Desmopressin in canine mammary carcinoma: Comments on the importance of the administration route

ALONSO, DANIEL F.; TURIC, ESTEBAN; GARONA, JUAN

VETERINARY AND COMPARATIVE ONCOLOGY

WILEY-BLACKWELL PUBLISHING, INC

Año: 2020

1476-5810

Several years ago, we proposed the hemostatic peptide desmopressin (1-desamino-8-D-arginine vasopressin; dDAVP) as a potential anti-metastatic agent to be used during surgical excision of locally advanced tumors. A prospective randomized study in 28 intact dogs with mammary carcinomas receiving perioperative intravenous dDAVP infusions (1 µg/kg) demonstrated a significant survival benefit in dogs with moderately (grade 2) or poorly differentiated (grade 3) tumors1. dDAVP is known to exert anti-proliferative and anti-angiogenic effects in laboratory models, by acting on AVPR2 vasopressin receptors present in tumor and endothelial cells. Moreover, dDAVP can induce the release of von Willebrand factor (VWF) from microvascular endothelium into blood circulation. Beyond its critical function in primary hemostasis, VWF plays a protective role against metastatic dissemination. An abrupt increase in VWF blood levels is able to interfere with the arrest of circulating cancer cells at target organs and also to induce apoptosis in micrometastatic foci2.The article entitled ?A prospective randomized trial of desmopressin in canine mammary carcinoma? recently published in Veterinary and Comparative Oncology by Sorenmo et al. retested dDAVP as a surgical adjuvant in 24 dogs with mammary carcinomas3. They reported that few dogs developed metastatic disease in this study, and no significant benefit of perioperative dDAVP administration was observed. We completely agree with the authors in the sense that subgroup comparisons between the high-risk subgroups were very underpowered, since none of the dogs with grade 2 tumors developed metastasis and only one dog with a grade 3 tumor was randomized to receive dDAVP3. More to the point, all intact dogs underwent ovariohysterectomy as part of their treatment in this study, thus reducing the risk of metastasis and possibly diminishing the impact of perioperative dDAVP on survival.