ISSN 2398-2942      

Osteosarcoma: chemotherapy protocols

icanis
Contributor(s):

Jane Dobson

Corey Saba


Protocol 1: Single-agent carboplatin

  • Week 1: CBC. Carboplatin Carboplatin 300 mg/m2 IV.
  • Week 2: No chemotherapy. Recheck CBC.
  • Week 3: No chemotherapy. Recheck CBC.
  • Week 4: Recheck CBC. Carboplatin 300 mg/m2 IV.
  • Week 7: Recheck CBC. Carboplatin 300 mg/m2 IV.
  • Week 10: Recheck CBC. Carboplatin 300 mg/m2 IV.

Important considerations

Carboplatin is a potent cytotoxic drug and should only be administered by trained personnel.

  • For dogs weighing <15 kg, reduce carboplatin dose to 250-270 mg/m2.
  • Myelosuppression, specifically neutropenia and/or thrombocytopenia, is the most common side effects of carboplatin. Neutrophil nadirs are variable with this drug and can occur at roughly 7, 14, and/or 21 days post-treatment. Gastrointestinal effects, such as anorexia and/or vomiting, may occur but are less common.
  • Perform a complete blood count (CBC Hematology: complete blood count (CBC) ) with platelet count Hematology: platelet count within 48 hours prior to every dose of chemotherapy. Delay chemotherapy by 3-7 days and recheck CBC if neutrophils <2000 cells/uL and/or if platelets <75,000 cells/uL.
  • Perform a CBC with platelet count 7 and 14 days after the first dose of carboplatin to assess degree of myelosuppression. Consider prophylactic antibiotics in afebrile, apparently healthy patients with neutrophil counts <1000 cells/uL. Consider hospitalization and treatment for sepsis (IV fluids and broad spectrum antibiotics) in febrile and/or sick patients with neutropenias. Once the nadir(s) has been established, 7 and 14 day post-chemotherapy CBCs are unnecessary unless the patient becomes ill and/or if dose reductions are required (see below).
  • Reduce carboplatin dose by 25% in patients experiencing significant myelosuppression, GI toxicity, and/or in those requiring hospitalization due to toxicity. Following dose reduction, recheck CBC with platelet count 7 and 14 days after treatment.
  • Recheck thoracic radiographs prior to 3rd or 4th treatment. If pulmonary metastasis is evident, discontinue carboplatin. Otherwise, continue treatments for 4-6 doses total.

Protocol 2: Single-agent doxorubicin

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Protocol 3: Alternating carboplatin/doxorubicin

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Legal and safety precautions

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Phillips B, Powers B E, Dernell W S et al (2009) Use of single-agent carboplatin as adjuvant or neoadjuvant therapy in conjunction with amputation for appendicular osteosarcoma in dogs. J Am Anim Hosp Assoc 45 (1), 33-38 PubMed.
  • Bacon N J, Ehrhart N P, Dernell W S et al (2008) Use of alternating administration of carboplatin and doxorubicin in dogs with microscopic metastases after amputation for appendicular osteosarcoma: 50 cases (1999-2006). J Am Vet Med Assoc 232 (10), 1504-1510 PubMed.
  • Kent M S, Strom A, London C A et al (2004) Alternating carboplatin and doxorubicin as adjunctive chemotherapy to amputation or limb-sparing surgery in the treatment of appendicular osteosarcoma in dogs. J Vet Intern Med 18 (4), 540-544 PubMed.
  • Bergman P J, MacEwen E G, Kurzman I D et al (1996) Amputation and carboplatin for treatment of dogs with osteosarcoma: 48 cases (1991 to 1993). J Vet Intern Med 10 (2), 76-81 PubMed.
  • Berg J, Weinstein M J, Springfield D S et al (1995) Results of surgery and doxorubicin chemotherapy in dogs with osteosarcoma. J Am Vet Med Assoc 206 (10), 1555-1560 PubMed.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code