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Onco Board Review > Skin, MCT, STS, OSA > Flashcards

Skin, MCT, STS, OSA Flashcards

1
Q

What is the sensitivity of ultrasound-guided FNA for diagnosis of OSA in dogs?

A

97%

Increased to 100% when ALP staining was used

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2
Q

Is feline sarcoma virus transmissible between cats?

A

No

Requires FeLV co-infection to replicate

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3
Q

Regional lymph node metastasis is documented in ?% of dogs with appendicular OSA at amputation and ?% at necropsy.

A
  1. 4% at amputation

6. 1% at necropsy

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4
Q

What is the recurrence rate following incomplete excision of maxillary OSA?

A

100%

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5
Q

Which histologic subtype of axial OSA carries the highest risk of metastasis?

A

Telangiectatic – 100% metastatic rate when occurs at axial sites

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6
Q

Up to ?% of feline OSA are extraskeletal.

A

40%

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7
Q

What is the reported metastatic rate for feline OSA?

A

5-10%

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8
Q

What impact does increased monocyte count have on disease free interval in dogs with OSA?

A

Decreased disease-free interval with monocyte count >0.4 x10^3 cells/uL

**does NOT need to be outside the reference range

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9
Q

Expression of which RTK was more common in lung tumors from dogs with pulmonary anthracosis than those without notable anthracosis?

A

EGFR

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10
Q

p53 has been related to what clinical outcome measure in cats with ISS?

A

recurrence

altered p53 sequence or cytoplasmic location related to recurrence

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11
Q

What is the recurrence rate in cats with ISS following radical surgery with 5cm margins

A

14%

20% met rate
11% major complication rate

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12
Q

What dose of CYC resulted in decreased number and percentage of circulating T-regs and tumor MVD?

A

15mg/m2 SID

12.5mg/m2 only decreased absolute T-reg #

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13
Q

What clinical factors are associated with malignant versus benign hepatic tumors in cats?

A

Elevated ALT, AST, and Tbili
Age at presentation
Clinical signs at presentation

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14
Q

Name two negative prognostic factors for feline exocrine pancreatic carcinoma.

A

Effusion

NSAID use

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15
Q

Which of the following is prognostic for outcome in feline lung tumors?

A

Presence of effusion
Tumor size
Histologic grade

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16
Q

What is the survival time following ulnectomy for telangiectatic OSA of the ulna?

A

7mo

Telangiectatic subtype was negative prognostic factor; dogs 7x more likely to die. Other subtypes had MST >1yr

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17
Q

What impact does increased monocyte and lymphocyte count have on OSA prognosis?

A

High monocyte or lymphocyte count = poor prognosis

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18
Q

Aside from morphologic subtype and IHC, what histologic factor is prognostic for fibrohistiocytic nodule?

A

lymphocyte %

<40% = grade 3

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19
Q

What percentage of mast cell tumors of the muzzle have metastasized at presentation?

A

59% to regional LNs

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20
Q

What changes in ISS demographics were seen following the recommendations of the VAS Task Force?

A

Significant decrease in intrascapular and thoracic tumors

Increased occurrence in right forelimb, both hindlimbs and caudolateral abdomen

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21
Q

COX-2 expression has been detected in what % of MCT?

A

78-92%

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22
Q

What clinicopathologic factors have been correlated with COX-2 staining intensity in canine MCT?

A 
higher grade (2 studies)
higher Ki67, MI, and MVD (1 study)
decreased survival (conflicting results)
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23
Q

Which RTK expression characteristics were associated with decreased MST/DFI in canine MCT?

A

Phospho-KIT
VEGFR2 staining (MCT>skin)
Diffuse cytoplasmic KIT staining

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24
Q

What did the use of COLD-PCR and DHPLC demonstrate regarding the rate of kit mutational status?

A

Conventional methods of detection likely underestimate mutational status

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25
Q

What types of activating mutations are identified in Kit juxtamembrane and extracellular domains, respectively?

A

juxtamembrane: ITDs (11 and 12)
extracellular: activating point mutations (8 and 9)

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26
Q

What was the concordance in mutational status and sequence between primary and metastatic MCT lesions?

A

100%

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27
Q

What impact did mRNA expression of Kit and SCF have on survival in canine MCT?

A

none

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28
Q

Which pathologic features were significantly associated with recurrent/metastatic subcutaneous MCT?

A

MI, Ki67, Ki67+AgNOR, kit pattern

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29
Q

Characterize the sensitivity and specificity of Ki67 vs MI for predicting death due to MCT.

