1
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Parker AS, Burton JH, Curran KM, Wolf‐Ringwall A, Thamm DH. Early progression during or after cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy indicates poor outcome with rescue protocols in dogs with multicentric lymphoma. J Vet Intern Med 2024; 38:2282-2292. [PMID: 38961691 PMCID: PMC11256168 DOI: 10.1111/jvim.17139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 06/13/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Dogs with lymphoma that fail cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy (CHOP) before completion of their protocol are commonly thought to have poor long-term outcome, but no previous studies have evaluated the effect of early relapse on progression-free interval (PFI) or overall survival time (OST) for patients undergoing rescue chemotherapy. OBJECTIVE Correlate rescue treatment outcomes in dogs with multicentric lymphoma with outcomes after 1st-line CHOP chemotherapy. METHODS Data were collected from 6 previous retrospective or prospective studies in 187 dogs with multicentric lymphoma that received 1st-line CHOP chemotherapy and then received either lomustine (CCNU), L-asparaginase and prednisone (LAP), or rabacfosadine (RAB, Tanovea), with or without prednisone or L-asparaginase. RESULTS The PFI after initiation of CHOP chemotherapy was significantly associated with response rate postprogression, PFI, and postrescue survival time (ST) for both rescue protocols. Immunophenotype (B- vs T-cell) was not significantly associated with response, PFI or OST for LAP but was significantly associated with response and PFI for RAB. CONCLUSION Dogs that experience short PFI during or after 1st-line CHOP chemotherapy had lower response rates to rescue treatment, with shorter PFI and ST. Immunophenotype did not significantly affect outcome with LAP but was associated with PFI for RAB.
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Affiliation(s)
- Ashley S. Parker
- Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
| | - Jenna H. Burton
- Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
| | - Kaitlin M. Curran
- Carlson College of Veterinary MedicineOregon State UniversityCorvallisOregonUSA
| | | | - Douglas H. Thamm
- Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
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2
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Chiara C, Luigi BM, Elisabetta T, Marta P, Katja R, Paola V. Use of Lomustine and Prednisolone as First-Line Treatment in Canine Multicentric Lymphoma. Vet Comp Oncol 2024. [PMID: 38890811 DOI: 10.1111/vco.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/27/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
Multiagent chemotherapy is considered the most effective treatment for canine high-grade lymphoma; however, due to cost and time requirements, single-agent protocols have also been described. The aim of our study was to evaluate the outcome and prognostic factors of dogs affected by multicentric lymphoma treated with lomustine and prednisolone as first-line treatment. Cases of medium-large-cell multicentric lymphoma treated with lomustine and prednisolone were included in the study. Response to therapy, time to progression (TTP), median disease-free interval (MDFI) and median survival time (MST) were retrospectively described. Thirty cases were included. Eleven (36.67%) were T cell, 11 (36.67%) were B cell and 8 (26.66%) had unknown immunophenotype. The overall response rate (RR) was 87%, with 15 patients achieving CR (50%) and 11 patients PR (37%). The median TTP, MDFI and MST were 42, 63 and 90 days, respectively. The only factor significantly associated with MDFI and MST was the stage. Dogs with multicentric lymphoma treated with lomustine and prednisolone have lower RR, TTP, MDFI and MST compared with dogs receiving multiagent protocols. Based on the short-lasting response, this study confirms that this protocol might have minimal utility beyond palliation.
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Affiliation(s)
- Catalucci Chiara
- Oncology Service, Clinica Veterinaria Malpensa AniCura, Samarate, Italy
| | | | | | - Pieri Marta
- Oncology Service, Clinica Veterinaria Nervianese, Nerviano, Italy
| | - Ruess Katja
- Oncology Service, Marigin Tierklinik, Feusisberg, Switzerland
| | - Valenti Paola
- Oncology Service, Clinica Veterinaria Malpensa AniCura, Samarate, Italy
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3
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Saba CF, Fan TM, Phillips BS, Wright ZM, Thamm DH. Alternating rabacfosadine and doxorubicin for treatment of naïve canine lymphoma. Vet Comp Oncol 2024; 22:278-283. [PMID: 38616055 DOI: 10.1111/vco.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/20/2024] [Accepted: 03/22/2024] [Indexed: 04/16/2024]
Abstract
The current standard of care treatment for canine lymphoma is a multi-agent, CHOP-based chemotherapy protocol. Single agent doxorubicin (DOX) is less burdensome; however, multi-agent chemotherapy protocols are often superior. The recently approved drug rabacfosadine (RAB, Tanovea) provides an attractive option for combination therapy with DOX, as both drugs demonstrate efficacy against lymphoma and possess different mechanisms of action. A previous study evaluating alternating RAB/DOX reported an overall response rate (ORR) of 84%, with a median progression-free survival time (PFS) of 194 days. The aim of this prospective trial was to evaluate the same protocol in an additional population of dogs. Fifty-nine dogs with treatment naïve lymphoma were enrolled. RAB (1.0 mg/kg IV) was alternated with DOX (30 mg/m2 IV) every 21 days for up to six total treatments (3 cycles). Response assessment and adverse event (AE) evaluation were performed every 21 days using VCOG criteria. The ORR was 93% (79% CR, 14% PR). The median time to maximal response was 21.5 days; median PFS was 199 days. T cell immunophenotype and lack of treatment response were predictive of inferior outcomes. AEs were mostly gastrointestinal. Six dogs developed presumed or confirmed pulmonary fibrosis; four were grade 5. One dog experienced grade 3 extravasation injury with RAB that resolved with supportive treatment. These data mirror those of the previously reported RAB/DOX study, and support the finding that alternating RAB/DOX is a reasonable treatment option for canine lymphoma.
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Affiliation(s)
- Corey F Saba
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Timothy M Fan
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Brenda S Phillips
- Veterinary Specialty Hospital of San Diego, San Diego, California, USA
| | | | - Douglas H Thamm
- Colorado State University Flint Animal Cancer Center, Fort Collins, Colorado, USA
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4
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Sztukowski KE, Yaufman Z, Cook MR, Aarnes TK, Husbands BD. Vincristine-induced adverse events related to body weight in dogs treated for lymphoma. J Vet Intern Med 2024; 38:1686-1692. [PMID: 38563346 PMCID: PMC11099714 DOI: 10.1111/jvim.17063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Traditional dosing of chemotherapy drugs based on body surface area may overdose small dogs, leading to an increased frequency of adverse events (AEs). HYPOTHESIS/OBJECTIVES Evaluate the frequency of hematologic and gastrointestinal AEs in dogs with newly diagnosed lymphoma treated with vincristine weighing ≤15 kg in comparison to dogs weighing >15 kg. We hypothesized that dogs weighing ≤15 kg would experience a higher frequency of AEs. ANIMALS One hundred and thirty-eight dogs with newly diagnosed lymphoma were treated with vincristine. METHODS A multicenter retrospective study reviewing hematologic data and medical record information. Complete blood counts were performed no more than 24 hours before vincristine administration and then between 4 and 8 days post-administration. Data were evaluated using logistic regression or ordinal logistic regression. RESULTS Thirty-eight dogs weighing ≤15 kg and 100 dogs weighing >15 kg were included. The median vincristine dose for both groups was 0.6 mg/m2. Seventeen (12.3%) instances of neutropenia occurred with no significant difference in overall frequency or grade between groups. Thirty initially asymptomatic substage A dogs (29.4%) experienced gastrointestinal AEs. Because of the widespread use of gastrointestinal supportive care medications, statistical comparison between groups could not be performed. Seven instances of hospitalization occurred (5.0%) and the risk of hospitalization did not differ significantly between groups (P = .37). CONCLUSIONS AND CLINICAL IMPORTANCE Vincristine dosed at ≤0.6 mg/m2 does not increase the risk of hematologic AEs in dogs weighing ≤15 kg.
