From the Research
Toceranib phosphate (Palladia) is the recommended treatment for apocrine gland adenocarcinoma in dogs, as it has been shown to provide a clinical benefit in 69% of dogs, with a median progression-free survival of 313 days and overall survival time of 827 days 1.
Treatment Administration
The treatment should be administered at a dose of 2.5-2.75 mg/kg orally every other day, with regular monitoring for side effects.
- Before starting treatment, a complete blood count, chemistry panel, and urinalysis should be performed to establish baseline values.
- These tests should be repeated every 2-4 weeks initially, then every 1-3 months during ongoing therapy.
Side Effects and Dose Reductions
Common side effects include gastrointestinal upset (vomiting, diarrhea), decreased appetite, and potential bone marrow suppression.
- Dose reductions to 2.0-2.25 mg/kg may be necessary if significant side effects occur.
- Rare but severe side effects such as palmar-plantar erythrodysesthesia syndrome can occur, and clinicians should be aware of this potential adverse event 2.
Mechanism of Action and Combination Therapy
Toceranib works by inhibiting multiple receptor tyrosine kinases involved in tumor growth, angiogenesis, and metastasis, making it effective against various malignancies including apocrine gland adenocarcinomas.
- This targeted therapy may be combined with surgical excision when possible for optimal outcomes, especially for localized tumors before metastasis occurs.
- The expression of PDGFR-β in 19.5% of neoplasms suggests that toceranib may be effective in treating apocrine gland adenocarcinoma by targeting this receptor 3.