A 
Ki67 = sensitive (87%) but poorly specific (58%)
MI = poorly sensitive (32%) but highly specific (96%)
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30
Q

Which of the following parameters carried the highest hazard ratio for risk of death in canine MCT: high histologic grade, MI, Ki67?

A

high histologic grade - HR = 45.6

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31
Q

What impact did Bcl-2 mRNA expression have on survival in canine MCT?

A

Increased Bcl-2 associated with increased mortality

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32
Q

What are minichromosome maintenance proteins, and in which malignancy has expression of MCM7 been shown to be prognostic?

A

Marker of cell proliferation (expressed throughout all cell cycle phases but not G0)
MCM7 >0.18 is prognostic for decreased survival in canine MCT

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33
Q

Using a cytologic grading scheme
that classified MCTs as high grade if they were poorly granulated or had at least 2 of 4 findings: mitotic figures, binucleated or multinucleated cells, nuclear pleomorphism, or >50% anisokaryosis, what was the Sn and Sp relative to histologic grading?

A

88% Sn

94% Sp

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34
Q

In a study evaluating cytologic grading of MCT, dogs with high histologic grade were ___X more likely to die of MCT within 2 year, those with a high cytologic grade were ____X more likely to die.

A

histologic - 39X

cytologic - 25X

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35
Q

Application of the 2-tiered/Kiupel grading criteria to cytologic grading resulted in a sensitivity, specificity, and accuracy of:

A

Sn - 85%
Sp - 97%
Accuracy - 94%

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36
Q

In a study comparing the two- and 3-tiered grading schemes for MCT, what was the 1-year survival probability for Grade II high/low grade?

A

Grade II/high - 46%

Grade II/low - 94%

37
Q

In a blinded study assessing concordance in grade between 28 pathologists using the Patnaik scale, what was the concordance for Grade III and Grade I/II

A

Grade 3 - 74%

Grade 1/2 - <64%

38
Q

What is the rate of BM involvement in dogs with cutaneous and visceral MCT, respectively?

A

cutaneous < 3%

visceral 56%

39
Q

Plasma histamine levels are elevated in appx what % of dogs with MCT?

A

75%

40
Q

Polycythemia vera is most commonly associated with a mutation in which gene?

A

JAK2

41
Q

How do Sertoli cell tumors and seminomas lead to thrombocytopenia?

A

ectopic estrogen production

42
Q

What was the prevalence of glomerular abnormalities detected by renal biopsy in dogs with mammary CA?

A

78%

31% had UPC >0.5

43
Q

Which 3 cytokines are thought to be primarily involved in cancer cachexia?

A

TNFa
IL-1B
IL-6

44
Q

Consumption of which omega-3 fatty acids may decrease loss of lean body mass and decrease tumor growth?

A

EPA and DHA

45
Q

Is bone lysis more common with digital SCC or melanoma?

A

SCC - 80%

melanoma only 21%

46
Q

What is the 1yr survival rate for dogs with subungual SCC?

A

95%

47
Q

What drives mast cell differentiation from bone-marrow derived precursors?

A

SCF (stem cell factor)

48
Q

Which juxtamembrane and extracellular domains of kit may harbor mutations?

A

Juxtamembrane - 11 and 12 (ITD)

Extracellular - 8 and 9 (point mutations)

49
Q

What histologic features predicted aggressive behavior in subcutaneous MCT?

A

MI >4
Infiltrative growth
Multinucleation

50
Q

Which 3 chemotherapy protocols carry the highest reported response rates for MCT?

A

Pred/VBL/CCNU - 57-64%
Pred/VBL/Cytoxan - 63%
COP-HU - 59%

51
Q 
What is the response rate of measurable MCT to the following drugs:
CCNU
Calcitriol
Hydroxyurea
Chlorambucil/Pred
A

CCNU - 44%
Calcitriol - 40%
Chlorambucil/pred - 38%
Hydroxyurea - 28%

52
Q

In the initial placebo-controlled trial of Palladia for canine MCT, what was the ORR and biological activity rate?

A

ORR - 37-43%

ORR + SD - 60%

53
Q

What was the MTD of VBL when combined with toceranib EOD to treat MCT? What was the ORR?

A 
MTD = 1.6mg/m2 q14d
ORR = 71%
54
Q

What was the clinical benefit rate of dogs with MCT treated with the humanized anti-KIT mAb KTN0158?

A

100% (PR + SD)

Was not dependent on kit mutational status

55
Q

In a study regarding the utility of staging in canine MCT, what was the rate of local and distant metastasis detected on routine staging of dogs presenting to a referral clinic for evaluation of MCT?

A

40%

LN mets - 31%
Distant mets - 6.8%

**all dogs with distant mets also had LN mets

56
Q

What % of canine STS expressed fibroblast growth factor 23 (FGF23). What paraneoplastic syndrome is FGF23 responsible for in humans?