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Affiliation(s)
- Keira E. Sztukowski
- Department of Clinical SciencesThe Ohio State University College of Veterinary MedicineColumbusOhioUSA
| | - Zachary Yaufman
- Department of Clinical SciencesThe Ohio State University College of Veterinary MedicineColumbusOhioUSA
- Present address:
Department of Small Animal Clinical SciencesVirginia‐Maryland College of Veterinary MedicineRoanokeVirginiaUSA
| | - Matthew R. Cook
- Nashville Veterinary SpecialistsNashvilleTennesseeUSA
- Present address:
Metropolitan Veterinary HospitalHighland HeightsOhioUSA
| | - Turi K. Aarnes
- Department of Clinical SciencesThe Ohio State University College of Veterinary MedicineColumbusOhioUSA
| | - Brian D. Husbands
- Department of Clinical SciencesThe Ohio State University College of Veterinary MedicineColumbusOhioUSA
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5
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Thamm DH. Novel Treatments for Lymphoma. Vet Clin North Am Small Anim Pract 2024; 54:477-490. [PMID: 38199913 DOI: 10.1016/j.cvsm.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Lymphoma is a common disease in companion animals. While conventional chemotherapy has the potential to induce remission and prolong life, relapse is common and novel treatments are needed to improve outcome. This review discusses recent modifications/adjustments to conventional standard of care therapy for canine and feline lymphoma, options for treatment or relapsed/refractory disease, and cutting-edge immunotherapy and small molecule-based approaches that are in varying stages of regulatory approval.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523-1620 USA.
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6
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Webster J, McNaught KA, Morris JS. Evaluation of a multiagent chemotherapy protocol combining vincristine, cyclophosphamide, mitoxantrone and prednisolone (CMOP) for treatment of feline intermediate-large cell lymphoma. J Feline Med Surg 2024; 26:1098612X241234614. [PMID: 38647264 PMCID: PMC11103311 DOI: 10.1177/1098612x241234614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVES The aim of this study was to determine response rates, median progression-free intervals (PFIs) and median survival times (MSTs) for cats with intermediate-large cell lymphoma treated with a vincristine, cyclophosphamide, mitoxantrone and prednisolone (CMOP) protocol. A secondary objective was to determine the tolerability of mitoxantrone used within this multiagent protocol. METHODS The medical records of 31 cats treated at a single institution between 2009 and 2022 were reviewed to identify suitable cases. Cats were included in the study if they had a confirmed diagnosis of intermediate-large cell lymphoma, had received a CMOP protocol as first-line treatment and had completed at least one 4-week cycle of this protocol. Modifications allowed in the protocol included the use of l-asparaginase, vinblastine substitution for vincristine, chlorambucil substitution for cyclophosphamide and dexamethasone or methylprednisolone substitution for prednisolone. RESULTS The overall response rate was 74% (n = 23), with 45% (n = 14) achieving complete remission (CR), 29% (n = 9) achieving partial remission (PR) and 26% (n = 8) achieving stable disease (SD). The Kaplan-Meier median PFI and MST were 139 days and 206 days, respectively. Responders (CR or PR) had a significantly longer (P <0.001) median PFI and MST compared with non-responders (SD) (176 days vs 62 days, and 251 days vs 61 days, respectively). Cats that achieved CR had a significantly longer median PFI and MST (P <0.001) at 178 days and 1176 days, respectively. The 6-month and 1- and 2-year survival rates in cats with CR were 64%, 57% and 35%, respectively. Treatment with mitoxantrone was generally well tolerated, with no cats experiencing Veterinary Cooperative Oncology Group adverse effects above grade 2. CONCLUSIONS AND RELEVANCE The CMOP protocol is an alternative and well-tolerated treatment for cats with intermediate-large cell lymphoma. As demonstrated with previous chemotherapy protocols, cats that respond to treatment, particularly those that achieve CR, are likely to have more durable responses.
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Affiliation(s)
- Jade Webster
- Small Animal Hospital, University of Glasgow, Glasgow, UK
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7
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Siewert JM, Gustafson DL, Weishaar KM, Galloway AM, Thamm DH. Individualized chemotherapy drug dose escalation in dogs with multicentric lymphoma. J Vet Intern Med 2023; 37:2402-2409. [PMID: 37787577 PMCID: PMC10658528 DOI: 10.1111/jvim.16875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/11/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND This study was performed to determine the ability to escalate drug doses in a 15-week CHOP protocol in dogs with multicentric lymphoma. HYPOTHESIS We hypothesized that at least 50% of dogs could successfully be escalated in at least 1 drug. Secondary aims were to establish objective response rate (ORR), progression-free interval (PFI), and overall survival time (OST). ANIMALS Thirty dogs with newly diagnosed multicentric lymphoma were prospectively treated with a 15-week CHOP protocol. METHODS This was a prospective cohort study. Drug doses that did not cause dose-limiting adverse effects (AEs) were increased using a standardized escalation protocol. AEs and response were assessed using VCOG criteria. Serial blood samples were collected after the first dose of each drug for pharmacokinetic analysis. RESULTS Of the 23 dogs with the opportunity to dose escalate, at least 1 drug was successfully escalated in 18 (78%). Vincristine was successfully escalated to 0.8 mg/m2 or higher in 11 dogs, cyclophosphamide to 300 mg/m2 or higher in 16 dogs, and doxorubicin to 35 mg/m2 or 1.4 mg/kg or higher in 9 dogs. Three of the 23 dogs (13%) were hospitalized at least once because of drug-induced AEs. Neutropenia was the most common dose-limiting toxicosis for all drugs. Peak doxorubicin concentrations were significantly lower in dogs where doxorubicin was successfully escalated. The objective response rate was 100%. The median progression free interval was 171 days. The median overall survival time was 254 days. CONCLUSIONS Drugs in the CHOP protocol can often be escalated safely with manageable AEs.
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Affiliation(s)
- Jacob M. Siewert
- Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
| | - Daniel L. Gustafson
- Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
- University of Colorado Comprehensive Cancer CenterAuroraColoradoUSA
| | | | | | - Douglas H. Thamm
- Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
- University of Colorado Comprehensive Cancer CenterAuroraColoradoUSA
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8
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Bennett P, Williamson P, Taylor R. Review of Canine Lymphoma Treated with Chemotherapy-Outcomes and Prognostic Factors. Vet Sci 2023; 10:vetsci10050342. [PMID: 37235425 DOI: 10.3390/vetsci10050342] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
While canine lymphoma is a relatively common and important disease seen by veterinarians, there are limited comprehensive reviews of the literature regarding the remission and survival times following chemotherapy, and the associated prognostic factors. This comprehensive thematic review covers the available veterinary literature covering treatment outcomes and identified prognostic factors. A lack of standardised approaches to evaluate and report the outcomes was identified, including factors that would alter the duration of responses by weeks, or occasionally months. After publication of the suggested reporting criteria, this has improved but is still not uniformly applied. The prognostic factors included for evaluation varied from as few as three to seventeen, with over 50 studies using only univariate analysis. Individual papers reported much longer outcomes than others, but assessing the outcomes overall, there has been minimal change over the last 40 years. This supports the belief that novel approaches for lymphoma therapy will be required to substantively improve outcomes.
