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Toxic effects and antitumor response of gemcitabine in combination with piroxicam treatment in dogs with transitional cell carcinoma of the urinary bladder

Laura Marconato DVM1, Eric Zini DVM, PhD2, Donna Lindner DVM3, Lisa Suslak-Brown DVM, DACVR4, Victoria Nelson DVM5, and Ann K. Jeglum DACVIM6
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  • 1 Veterinary Oncology Service and Research Center, 739 E Nields St, West Chester, PA 19382.
  • | 2 Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zürich, CH-8057 Zürich, Switzerland.
  • | 3 Veterinary Oncology Service and Research Center, 739 E Nields St, West Chester, PA 19382.
  • | 4 Veterinary Oncology Service and Research Center, 739 E Nields St, West Chester, PA 19382.
  • | 5 Veterinary Oncology Service and Research Center, 739 E Nields St, West Chester, PA 19382.
  • | 6 Veterinary Oncology Service and Research Center, 739 E Nields St, West Chester, PA 19382.

Abstract

Objective—To investigate whether combined treatment with gemcitabine and piroxicam in dogs with transitional cell carcinoma (TCC) of the urinary bladder is tolerated and provides an advantage in terms of survival time over previously reported treatments.

Design—Clinical trial.

Animals—38 dogs with TCC of the urinary bladder.

Procedures—Dogs were treated with gemcitabine (800 mg/m2, IV over 30 to 60 minutes, q 7 d) and piroxicam (0.3 mg/kg [0.14 mg/lb], PO, q 24 h). Complete blood cell counts were monitored prior to each gemcitabine treatment. All toxic effects of gemcitabine in dogs were recorded. Primary tumors were ultrasonographically reevaluated after 4 gemcitabine treatments.

Results—Dogs received a median of 8 gemcitabine treatments (range, 1 to 38 treatments/dog). In response to treatment, 10 of 38 (26.3%) dogs had grade 1 gastrointestinal tract signs, 11 (28.9%) had grade 2, and 5 (13.2%) had grade 3. Grade 1 neutropenia developed in 6 (15.8%) dogs and grade 2 and 3 neutropenia in 2 (5.3%) dogs each. Thrombocytopenia was rare. All dogs had improvement of clinical signs of disease. Two dogs had a complete tumor response, 8 had a partial response, 19 had stable disease, and 8 had progressive disease. Median survival time with treatment was 230 days.

Conclusions and Clinical Relevance—Administration of gemcitabine in combination with piroxicam treatment failed to provide a longer overall survival time in dogs with TCC of the urinary bladder, compared with previously reported treatment strategies. However, this combination of chemotherapy did provide a new treatment alternative with fewer adverse effects.

Abstract

Objective—To investigate whether combined treatment with gemcitabine and piroxicam in dogs with transitional cell carcinoma (TCC) of the urinary bladder is tolerated and provides an advantage in terms of survival time over previously reported treatments.

Design—Clinical trial.

Animals—38 dogs with TCC of the urinary bladder.

Procedures—Dogs were treated with gemcitabine (800 mg/m2, IV over 30 to 60 minutes, q 7 d) and piroxicam (0.3 mg/kg [0.14 mg/lb], PO, q 24 h). Complete blood cell counts were monitored prior to each gemcitabine treatment. All toxic effects of gemcitabine in dogs were recorded. Primary tumors were ultrasonographically reevaluated after 4 gemcitabine treatments.

Results—Dogs received a median of 8 gemcitabine treatments (range, 1 to 38 treatments/dog). In response to treatment, 10 of 38 (26.3%) dogs had grade 1 gastrointestinal tract signs, 11 (28.9%) had grade 2, and 5 (13.2%) had grade 3. Grade 1 neutropenia developed in 6 (15.8%) dogs and grade 2 and 3 neutropenia in 2 (5.3%) dogs each. Thrombocytopenia was rare. All dogs had improvement of clinical signs of disease. Two dogs had a complete tumor response, 8 had a partial response, 19 had stable disease, and 8 had progressive disease. Median survival time with treatment was 230 days.

Conclusions and Clinical Relevance—Administration of gemcitabine in combination with piroxicam treatment failed to provide a longer overall survival time in dogs with TCC of the urinary bladder, compared with previously reported treatment strategies. However, this combination of chemotherapy did provide a new treatment alternative with fewer adverse effects.

Contributor Notes

Dr. Marconato's present address is Animal Oncology and Imaging Center, Rothusstrasse 2, CH-6331 Hünenberg, Switzerland.

Presented in part at the 22nd Annual Veterinary Cancer Society Conference, New York, September 2002.

Address correspondence to Dr. Marconato (marconato@aoicenter.ch).