A

31% expressed FGF23

causes osteomalacia in humans due to renal phosphate wasting and subsequently decreased VitD

57
Q

What is the sensitivity and specificity of palpation for LN metastasis of MCT?

A

71% Sn, 54% Sp

58
Q

In a study evaluating surgically planned vs histologically measured tumor margins for dogs with MCT, how much smaller than surgical margins were histologic margins?

A

35-42%

59
Q

In a study evaluating histologically safe margins for MCT, what were the recurrence rates for high and low grade tumors?

A

High - 36%

Low - 4%

60
Q

A modified proportional margin technique for removal of cutaneous MCT resulted in complete excision of what % of tumors?

A

85%

61
Q

What was the ORR of MCT to neoadjuvant prednisone?

A

70%

**no difference in response rate between 1mg/kg vs 2.2mg/kg

62
Q

Following incomplete or close surgical excision of MCT, what was the recurrence rate for untreated, reexcised, and irradiated tumors?

A

Untreated - 38%
Re-excised - 13%
Radiation - 8%

63
Q

In dogs with completely excised, high Ki67 Grade II MCT, which treatment results in statistically improved survival: VBL/pred or masitinib?

A

VBL/pred statistically superior to masitinib

64
Q

What was the CR rate of canine MCT folowing electrochemotherapy and periturmoal IL-2?

A

72% CR rate

65
Q

What is the ORR to masitinib for measurable MCT?

A

50 - 82%

Lowe study: 39% CR, 44% PR

66
Q

What is the MTD of CCNU when given with pulse-dose toceranib? What is the ORR to this combination for canine MCT?

A

50mg/m2

46% RR

67
Q

What is the rate of febrile neutropenia following 3.5mg/m2 VBL?

A

8% in 2 studies

68
Q

What is the ORR of canine MCT to alternating CCNU and high dose (3.5mg/m2) VBL?

A

65%

69
Q

What percentage of dogs experienced grade 3-4 AEs at 2.67-3.0 mg/m2 vinblastine?

A

5.9-9.5%

70
Q

What is the ORR of canine MCT to single agent vinblastine at 2.0 and 3.5 mg/m2, respectively?

A
  1. 0mg/m2 –> 12% (all PR)

3. 5mg/m2 –< 27% (1 CR)

71
Q

What was the rate of grade IV neutropenia following VBL 3.5mg/m2?

A

46%

72
Q

What was the ORR to Paccal Vet in dogs with measuarble Grade II-III MCT?

A

59%

73
Q

What was the ORR in the initial placebo-controled trial of Palladia in MCT?

A

42.8%

74
Q

What is the most common gain of function mutation in KIT in canine MCT?

A

ITD in exon 11

75
Q

What is the ORR of MCT to toceranib + pred + hypofractionated RT?

A

76%

59% CR!

76
Q

What is the rate of metastasis to local lymph nodes for oral and perioral MCT in dogs?

A

59%

77
Q

For MCT of the pinna, did cartilage infiltration impact outcome?

A

No

78
Q

What was the ORR in the initial placebo-controled trial of Palladia in MCT?

A

42.8%

79
Q

What is the most common gain of function mutation in KIT in canine MCT?

A

ITD in exon 11

80
Q

What is the ORR of MCT to toceranib + pred + hypofractionated RT?

A

76%

59% CR!

81
Q

What is the rate of metastasis to local lymph nodes for oral and perioral MCT in dogs?

A

59%

82
Q

For MCT of the pinna, did cartilage infiltration impact outcome?

A

No

83
Q

Were nuclear morphometric features such as mean nuclear area and mean diameter prognostic in canine ceruminous gland ACA?

A

yes

84
Q

What % of canine STS expressed fibroblast growth factor 23 (FGF23). What paraneoplastic syndrome is FGF23 responsible for in humans?

A

31% expressed FGF23

causes osteomalacia in humans due to renal phosphate wasting and subsequently decreased VitD

85
Q

Which of the following pathways were highly expressed in the majority of canine perivascular wall tumors? VEGF, PDGFB, bFGF, TGFB, COX2

A

VEGF
PDGFB

bFGF in 47%, cox2 in only 35%

86
Q

Compare the incidence of OSA in dogs and humans?

A

14X higher in dogs

87
Q

Which of the following is more similar to human TP3: canine or murine TP3?

A

canine (>90%)

88
Q

What is the most frequent genetic alteration observed in both canine and human OSA?

A

amplification of Myc and c-kit

karyotypes of both are complex and chaotic

Onco Board Review (6 decks)

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