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Affiliation(s)
- Peter Bennett
- The Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, NSW 2006, Australia
- The University of Sydney Nano Institute, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Peter Williamson
- The Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Rosanne Taylor
- The Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown, NSW 2006, Australia
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9
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Veluvolu S, Willcox JL, Skorupski KA, Al-Nadaf S, Rebhun R, Wittenburg L. Fractionated oral dosing and its effect on cyclophosphamide pharmacokinetics in dogs with high-grade multicentric lymphoma. Vet Comp Oncol 2023; 21:20-27. [PMID: 36057542 PMCID: PMC9928601 DOI: 10.1111/vco.12856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/09/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022]
Abstract
Cyclophosphamide (CP) is an alkylating agent commonly included in multi-drug treatment protocols for canine cancer. As a prodrug, CP requires hepatic metabolism for activation to the intermediate compound 4-hydroxycyclophosphamide (4-OHCP) which then spontaneously forms alkylating phosphoramide mustard. CP is frequently administered in a fractionated manner, with the total dose given over multiple days. CP is reported to cause auto-induction of metabolism in humans, with faster CP clearance and relatively increased 4-OHCP formation following fractionated versus bolus dosing, however canine pharmacokinetic studies of CP dose fractionation are lacking. The study objective was to evaluate the pharmacokinetics of fractionated oral CP dosing at a dose of 200-250 mg/m2 over 3 to 4 days in a prospectively identified population of cancer-bearing dogs. Plasma concentrations of CP and 4-OHCP were measured by ultra-high performance liquid chromatography tandem-mass spectrometry in eight dogs following the first and last doses to assess for auto-induction of CP metabolism. No significant difference in the rate of CP elimination between first and last doses were detected (0.73 ± 0.46 vs. 1.22 ± 0.5 h-1 ; p = .125). Additionally, no significant difference in dose-normalized 4-OHCP exposure was identified between first and last doses (5.9 ± 2.1 vs. 7.9 ± 6.4 h × ng/ml; p = .936). These results suggest that fractionated dosing may not increase exposure to the active metabolite of CP in dogs as it does in humans. As such, standard bolus dosing and fractionated dosing may be equivalent in terms of bio-activation of CP in dogs administered a dose of 200-250 mg/m2 .
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Affiliation(s)
- Sridhar Veluvolu
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA
| | - Jennifer L. Willcox
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA,Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
| | - Katherine A. Skorupski
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA,Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
| | - Sami Al-Nadaf
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA,Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
| | - Robert Rebhun
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA,Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
| | - Luke Wittenburg
- Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
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10
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Zaidi B, Mukhopadhyay A, Ramos-Vara JA, Dhawan D, Ruple A, Childress MO. Serum thymidine kinase 1 activity as a prognostic biomarker in dogs with chemotherapy-treated diffuse large B-cell lymphoma. Vet Comp Oncol 2023; 21:200-207. [PMID: 36651594 DOI: 10.1111/vco.12876] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 11/02/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is frequently treated with chemotherapy incorporating cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP), which induces remission in 80% to 95% of cases. However, not all dogs derive meaningful benefit from CHOP, and prognostic factors for dogs with DLBCL are poorly defined. Serum thymidine kinase 1 (TK1) activity, a marker of tumour cell proliferation, has shown promising initial results as a prognostic biomarker in dogs with multicentric lymphomas. The purpose of this study was to determine if baseline serum TK1 activity is associated with clinical outcome in dogs with CHOP-treated DLBCL. Baseline serum TK1 activity was measured in banked sera from 98 dogs with CHOP-treated DLBCL using a commercially available ELISA kit. Data on other potential prognostic factors were abstracted retrospectively from electronic medical records. Multivariable statistical methods were used to identify associations between TK1 and other potential prognostic factors with progression-free survival (PFS) and attainment of complete remission. TK1 activity at baseline was not associated with PFS (p = .299) or attainment of complete remission (p = .910) following CHOP chemotherapy. Of the other prognostic factors analysed, only purebred (vs. mixed breed) status (HR 8.81, 95% CI 1.68-46.30, p = .010), attainment of complete (vs. partial) remission (HR 0.09, 95% CI 0.02-0.49, p = .006), and baseline serum C-reactive protein concentration (HR 1.19, 95% CI 1.07-1.32, p = .001) were independently associated with PFS. Based on these findings, baseline serum TK1 activity does not appear to be a useful prognostic biomarker in dogs with CHOP-treated DLBCL.
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Affiliation(s)
- Bushra Zaidi
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Abhijit Mukhopadhyay
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - José A Ramos-Vara
- Department of Comparative Pathobiology, College of Veterinary, Purdue University, West Lafayette, Indiana, USA
| | - Deepika Dhawan
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Audrey Ruple
- Department of Comparative Pathobiology, College of Veterinary, Purdue University, West Lafayette, Indiana, USA
| | - Michael O Childress
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
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11
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Limmer S, Nerschbach V, Eberle N, Teske E, Simon Betz D. Efficacy and tolerability of a 12-week combination chemotherapy followed by lomustine consolidation treatment in canine B- and T-cell lymphoma. Acta Vet Scand 2022; 64:36. [PMID: 36503518 PMCID: PMC9743771 DOI: 10.1186/s13028-022-00660-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND High-grade lymphoma in dogs is a chemotherapy-responsive neoplasia with remission rates exceeding 80% under combination chemotherapy protocols. Usually these protocols are intensive and 24 + weeks. The objective of the present study was to investigate if a shorter protocol combined with an oral lomustine maintenance treatment (3 × in 8 weeks) would present an acceptable result, both for B- and T-cell lymphomas, and for the different types of lymphomas normally encountered in private veterinary practice. RESULTS 144 dogs entered the study. Lymphoma types included multicentric (n = 123), alimentary (n = 13), miscellaneous (n = 7), and mediastinal lymphoma (n = 1). Overall response rate was 83.3% (B-cell: 86.6%, T-cell: 79.4%). Complete remission (CR) was achieved in 72.2% (B-cell: 77.3%, T-cell: 67.6%) and partial remission (PR) in 11.1% (B-cell: 9.3%, T-cell: 11.8%) of the dogs. Median duration of first CR amounted to 242 days (B-cell: 263 d, T-cell: 161 d). Median survival in dogs with CR was 374 days (B-cell: 436 d, T-cell: 252 d), and median overall survival time was 291 days (B-cell: 357d, T-cell: 210d). Immunophenotype demonstrated an independent significant influence on duration of remission and survival in the whole group. Findings of splenic and hepatic cytology were not significant associated with patient outcome. Treatment was well tolerated; the majority of adverse events were classified as grade 1 or 2. CONCLUSIONS Short-term chemotherapy followed by lomustine consolidation leads to compara-ble remission and survival times compared to conventional protocols with cyclophosphamide, doxorubicin, vincristine and prednisolone with acceptable toxicosis in dogs with both B-cell and T-cell lymphoma.
