Bladder TCC (urothelial carcinoma) in dogs: firocoxib alone or with cisplatin vs cisplatin alone — POSSIBLE

In dogs with bladder TCC (urothelial carcinoma), does firocoxib alone, or added to cisplatin, match/beat cisplatin alone for response and survival?

Shelf #116 · gate-verified and approved by the developer

POSSIBLE: One randomised trial answers the response half of this question and does not answer the survival half. In Knapp 2013, 44 dogs with naturally occurring urinary bladder transitional cell carcinoma (TCC) were randomised to cisplatin alone, firocoxib alone, or cisplatin + firocoxib. The combination's remission rate was 57%, significantly higher than cisplatin alone at 13% (P = .021) — an absolute difference of 44 percentage points. Firocoxib alone did not match the combination, but it had single-agent activity: partial remission in 20% of dogs and stable disease in a further 33%. On survival, the draft question cannot be answered from this record: the trial's abstract reports no survival times for any arm, so no survival figure is carded on this shelf and none should be inferred from remission rates. Toxicity did not buy the combination any relief either: renal and gastrointestinal toxicoses were common in dogs receiving cisplatin, with no significant differences between cisplatin alone and cisplatin/firocoxib. A single 44-dog trial, an unblinded design as far as the record shows, and a response (not survival) endpoint cap this shelf at POSSIBLE. Tier C, per the build instruction: the question as drafted carries a survival claim, and survival claims stay personal to John — the record carded here supports a response claim only. Drafted Nov 10, 2026 (VetMed build, topic #116); all figures from abstracts fetched and verified at drafting.

Knapp 2013 (randomised): cisplatin + firocoxib remission 57% vs cisplatin alone 13% (P = .021); firocoxib alone gave 20% partial remission and 33% stable disease

Randomized trial (record's own title wording); publication type Randomized Controlled Trial; blinding not stated in the record

Who: Dogs: 44 dogs with naturally occurring urinary bladder transitional cell carcinoma (TCC) in a clinical referral setting, randomized to receive cisplatin (60 mg/m2 IV every 21 days), firocoxib (5 mg/kg orally every 24 hours), or the combination; tumour measurements before treatment and at 6-week intervals, renal function monitored by serum creatinine, iohexol clearance and urine specific gravity, and toxicoses graded by Veterinary Co-Operative Oncology Group (VCOG) criteria.

Result: The remission rate with cisplatin/firocoxib (57%) was significantly (P = .021) higher than that with cisplatin alone (13%). Firocoxib alone induced partial remission in 20% of dogs and stable disease in 33% of dogs. Renal and gastrointestinal toxicoses were common in dogs receiving cisplatin, but there were no significant differences between dogs receiving cisplatin or cisplatin/firocoxib. The authors conclude firocoxib significantly enhanced the antitumor activity of cisplatin, resulting in partial remission in more than half of cases, that the toxicoses inherent to cisplatin were nonetheless noted with the combination, and that firocoxib had antitumor effects as a single agent and can be considered a palliative treatment for dogs with TCC.

Watch out: Three limits on the face of the record. (1) SURVIVAL: the abstract reports remission and stable-disease rates only — no survival times for any arm — so this card supports a response claim, not the survival half of the drafted question; remission is not carded here as a survival surrogate. (2) Arm sizes are not given in the abstract, so the 57% and 13% rates cannot be turned back into exact dog counts from this record. (3) The record states randomisation but nowhere states blinding of tumour measurement, and none is claimed; tumour measurements at 6-week intervals in an unblinded trial are a softer endpoint than the P value alone suggests.

Knapp DW, Henry CJ, Widmer WR, Tan KM, Moore GE, Ramos-Vara JA, Lucroy MD, Greenberg CB, Greene SN, Abbo AH, Hanson PD, Alva R, Bonney PL. Randomized trial of cisplatin versus firocoxib versus cisplatin/firocoxib in dogs with transitional cell carcinoma of the urinary bladder. J Vet Intern Med. 2013;27(1):126-33. PMID: 23205923. Registry ID: none in the record. MeSH: 4-Butyrolactone/administration & dosage,adverse effects,analogs & derivatives,therapeutic use · Animals · Antineoplastic Agents/administration & dosage,adverse effects,therapeutic use · Carcinoma, Transitional Cell/drug therapy,veterinary · Cisplatin/administration & dosage,adverse effects,therapeutic use · Dog Diseases/chemically induced,drug therapy · Dogs · Drug Therapy, Combination · Female · Gastrointestinal Diseases/chemically induced,veterinary · Male · Quality of Life · Sulfones/administration & dosage,adverse effects,therapeutic use · Urinary Bladder Neoplasms/drug therapy,veterinary

Synthesis: the combination beats cisplatin alone for remission and firocoxib alone is active but weaker — and survival is simply not in the record

Synthesis

Who: Synthesis of the card above: Knapp DW et al. 2013, a randomised three-arm trial in 44 dogs with naturally occurring urinary bladder TCC (cisplatin 60 mg/m2 IV q21d, firocoxib 5 mg/kg PO q24h, or both).

Result: On tumour response, the ranking in this single trial is clear: cisplatin + firocoxib 57% remission > firocoxib alone (20% partial remission, 33% stable disease) and cisplatin alone (13% remission), with the combination-vs-cisplatin difference significant at P = .021. On toxicity, adding firocoxib did not significantly change the renal and gastrointestinal toxicoses that were common on cisplatin. On survival, this shelf has nothing to report: the record gives no survival figures, so the honest answer to 'does it prolong survival?' is that this trial, as recorded, does not say.

Watch out: A one-trial shelf. No second randomised trial of this combination was carded, the trial is small (44 dogs across three arms), and response-rate advantages in TCC do not automatically translate into survival advantages — which is precisely why the survival part of the question is left open here rather than filled in from the response data.

Synthesis of Knapp DW et al. PMID: 23205923. Registry IDs as on the individual card.

Back to the library index · VetMed home

VetMed is an educational resource, not veterinary advice.