Name
- Toceranib phosphate.
Class of drug
- A tyrosine kinase (TK) inhibitor.
Uses
Action
- Kills tumor cells by inhibiting TK which is important is regulating cell growth.
- Inhibits tumor angiogenesis by inhibiting TKs such as platelet derived growth factor receptor (PDGFR), vascular endothelial growth factor receptor (VEGFR) and fibroblast growth factor receptor (FGFR).
Indications
- Indicated for the Patnaik Grade II or III, recurrent, cutaneous mast cell tumors
with or without regional lymph node involvement in dogs. The presence of the KIT mutation is more common in high grade mast cell tumors, and mast cell tumors with the KIT mutation tend to be more responsive to Palladia. - Preliminary studies have also demonstrated promising responses in anal sac adenocarcinomas, gastrointestinal stromal cell tumors (GIST), thyroid carcinomas, malignant melanomas and nasal adenocarcinomas.
- Preliminary studies in cats suggest a dose of 2.5 mg/kg three days per week may be beneficial in the treatment of mast cell tumors.
Adverse reactions
Effects of overdosage
- Vomiting and diarrhea.
Other reported reactions
- Most common side effects are diarrhea, decreased/loss of appetite, weight loss and blood in feces. GI signs should be treated early and aggressively to avoid progression of signs and to avoid cessation of Palladia dosing.
- Depigmentation of the nasal planum due to effects of Palladia on macrophages.
- Muscle pain can occur.
Treatment
- Vomiting is treated with Prilosec or Carafate and Metoclopramide . Dolasetron or Cerenia can be used if these are not effective. Diarrhea is treated with Immodium. Palladia may need to be discontinued if GI effects cannot be managed with supportive care and dose reductions.
- Muscle pain usually responds to discontinuation of Palladia for 3 4 days along with analgesics such as Tramadol and NSAIDs .