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Affiliation(s)
- Stefanie Limmer
- grid.412970.90000 0001 0126 6191Small Animal Hospital, University of Veterinary Medicine Hannover, Bünteweg 9, Gebäude 280, 30559 Hannover, Germany
| | - Verena Nerschbach
- grid.412970.90000 0001 0126 6191Small Animal Hospital, University of Veterinary Medicine Hannover, Bünteweg 9, Gebäude 280, 30559 Hannover, Germany
| | - Nina Eberle
- Center for Small Animal Medicine, VetSpezial, Im Kornfeld 7, 31275 Lehrte, Germany
| | - Erik Teske
- grid.5477.10000000120346234Department of Clinical Sciences, Veterinary Faculty, Utrecht University, P.O. Box 80.154, 3508TD Utrecht, The Netherlands
| | - Daniela Simon Betz
- grid.412970.90000 0001 0126 6191Small Animal Hospital, University of Veterinary Medicine Hannover, Bünteweg 9, Gebäude 280, 30559 Hannover, Germany ,Independent Scientific Writing, Translation & Consultancy Clinical Oncology, Bünteweg 9, Gebäude 280, 30559 Hannover, Germany
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12
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Rout ED, Fernandez M, Yoshimoto JA, Hughes KL, Avery AC, Burton JH. Clinical outcome and Ki67 evaluation in dogs with nodal small cell B-cell lymphoma diagnosed by flow cytometry. Vet Med (Auckl) 2022; 36:1770-1781. [PMID: 35996942 PMCID: PMC9511060 DOI: 10.1111/jvim.16515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022]
Abstract
Background Nodal small cell B‐cell lymphoma subtypes in dogs cannot be distinguished by flow cytometry and information regarding treatment, prognosis, and outcome are limited. Hypothesis/Objectives Objectives were to describe outcome in dogs with nodal small cell B‐cell lymphoma diagnosed by flow cytometry and correlate clinical and laboratory data with survival. We hypothesized that B‐cell Ki67 expression measured by flow cytometry is associated with shorter progression free survival (PFS) and overall survival (OS). Animals Forty‐nine dogs with nodal small cell B‐cell lymphoma, defined by >80% CD21+ B‐cells by flow cytometry and small‐sized B‐cells by forward scatter. Methods Retrospective study reviewing treatment and outcome data extracted from medical records. Percentage of Ki67‐expressing B‐cells was measured by flow cytometry. Clinical, laboratory, and flow cytometry data were assessed for association with outcome. Results Median percentage of B‐cell Ki67 was 41% (range, 3%‐97%). Median PFS was 119 days and median OS was 222 days (n = 49). Among cases treated with CHOP‐based chemotherapy (n = 32), median PFS was 70 days, median OS was 267 days, and 50% of cases achieved complete response. Low percentage of B‐cell Ki67 (≤11%) was associated with prolonged OS by univariable analysis. Greater age, substage B, high B‐cell CD25 expression and low B‐cell CD21 and class II major histocompatibility complex expression by flow cytometry were independently associated with shorter OS. Conclusions and Clinical Importance Most nodal small cell B‐cell lymphoma cases had aggressive disease. Low Ki67 expression can help identify cases with better prognosis. Age, substage, and flow cytometry variables are useful prognostic factors.
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Affiliation(s)
- Emily D Rout
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Monica Fernandez
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Janna A Yoshimoto
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Kelly L Hughes
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Anne C Avery
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Jenna H Burton
- Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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13
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Chu S, Avery A, Yoshimoto J, Bryan JN. Genome wide exploration of the methylome in aggressive B-cell lymphoma in Golden Retrievers reveals a conserved hypermethylome. Epigenetics 2022; 17:2022-2038. [PMID: 35912844 PMCID: PMC9665123 DOI: 10.1080/15592294.2022.2105033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Few recurrent DNA mutations are seen in aggressive canine B cell lymphomas (cBCL), suggesting other frequent drivers. The methylated island recovery assay (MIRA-seq) or methylated CpG-binding domain sequencing (MBD-seq) was used to define the genome-wide methylation profiles in aggressive cBCL in Golden Retrievers to determine if cBCL can be better defined by epigenetic changes than by DNA mutations. DNA hypermethylation patterns were relatively homogenous within cBCL samples in Golden Retrievers, in different breeds and in geographical regions. Aberrant hypermethylation is thus suspected to be a central and early event in cBCL lymphomagenesis. Distinct subgroups within cBCL in Golden Retrievers were not identified with DNA methylation profiles. In comparison, the methylome profile of human DLBCL (hDLBCL) is relatively heterogeneous. Only moderate similarity between hDLBCL and cBCL was seen and cBCL likely cannot be accurately classified into the subtypes seen in hDLBCL. Genes with hypermethylated regions in the promoter-TSS-first exon of cBCL compared to normal B cells often also had additional hyper- and hypomethylated regions distributed throughout the gene suggesting non-randomized repeat targeting of key genes by epigenetic mechanisms. The prevalence of hypermethylation in transcription factor families in aggressive cBCL may represent a fundamental step in lymphomagenesis.
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Affiliation(s)
- Shirley Chu
- Department of Veterinary Medicine and Surgery, University of Missouri, 900 E. Campus Drive, Columbia, MO, USA
| | - Anne Avery
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Janna Yoshimoto
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Jeffrey N Bryan
- Department of Veterinary Medicine and Surgery, University of Missouri, 900 E. Campus Drive, Columbia, MO, USA
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14
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Park JH, Lee JH, An JH, Park CW, Choi YP, Seo SW, Lee HW, Youn HY. Anticancer activity of IRAK-4 inhibitors against canine lymphoid malignancies. Vet Comp Oncol 2022; 20:632-640. [PMID: 35340094 DOI: 10.1111/vco.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 02/24/2022] [Accepted: 03/15/2022] [Indexed: 11/27/2022]
Abstract
The interleukin-1 receptor-related kinase 4 (IRAK4), downstream of myd88, plays an essential role in hyperactive TLR signaling seen in some B-cell lymphomas. In particular, efficient IRAK4 inhibitors of activated B-cell subtype of human diffuse large B-Cell lymphoma (DLBCL) are being developed. However, the anticancer effect of IRAK-4 inhibitors in veterinary medicine has not been elucidated. It is therefore explored in this study involving the GL-1 and CL-1 canine lymphoma cell lines in vitro. MyD88 expression was analysed using polymerase chain reaction. GL-1 and CL-1 cells were subjected to concentration- and time-dependent treatment with an IRAK-4 inhibitor and assessed for viability, TLR signalling association, and apoptosis using a cell counting Kit-8 assay, Western blotting, and flow cytometry. The GL-1 and CL-1 cells exhibited enhanced MyD88 expression, however, canine peripheral blood mononuclear cells (cPBMCs) did not. The IRAK-4 inhibitor reduced cell viability in a dose- and time-dependent manner, significantly reduced the phosphorylation of molecules associated with TLR signalling at IC50 such as IRAK1, IRAK4, NF-κB and STAT3, and induced apoptosis in GL-1 and CL-1 cells. The anticancer effect of the IRAK-4 inhibitor on canine lymphoma cells is mediated by apoptosis via downregulation of TLR signalling. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jun-Hyeong Park
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Jeong-Hwa Lee
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Ju-Hyun An
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Chong-Woo Park
- Future Medicine Co., Ltd., 54, Changup-ro, Sujung-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Yoon-Pyo Choi
- Future Medicine Co., Ltd., 54, Changup-ro, Sujung-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seong-Wook Seo
- Future Medicine Co., Ltd., 54, Changup-ro, Sujung-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Hyuk-Woo Lee
- Future Medicine Co., Ltd., 54, Changup-ro, Sujung-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Hwa-Young Youn
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
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15
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Weishaar KM, Wright ZM, Rosenberg MP, Post GS, McDaniel JA, Clifford CA, Phillips BS, Bergman PJ, Randall EK, Avery AC, Thamm DH, Christman Hull AA, Gust CM, Donoghue AR. Multicenter, randomized, double‐blinded, placebo‐controlled study of rabacfosadine in dogs with lymphoma. J Vet Intern Med 2021; 36:215-226. [PMID: 34952995 PMCID: PMC8783351 DOI: 10.1111/jvim.16341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background Rabacfosadine (RAB, Tanovea‐CA1) is a novel chemotherapy agent conditionally approved for the treatment of lymphoma in dogs. Hypothesis/Objectives To determine the efficacy and safety of RAB in dogs with lymphoma. Animals One hundred and fifty‐eight client‐owned dogs with naïve or relapsed multicentric lymphoma were prospectively enrolled from January to October 2019. Methods Dogs were randomized to receive RAB or placebo at a 3 : 1 ratio. Treatment was given every 21 days for up to 5 treatments. Study endpoints included progression‐free survival (PFS), overall response rate (ORR) at a given visit, best overall response rate (BORR), and percent progression free 1 month after treatment completion. Safety data were also collected. Results The median PFS was significantly longer in the RAB group compared to placebo (82 vs 21 days; P < .0001, HR 6.265 [95% CI 3.947‐9.945]). The BORR for RAB‐treated dogs was 73.2% (50.9% complete response [CR], 22.3% partial response [PR]) and 5.6% (0% CR, 5.6% PR) for placebo‐treated dogs (P < .0001). One month after the last treatment, 37 RAB‐treated dogs (33%) were progression free compared with no placebo‐treated dogs (P < .0001). The most common adverse events observed in the RAB group were diarrhea (87.5%), decreased appetite (68.3%), and vomiting (68.3%) and were generally low grade and reversible. Serious adverse events were reported in 24 RAB‐treated (20%) and 5 placebo‐treated dogs (13%). Conclusions and Clinical Importance Rabacfosadine demonstrated statistically significant antitumor efficacy in dogs with lymphoma when administered every 21 days for up to 5 treatments as compared to placebo.
