenin’s roles in OSA survival and DFI (Stein VCO 2010)

A

OSA stains positive for B-catenin, healthy bone doesn’t

This study looked for mutations in exon 3, but non found

expression was not correlated with survival or DFI

(similarly Wnt signaling not so important in OSA either)

45
Q

Whole geneome mapping of Scottish deerhounds with OSA found a linkage between phenotypes and markers located on ____ which is synthetic to the humnan _____. (Phillips Genomics 2010) **Committee**

A

deerhounds: CFA34
humans: 3q26

46
Q

c-met expression was not associated with ____ in dogs with OSA but was associated with _____ (Fieten Vet Path 2009)

A

not associated with DIF or ST

was associated with LN mets

47
Q

Zoledronate downregulates ____ expression and functionality by ______ (byrum JVIM 2016)

A

CXCR4

mechanism = augmented proteasome degradation and reduced prenylation of the heterotrimeric G-proteins

48
Q

Single agent pamidronate had was rate of response for how long in dogs? Higher doses were correlated with what? (Fan JVIM 2007)

A

28% resxponded for > 4mo (median 231d)

Higher dose had greater urine reduction of NTx concentration but no sig difference in% response or duration of pain control

49
Q

In dogs treated with pamidronate + pRT + IV dox for OSA bone pain, what % of dogs had durable analgesia? What was the conclusion about combining pamid + RT in this study? (Fan JVIM 2009)

A

40% analgesia lasting >112d.

pamid + pRT didn’t appear to improve pain control but may decrease focal bone resorption (measureed by NTx and rBMD)

50
Q

Dogs with OSA with what type of macrophages had a significantly longer DFI? What location was associated with a significantly lower % of these macros? (Withers VCO 2019)

A

> 4.7% of CD204+ macros experience sig longer DFI

sig lower CD204+ macors detected in prox humerus

51
Q

What aree common features of dogs that survived >1yr after treatment for OSA? (Culp JAVMA 2014)

A
  • high ALP in 48%
  • most common site = distal radius
  • dogs that developed surgical site infection after limb-spare

median survival beyond 1 yr = 8mo (243d)

52
Q

What location on the skull for OSA was associated with a higher risk of local recurrence? (Selmic JAVMA 2014)

A

Calvarium

53
Q

What was the rate of local recurrence or progression for dogs with maxillary, mandibular or calvarium OSA? What was the MST and what waas prognostic? (Selmic JAVMA 2014)

A

Progression in 51%

MST 239d (8mo)

MST w surgery = 329d (11mo)

clean sx margins decreased risk of local recurrence and death

54
Q

What is the rate of LN mets at dx and MST for dogs with OSA with ln mets?

A

4.4% at time of amp

MST 59d

55
Q

What is stage III OSA and what was the overall MST for these dogs? What was associated with a better outcome? (Boston JAVMA 2006)

A

Metstatic OSA

MST 76d (2.5mo)

pRT + chemo did better (130d = 4.3mo)

bone mets better than soft tissue mets

56
Q

A (low/high) CD8:Treg ratio was associated with a shorter survival time in dogs with OSA. (Biller JVIM 2010)

A

Lower CD8:Treg = shorter

dogs with OSA had sig fewer CD8 t cells and more Tregs

57
Q

What was predictive out outcome in dogs with OSA treated with surgery + carbo? (Saam JAVMA 2011)

A

Preop proteinuria

Histo: intravascular invasion, MI 5/3hpf

Grade III classification

58
Q

Elevated total cholesterol was significantly associated with a (reduced/increased) hazard ratio for overall mortality in dogs with OSA (Leeper JSAP 2017)

A

associated with a reduced hazard ratio

59
Q

What was the MST for dogs with ulnar OSA treated with either partial ulnar ostectomy, amp or no surgery? What was prognostic? (Sivacolundhu JAVMA 2013)

A

MST 463d (15mo)

partial ulnar ostectomy = low complication rate w/ good to excellent limb function

telangiectatic OSA = negative prog factor (MST 208d)

60
Q

What was the outcome for 9 dogs with vertebral OSA (primary or metastatic) treated with SRT? (Swift VCO 2018)

A

5/6 improved spine pain

MST 139d (4.6mo), median duration of pain control 77d (2.5mo)

61
Q

What was the dose limiting structure for dogs treated with SRT for vertebral OSA? What was the significance of this? (Swift VCO 2018)

A

late responding spinal cord

many patients died prior to developing late RT tox

62
Q

What was associated with the risk for fracture on CT for dogs with OSA treated with a single fraction of SRT? What was the overall rate of path fx and timing? (Kubicek VRU 2016)

A

subchondral bone involvement

63% developed path fx, median 6mo

63
Q

What was associated with survival time for dogs with OSA that developed cutaneous or SQ mets? (parachini-winter JVIM 2019) **Committee member**

A

treatment

sx + chemo = 94d (3mo) vs. w/o tx = 11d

64
Q

Dogs w/ history of TPLO were _____x as likely to develop proximal tibial OSA as dogs with no TPLO and _____ was associated with an 11% increase in odds of PT OSA. (Selmic JAVMA 2018)

A

TPLO = 40x as likely to develop PT OSA

Each 1kg increase in body weight associated w/ 11% increase in odds of PT OSA

65
Q

Has water fluoridation been shown to contribute to development of OSA in dogs? (Rebhun VCO 2016)

A

nope

66
Q

What locations of OSA were most commonly associated with pathologic fracture in dogs? (Rubin JAVMA 2015)

A

Femur (57%), tibia (53%)

humerus (37%)

Radius (20%)

ulna (50%)

67
Q

Dogs with primary vertebral OSA had the best MST when treated with what? (Dixon VCO 2019)

A

Combination of decompressive sx + RT + chemo (261d = 8.7mo)

sx alone = 42d

sx + chemo = 82d

sx + RT = 101 d

68
Q

What criteria are used to decide if metastasectomy is appropriate for a dog with OSA?

A
  1. primary tumor in complete remission, preferrably >300d
  2. one or two nodules visible on survey CXR
  3. metastasis confined to the lungs (neg bone scan)
  4. long doubling time (>30d) w/ no new lesions w/in this time
69
Q

What was the overall rate of infection for dogs undergoing either allograft or endoprosthesis for limb-spare for OSA? (Liptak Vet Surg 2006)

A

55-60%

this study showed longer MST for dogs w/ infecion (685s) vs. not (289d) - not necessarily supported by all lit

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