Quimioterapia e terapia molecular no tratamento de mastocitomas caninos: revisão sistemática
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2015
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O mastocitoma cutâneo canino é considerado uma das neoplasias de pele mais frequentes no cão. Esta revisão sistemática incluiu ensaios clínicos randomizados e estudos prospectivos publicados entre 1997 e 2013, tendo-se analisado no total 13 artigos (898 cães) sobre quimioterapia e terapia molecular no tratamento de mastocitomas cutâneos caninos, com o objectivo de avaliar a eficácia e segurança dos diferentes tipos de protocolo em cães com mastocitomas de grau histológico II e III, com ou sem evidência de metastização. Os estudos destes dois grupos de tratamento foram comparados quanto à sua validade, avaliação dos participantes, características dos participantes e neoplasias, avaliação dos resultados e ainda em relação aos seus efeitos adversos. O protocolo de quimioterapia com maior eficácia emprega a administração alternada de lomustina, vinblastina e prednisolona, mas um terço dos doentes apresentam efeitos adversos moderados a severos. Dos inibidores de tirosinas-cinases, o fosfato de toceranib foi o que apresentou uma maior taxa de eficácia clínica. A sua toxicidade assemelha-se à dos protocolos de quimioterapia, pelo que a sua utilização deve ser igualmente monitorizada. No conhecimento do autor esta é a primeira revisão sistemática realizada em Portugal sobre a eficácia clínica e segurança destes dois grupos de tratamentos do mastocitoma cutâneo canino.
Mast cell tumors represent one of the most common cutaneous tumours in the dog. This systematic review included randomized controlled trials and prospective clinical trials published between 1997 and 2013. Thirteen studies, enrolling 898 dogs, about chemotherapy and small molecule tyrosine kinase inhibitors were included in this systematic review on the treatment of mast cell tumours, in order to evaluate the efficacy and safety of different types of protocols in dogs with grade II /III tumours with or without metastasis. These two groups of studies were compared with regard to validity, subjects’ assessment, subjects and tumours characteristics, outcomes assessment and adverse drug events. The most efficient protocol included the administration of lomustine, vinblastine and prednisolone, however one third of the dogs exhibited mild to severe adverse events. In the group of tyrosine kinase inhibitors, toceranib phosphate demonstrated the higher clinical efficacy. However, patients receiving toceranib phosphate should be closely monitored, as they would be for conventional cytotoxic therapy due to the toxicity related events. To the best knowledge of the author this was the first systematic review in Portugal about clinical efficacy and safety of these two options of canine cutaneous mast cell tumours treatment.
Mast cell tumors represent one of the most common cutaneous tumours in the dog. This systematic review included randomized controlled trials and prospective clinical trials published between 1997 and 2013. Thirteen studies, enrolling 898 dogs, about chemotherapy and small molecule tyrosine kinase inhibitors were included in this systematic review on the treatment of mast cell tumours, in order to evaluate the efficacy and safety of different types of protocols in dogs with grade II /III tumours with or without metastasis. These two groups of studies were compared with regard to validity, subjects’ assessment, subjects and tumours characteristics, outcomes assessment and adverse drug events. The most efficient protocol included the administration of lomustine, vinblastine and prednisolone, however one third of the dogs exhibited mild to severe adverse events. In the group of tyrosine kinase inhibitors, toceranib phosphate demonstrated the higher clinical efficacy. However, patients receiving toceranib phosphate should be closely monitored, as they would be for conventional cytotoxic therapy due to the toxicity related events. To the best knowledge of the author this was the first systematic review in Portugal about clinical efficacy and safety of these two options of canine cutaneous mast cell tumours treatment.
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Orientação: Andreia Santos
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MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, CÃES, NEOPLASIAS, MASTOCITOMAS, QUIMIOTERAPIA, TERAPIAS, DOGS, NEOPLASMS, MAST CELL TUMOR, CHEMOTHERAPY, THERAPIES, MEDICINA VETERINÁRIA, VETERINARY MEDICINE, CANÍDEOS, CANIDS