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Affiliation(s)
- Kristen M. Weishaar
- Flint Animal Cancer Center Colorado State University Fort Collins Colorado USA
| | | | | | | | | | | | | | | | - Elissa K. Randall
- Department of Radiology Colorado State University Fort Collins Colorado USA
| | - Anne C. Avery
- Department of Microbiology, Immunology, and Pathology Colorado State University Fort Collins Colorado USA
| | - Douglas H. Thamm
- Flint Animal Cancer Center Colorado State University Fort Collins Colorado USA
| | | | - Cathy M. Gust
- GustPMConsulting, LLC Westlake Village California USA
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Koo J, Choi K, Lee P, Polley A, Pudupakam RS, Tsang J, Fernandez E, Han EJ, Park S, Swartzfager D, Qi NSX, Jung M, Ocnean M, Kim HU, Lim S. Predicting Dynamic Clinical Outcomes of the Chemotherapy for Canine Lymphoma Patients Using a Machine Learning Model. Vet Sci 2021; 8:vetsci8120301. [PMID: 34941828 PMCID: PMC8704313 DOI: 10.3390/vetsci8120301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022] Open
Abstract
First-line treatments of cancer do not always work, and even when they do, they cure the disease at unequal rates mostly owing to biological and clinical heterogeneity across patients. Accurate prediction of clinical outcome and survival following the treatment can support and expedite the process of comparing alternative treatments. We describe the methodology to dynamically determine remission probabilities for individual patients, as well as their prospects of progression-free survival (PFS). The proposed methodology utilizes the ex vivo drug sensitivity of cancer cells, their immunophenotyping results, and patient information, such as age and breed, in training machine learning (ML) models, as well as the Cox hazards model to predict the probability of clinical remission (CR) or relapse across time for a given patient. We applied the methodology using the three types of data obtained from 242 canine lymphoma patients treated by (L)-CHOP chemotherapy. The results demonstrate substantial enhancement in the predictive accuracy of the ML models by utilizing features from all the three types of data. They also highlight superior performance and utility in predicting survival compared to the conventional stratification method. We believe that the proposed methodology can contribute to improving and personalizing the care of cancer patients.
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Affiliation(s)
- Jamin Koo
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
- ImpriMedKorea, Inc., Seoul Startup Hub, Seoul 04147, Korea;
- Department of Chemical Engineering, Hongik University, Seoul 04066, Korea
| | - Kyucheol Choi
- ImpriMedKorea, Inc., Seoul Startup Hub, Seoul 04147, Korea;
| | - Peter Lee
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Amanda Polley
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Raghavendra Sumanth Pudupakam
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Josephine Tsang
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Elmer Fernandez
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Enyang James Han
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Stanley Park
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Deanna Swartzfager
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Nicholas Seah Xi Qi
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Melody Jung
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Mary Ocnean
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Hyun Uk Kim
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea;
| | - Sungwon Lim
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
- ImpriMedKorea, Inc., Seoul Startup Hub, Seoul 04147, Korea;
- Correspondence:
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17
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Chavalle T, Chamel G, Denoeux P, Lajoinie M, Sayag D, Berny P, Ponce F. Are severe adverse events commonly observed in dogs during cancer chemotherapy? A retrospective study on 155 dogs. Vet Comp Oncol 2021; 20:393-403. [PMID: 34775666 DOI: 10.1111/vco.12782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 11/29/2022]
Abstract
Overall prevalence of severe adverse events (sAE) has been poorly studied in veterinary medicine and peer-reviewed studies mostly focused on a single protocol, making it difficult to have a general overview. The aim of this retrospective study was to assess the frequency and risk factors of sAE secondary to various protocols of chemotherapy in dogs. Medical records of 155 dogs receiving chemotherapy between January 2013 and December 2018 were reviewed. Adverse events (AE) were graded according to Veterinary Comparative Oncology Group-common terminology criteria for AE (VCOG-CTCAE) grading system. Statistical analyses were performed to determine whether demographic, cancer type and chemotherapy protocol were associated with development of sAE and their consequences. AE were reported at least once in 124 (80%) dogs and sAE were observed in 50 (32.3%) dogs. Among them, 23 (14.8%) had gastro-intestinal and 31 (20.0%) had myelotoxic events. sAE led to hospitalisation in 37 (23.9%) dogs, to chemotherapy arrest in 12 (7.7%) dogs and to euthanasia or death in 9 (5.8%) dogs. Haematopoietic tumours were statistically associated with a higher frequency of sAE (p = .004), gastrointestinal sAE (p = .009) and hospitalisation (p = .004). A body weight over 10 kg was associated with less haematological sAE (p < .001). The use of a multi-agent protocol was highlighted as a risk factor for sAE (p = .038) and haematological sAE (p < .001). sAE following chemotherapy and leading to hospitalisation, chemo arrest or death were relatively common. A special attention during chemotherapy follow-up should be given to small dogs and those receiving multi-agent protocol or treated for haematopoietic tumours.
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Affiliation(s)
- Thomas Chavalle
- Service de cancérologie, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | - Gabriel Chamel
- Service de cancérologie, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France.,UR ICE, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | - Pauline Denoeux
- Service de cancérologie, Centre Hospitalier Vétérinaire Atlantia, Nantes, France
| | - Mathilde Lajoinie
- Service de cancérologie, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | - David Sayag
- ONCOnseil - Unité d'expertise en oncologie vétérinaire, Toulouse, France
| | - Philippe Berny
- UR ICE, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
| | - Frédérique Ponce
- Service de cancérologie, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France.,UR ICE, VetAgro Sup, Université de Lyon, Marcy l'Etoile, France
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18
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Blaxill J, Buzzacott P, Finlay J. Prognostic indicators for naïve canine non-indolent T-cell lymphoma treated with combination lomustine, vincristine, procarbazine and prednisolone chemotherapy. Vet Comp Oncol 2021; 20:215-226. [PMID: 34464024 DOI: 10.1111/vco.12768] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022]
Abstract
Lomustine, vincristine, procarbazine and prednisolone (LOPP) chemotherapy has been suggested to be an effective treatment for dogs with naïve non-indolent T-cell lymphoma (TCL). Studies evaluating prognostic factors for dogs with TCL treated with LOPP chemotherapy are lacking. The aim of this retrospective study was to assess potential prognostic factors for canine naïve non-indolent TCL treated with the LOPP protocol. This was a retrospective cohort study of naïve non-indolent TCL treated with the LOPP chemotherapy protocol at a single specialty veterinary oncology clinic. Sixty-seven dogs met the inclusion criteria. The outcomes assessed included progression free survival (PFS), overall survival time (OST) and duration of complete response (DCR). The overall median PFS was 118 days (range 7-2302 days). The median OST was 202 days (range 8-2302 days). The overall median DCR was 316 days (range 38-2261 days). Number of treatments administered (p < .0001), multicentric disease (p = .044) and the presence of hypercalcaemia (p = .006) were prognostic indicators for PFS. Increasing number of treatments (p < .0001) and age (p = .0088) were prognostic indicators for OST. To our knowledge, this is the first study to describe hypercalcaemia as a positive prognostic indicator of PFS for TCL treated with LOPP chemotherapy. LOPP chemotherapy can be considered as a first-line treatment protocol against naïve hypercalcaemic non-indolent TCL.
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Affiliation(s)
- John Blaxill
- University of Sydney Veterinary Teaching Hospital, Sydney, New South Wales, Australia
| | - Peter Buzzacott
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
| | - Jessica Finlay
- Perth Veterinary Specialists, Osborne Park, Western Australia, Australia
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19
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Lee JJ, Liao AT, Wang SL. L-Asparaginase, Doxorubicin, Vincristine, and Prednisolone (LHOP) Chemotherapy as a First-Line Treatment for Dogs with Multicentric Lymphoma. Animals (Basel) 2021; 11:ani11082199. [PMID: 34438662 PMCID: PMC8388373 DOI: 10.3390/ani11082199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022] Open
Abstract
Cyclophosphamide exhibits the weakest therapeutic effect compared with vincristine and doxorubicin in the CHOP (C, cyclophosphamide; H, doxorubicin; O, vincristine; and P, prednisolone) chemotherapeutic protocol for the treatment of canine lymphoma. Twenty dogs with multicentric lymphoma were treated using the LHOP protocol, which used l-asparaginase in place of cyclophosphamide, and the outcomes were historically compared with those of dogs that received CHOP chemotherapy in the same institution. No significant differences were found in age (p = 0.107), body weight (p = 0.051), sex (p = 0.453), clinical stage V (p = 1), substage b (p = 0.573), T-cell phenotype (p = 0.340), overall response (p = 1), and hypercalcaemia status (p = 1) between the LHOP and CHOP groups. The adverse effects of l-asparaginase were well tolerated and self-limiting. The median PFS (progression-free survival) and median ST (survival time) in the LHOP group were 344 days (range: 28-940 days) and 344 days (range: 70-940 days), respectively. The median PFS and median ST in the CHOP group were 234 days (range: 49-1822 days) and 314 days (range: 50-1822 days), respectively. The dogs that received LHOP chemotherapy had a significantly longer PFS than the dogs that received CHOP chemotherapy (p = 0.001). No significant difference was observed in ST between the LHOP and CHOP groups (p = 0.131). Our study findings thus indicate that the LHOP protocol can be used as a first-line chemotherapeutic protocol in canine multicentric lymphoma.
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Affiliation(s)
- Jih-Jong Lee
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan;
- Animal Cancer Center, College of Bioresources and Agriculture, National Taiwan University, Taipei 10617, Taiwan;
- National Taiwan University Veterinary Hospital, College of Bioresources and Agriculture, National Taiwan University, Taipei 10672, Taiwan
| | - Albert Taiching Liao
- Animal Cancer Center, College of Bioresources and Agriculture, National Taiwan University, Taipei 10617, Taiwan;
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Shang-Lin Wang
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan;
- Animal Cancer Center, College of Bioresources and Agriculture, National Taiwan University, Taipei 10617, Taiwan;
- National Taiwan University Veterinary Hospital, College of Bioresources and Agriculture, National Taiwan University, Taipei 10672, Taiwan
- Correspondence: ; Tel.: +886-2-27396828 (ext. 4040)
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20
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Rassnick KM, Bailey DB, Kamstock DA, LeBlanc CJ, Berger EP, Flory AB, Kiselow MA, Intile JL, Malone EK, Regan RC, Musser ML, Yanda N, Johannes CM. Survival time for dogs with previously untreated, peripheral nodal, intermediate- or large-cell lymphoma treated with prednisone alone: the Canine Lymphoma Steroid Only trial. J Am Vet Med Assoc 2021; 259:62-71. [PMID: 34125606 DOI: 10.2460/javma.259.1.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate survival times for dogs with previously untreated, peripheral nodal, intermediate- or large-cell lymphoma treated with prednisone alone. ANIMALS 109 client-owned dogs recruited from 15 institutions in the United States. PROCEDURES Dogs were treated with prednisone at a dosage of 40 mg/m2, PO, once daily for 7 days and at a dosage of 20 mg/m2, PO, once daily thereafter. Quality of life (QOL) was assessed by owners with a visual analog scale when treatment was started (day 0), 1 and 2 weeks after treatment was started, and every 4 weeks thereafter. The primary outcome of interest was survival time as determined by the Kaplan-Meier method. Factors potentially associated with survival time were examined. RESULTS Median overall survival time was 50 days (95% CI, 41 to 59 days). Factors associated with survival time included substage (a vs b) and immunophenotype (B cell vs T cell). Owner-assigned QOL scores on days 0 and 14 were significantly positively correlated with survival time. When QOL score was dichotomized, dogs with day 0 or day 14 QOL scores ≥ 50 had significantly longer survival times, compared with dogs with day 0 or day 14 QOL scores < 50. No variables were predictive of long-term (> 120 days) survival. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that survival times were short for dogs with previously untreated, peripheral nodal, intermediate- or large-cell lymphoma treated with prednisone alone. Owner-perceived QOL and clinician-assigned substage were both associated with survival time. Findings provide potentially important information for clinicians to discuss with owners of dogs with lymphoma at the time treatment decisions are made.
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21
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Morinaga Y, Igase M, Yanase T, Sakai Y, Sakai H, Fujiwara-Igarashi A, Tsujimoto H, Okuda M, Mizuno T. Expression of DEP Domain-Containing 1B in Canine Lymphoma and Other Types of Canine Tumours. J Comp Pathol 2021; 185:55-65. [PMID: 34119232 DOI: 10.1016/j.jcpa.2021.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/08/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
Canine lymphoma is the most common haematological malignancy in dogs and is typically treated with multidrug chemotherapy. Most cases are at risk of relapse after several courses of chemotherapy and the oncogenic mechanism remains unknown. This study was aimed at identifying genes expressed in canine lymphoma by cDNA microarray. We found elevated expression of Dishevelled, EGL-10 and pleckstrin (DEP) domain-containing 1B (DEPDC1B) in canine lymphoma cells compared with cells and tissues from healthy dogs. Canine DEPDC1B protein was detected in 13 of 41 lymphoma specimens by immunohistochemistry, but was not detected in lymph nodes from normal dogs. Immunoreactive DEPDC1B protein was also detected in several other types of canine tumour. This is the first report documenting the association of DEPDC1B with canine cancer and the results suggest that DEPDC1B might serve as a potential marker or therapeutic target for canine malignancies.
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Affiliation(s)
- Yuki Morinaga
- Laboratory of Molecular Diagnostics and Therapeutics, Japan
| | - Masaya Igase
- Laboratory of Molecular Diagnostics and Therapeutics, Japan
| | - Takuma Yanase
- Laboratory of Molecular Diagnostics and Therapeutics, Japan
| | - Yusuke Sakai
- Laboratory of Veterinary Pathology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Hiroki Sakai
- Laboratory of Veterinary Pathology, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
| | - Aki Fujiwara-Igarashi
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Hajime Tsujimoto
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Masaru Okuda
- Laboratory of Veterinary Internal Medicine, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Takuya Mizuno
- Laboratory of Molecular Diagnostics and Therapeutics, Japan.
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22
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Benjamin SE, Sorenmo KU, Krick EL, Salah P, Walsh KA, Weinstein NM, Keuler NS, Avery AC, Atherton MJ, Lenz JA. Response-based modification of CHOP chemotherapy for canine B-cell lymphoma. Vet Comp Oncol 2021; 19:541-550. [PMID: 33729654 DOI: 10.1111/vco.12693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/10/2021] [Accepted: 03/14/2021] [Indexed: 12/24/2022]
Abstract
Despite high initial response rates, a subset of dogs with B-cell lymphoma responds less robustly to CHOP-based chemotherapy and experiences shorter survival. One hundred and four dogs with nodal B-cell lymphoma were treated with a response-based CHOP (RBCHOP) protocol modified based on response to individual drugs during the first chemotherapy cycle. Dogs achieving complete (CR) or partial response (PR) at week 3, following treatment with vincristine and cyclophosphamide, received RBCHOP 1 (n = 72), a protocol sequentially rotating vincristine, cyclophosphamide, and doxorubicin. Dogs without a detectable response at week 3 that subsequently achieved CR or PR following treatment with doxorubicin received RBCHOP 2 (n = 14), in which four doses of doxorubicin were given consecutively followed by vincristine and cyclophosphamide. Dogs that failed to respond at week 3 and then to doxorubicin at week 5 assessment were offered rescue chemotherapy (RBCHOP 3, n = 18). Median progression free survival (PFS) and overall survival time (OST) were similar between RBCHOP 1 (PFS 210 days, OST 354 days) and RBCHOP 2 (PFS 220 days, OST 456 days), but significantly shorter for RBCHOP 3 (PFS 34 days, OST 80.5 days, P < 0.001). No presenting signalment nor hematologic variable differentiated patient cohort, however, dogs in RBCHOP 2 and RBCHOP 3 were more likely to have a lymphocytosis at diagnosis (P = 0.02 and 0.04, respectively). Protocol modification based on response during the first cycle resulted in similar toxicity profiles and outcomes to previously published variants of CHOP, and prognosis remained poor for dogs failing to respond during the first treatment cycle.
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Affiliation(s)
- Sarah E Benjamin
- Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Karin U Sorenmo
- Department of Biomedical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Erika L Krick
- Department of Oncology, Mount Laurel Animal Hospital, Mt Laurel Township, New Jersey, USA
| | - Pascale Salah
- Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Koranda A Walsh
- Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Nicole M Weinstein
- Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas S Keuler
- Department of Statistics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Anne C Avery
- Department of Microbiology, Immunology & Pathology, Colorado State University College of Veterinary Medicine & Biomedical Sciences, Fort Collins, Colorado, USA
| | - Matthew J Atherton
- Department of Biomedical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Jennifer A Lenz
- Department of Clinical Science & Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
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Henriques J, Felisberto R, Constantino-Casas F, Cabeçadas J, Dobson J. Peripheral blood cell ratios as prognostic factors in canine diffuse large B-cell lymphoma treated with CHOP protocol. Vet Comp Oncol 2020; 19:242-252. [PMID: 33247533 DOI: 10.1111/vco.12668] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/07/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common haematopoietic tumour in dogs and recognized as clinical model for its human counterpart. Recently, neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte (LMR) ratios have been shown to predict time-to-progression (TTP) and lymphoma-specific survival (LSS) in dogs with DLBCL treated with CHOP-based chemotherapy. We retrospectively evaluated in 59 dogs diagnosed with DLBCL the prognostic value of haematological parameters and derived ratios: NLR, LMR, platelet-to-lymphocyte (PLR) and platelet-to-neutrophil (PNR) ratios for TTP, LSS and associated secondary end-points (time-to-progression-rate [TTPR] and lymphoma-specific survival-rate [LSSR]) as rates at 180 and 365 days. PNR is an independent prognostic marker (p ≤ .001) for TTPR/180 and 365 days, dogs with a PNR above 0.032 were more likely to progress before 180 days (sensitivity 46.5%, specificity 87.5%, p = .004). On univariate analysis, NLR showed a prognostic significance for LSSR/180 (p = .006) and LSSR/365 (p = .009). A baseline NLR value below 7.45 was positively associated with survival at 180 days (sensitivity 52%, specificity 85.3%, p = .025). The presence of substage b, was associated with early progression and decreased survival at 180 days (p = .031). Anaemia significantly reduced LSSR at 365 days (p = .028). This is the first study evaluating PLR and PNR in canine DLBCL and demonstrates that PNR could be a predictor of early lymphoma progression. Since peripheral blood cell composition can be affected by several non-oncological causes, the development of larger multicenter studies with homogeneous inclusion criteria could help to better determine the true predictive values of blood cell ratios in dogs' DLBCL treated with CHOP chemotherapy.
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Affiliation(s)
| | | | | | - José Cabeçadas
- Instituto Português de Oncologia de Lisboa, Serviço de Anatomia Patológica, IPO-FG-Lisboa, Lisbon, Portugal
| | - Jane Dobson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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24
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Liquid biopsy based on small extracellular vesicles predicts chemotherapy response of canine multicentric lymphomas. Sci Rep 2020; 10:20371. [PMID: 33230132 PMCID: PMC7683601 DOI: 10.1038/s41598-020-77366-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 11/04/2020] [Indexed: 12/11/2022] Open
Abstract
Lymphoma is the most common type of canine hematological malignancy where the multicentric (cMCL) form accounts for 75% of all cases. The standard treatment is the CHOP chemotherapy protocols that include cyclophosphamide, doxorubicin, vincristine and prednisone, where the majority of dogs achieve complete/partial response; however, it is very important to predict non-responsive cases to improve treatment and to develop new targeted therapies. Here we evaluate a liquid biopsy approach based on serum Small Extracellular Vesicles enriched for exosomes (SEVs) to predict cMCL chemotherapy response. Nineteen dogs at the end of the 19-week chemotherapy protocol (8 Complete Response and 11 Progressive Disease) were evaluated for serum SEVs size, concentration and screened for 95 oncomirs. PD patients had higher SEVs concentration at the diagnosis than CR patients (P = 0.034). The ROC curve was significant for SEVs concentration to predict the response to CHOP (AUC = 0.8011, P = 0.0287). A potential molecular signature based on oncomirs from SEVs (caf-miR-205, caf-miR-222, caf-mir-20a and caf-miR-93) is proposed. To the best of our knowledge, this is the first study demonstrating the potential of a liquid biopsy based on SEVs and their miRNAs content to predict the outcome of chemotherapy for canine multicentric lymphomas.
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25
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Hsu CH, Tomiyasu H, Lee JJ, Tung CW, Liao CH, Chuang CH, Huang LY, Liao KW, Chou CH, Liao ATC, Lin CS. Genome-wide DNA methylation analysis using MethylCap-seq in canine high-grade B-cell lymphoma. J Leukoc Biol 2020; 109:1089-1103. [PMID: 33031589 DOI: 10.1002/jlb.2a0820-673r] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 08/11/2020] [Accepted: 09/18/2020] [Indexed: 01/01/2023] Open
Abstract
DNA methylation is a comprehensively studied epigenetic modification and plays crucial roles in cancer development. In the present study, MethylCap-seq was used to characterize the genome-wide DNA methylation patterns in canine high-grade B-cell lymphoma (cHGBL). Canine methylated DNA fragments were captured and the MEDIUM-HIGH and LOW fraction of methylated DNA was obtained based on variation in CpG methylation density. In the MEDIUM-HIGH and LOW fraction, 2144 and 1987 cHGBL-specific hypermethylated genes, respectively, were identified. Functional analysis highlighted pathways strongly related to oncogenesis. The relevant signaling pathways associated with neuronal system were also revealed, echoing recent novel findings that neurogenesis plays key roles in tumor establishment. In addition, 14 genes were hypermethylated in all the cHGBL cases but not in the healthy dogs. These genes might be potential signatures for tracing cHGBL, and some of them have been reported to play roles in various types of cancers. Further, the distinct methylation pattern of cHGBL showed a concordance with the clinical outcome, suggesting that aberrant epigenetic changes may influence tumor behavior. In summary, our study characterized genome-wide DNA methylation patterns using MethylCap-seq in cHGBL; the findings suggest that specific DNA hypermethylation holds promise for dissecting tumorigenesis and uncovering biomarkers for monitoring the progression of cHGBL.
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Affiliation(s)
- Chia-Hsin Hsu
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Hirotaka Tomiyasu
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Jih-Jong Lee
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Chun-Wei Tung
- Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Chi-Hsun Liao
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Hsun Chuang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Ling-Ya Huang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Kuang-Wen Liao
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Chung-Hsi Chou
- Zoonoses Research Center and School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Albert T C Liao
- Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Chen-Si Lin
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
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26
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Lee WS, Lee JJ, Liao AT, Kao CL, Wang SL. Association between weight change during initial chemotherapy and clinical outcome in dogs with multicentric lymphoma. Vet Comp Oncol 2020; 19:53-60. [PMID: 32654343 DOI: 10.1111/vco.12637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/14/2020] [Accepted: 07/08/2020] [Indexed: 11/27/2022]
Abstract
The majority of the known prognostic factors in dogs with lymphoma have been evaluated before treatment commences or at the time of diagnosis. Prognostic factors evaluated during the initial phase of treatment are less described but may provide important clinical information. In this retrospective study, 82 canine lymphoma patients were categorized according to the weight change between diagnosis and after 5 weeks of chemotherapy. Dogs that gained greater than 5% or lost greater than 5% of initial body weight were categorized as increased- or decreased-weight groups, respectively. Those in which weight changed less than 5% were categorized as the maintained-weight group. The median progression-free survival (PFS) in the increased-weight group, maintained-weight group and decreased-weight group was 226, 256 and 129 days, respectively. The decreased-weight group had significantly shorter PFS than the increased and maintained groups (P = .023, P = .003, respectively). The median survival time (ST) in the increased-weight group, maintained-weight group and decreased-weight group was 320, 339 and 222 days, respectively. There was no significant difference in ST among the three groups (P = .128). In Cox-regression results, weight change group and initial body weight were significant risk factors associated to PFS (P = .007, P = .001, respectively) while only patient's initial body weight was a significant risk factor to ST (P = .013). In conclusion, evaluation of initial body weight and weight changes over time can provide valuable information regarding PFS and ST in dogs with multicentric lymphoma.
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Affiliation(s)
- Wei-Shan Lee
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Jih-Jong Lee
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC.,Animal Cancer Center, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan, ROC.,National Taiwan University Veterinary Hospital, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan, ROC
| | - Albert Taiching Liao
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC.,Animal Cancer Center, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan, ROC
| | - Chia-Lien Kao
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC.,National Taiwan University Veterinary Hospital, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan, ROC
| | - Shang-Lin Wang
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC.,Animal Cancer Center, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan, ROC.,National Taiwan University Veterinary Hospital, College of Bioresources and Agriculture, National Taiwan University, Taipei, Taiwan, ROC
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27
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Campbell O, MacDonald VS, Dickinson RM, Gagnon J. Evaluation of the effect of vincristine on platelet count in dogs with lymphoma. J Small Anim Pract 2019; 60:734-738. [PMID: 31737905 DOI: 10.1111/jsap.13080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 08/23/2019] [Accepted: 08/30/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To determine the effect of vincristine administration on the platelet count, platelet morphology and incidence of thrombocytopenia in dogs diagnosed with lymphoma. MATERIAL AND METHODS Medical records of 59 dogs with lymphoma receiving vincristine sulphate were reviewed retrospectively. RESULTS Following vincristine administration the platelet count was higher and the number of thrombocytopenic patients was lower. No difference was found in the number of dogs with enlarged and elliptical platelets following vincristine treatment. CLINICAL SIGNIFICANCE Vincristine administration increases platelet counts in dogs with lymphoma. It is not contra-indicated to administer vincristine to dogs with lymphoma that are thrombocytopenic.
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Affiliation(s)
- O Campbell
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5B4, Canada
| | - V S MacDonald
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5B4, Canada
| | - R M Dickinson
- Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5B4, Canada
| | - J Gagnon
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5B4, Canada
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28
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Thamm DH, Gustafson DL. Drug dose and drug choice: Optimizing medical therapy for veterinary cancer. Vet Comp Oncol 2019; 18:143-151. [PMID: 31487110 DOI: 10.1111/vco.12537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/29/2019] [Accepted: 09/02/2019] [Indexed: 12/18/2022]
Abstract
Although novel agents hold great promise for the treatment of animal neoplasia, there may be room for significant improvement in the use of currently available agents. These improvements include altered dosing schemes, novel combinations, and patient-specific dosing or selection of agents. Previous studies have identified surrogates for "individualized dose intensity,", for example, patient size, development of adverse effects, and pharmacokinetic parameters, as potential indicators of treatment efficacy in canine lymphoma, and strategies for patient-specific dose escalation are discussed. Strategies for treatment selection in individual patients include conventional histopathology, protein-based target assessment (eg, flow cytometry, immunohistochemistry, and mass spectrometry), and gene-based target assessment (gene expression profiling and targeted or global sequencing strategies). Currently available data in animal cancer evaluating these strategies are reviewed, as well as ongoing studies and suggestions for future directions.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado.,Developmental Therapeutics Program, University of Colorado Comprehensive Cancer Center, Fort Collins, Colorado
| | - Daniel L Gustafson
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado.,Developmental Therapeutics Program, University of Colorado Comprehensive Cancer Center, Fort Collins, Colorado
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29
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Abstract
Lymphoma is a common disease in companion animals. Although conventional chemotherapy has the potential to induce remission and prolong life, relapse is common, and novel treatments are needed to improve outcome. This review discusses recent modifications/adjustments to conventional standard of care therapy for canine and feline lymphoma, as well as cutting-edge immunotherapy and small-molecule-based approaches that are in varying stages of regulatory approval.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523-1620, USA.
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30
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Vos N, Pellin M, Vail DM. A comparison of 12- and 19-week CHOP protocols using non-randomized, contemporaneous controls. Vet Comp Oncol 2019; 17:276-284. [PMID: 31140707 DOI: 10.1111/vco.12465] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 01/07/2023]
Abstract
This study is a concurrent comparison of two versions of CHOP protocols, a 19-week CHOP and a comparatively overall dose-intense 12-week CHOP. The 12-week protocol was designed to be 58% more dose intense than the 19-week protocol for both doxorubicin and cyclophosphamide; however, it was 21% less dose intense for vincristine (VCR). Forty-seven dogs were included for evaluation, and the characteristics of each population were similar. For dogs receiving the 19-week CHOP protocol, 89.5% experienced a complete response, with a median progression-free survival (PFS) of 245 days and median overall survival (OS) of 347 days. For dogs receiving the 12-week CHOP protocol, 89.3% experienced a complete response, with a median PFS of 141 days and median OS of 229 days. When evaluated by Log-rank analysis, the difference of PFS (P = 0.047) and OS (P = 0.013) between the groups were statistically significant. In summary, these data suggest that despite overall increased dose-intensity, dogs receiving treatment with a 12-week CHOP protocol experience less durable remission than our standard 19-week protocol in this population. Additional prospective investigation will be required to explore the implication that VCR dose intensity and/or shorter overall temporal drug exposure in this protocol may result in diminished efficacy.
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Affiliation(s)
- Nathaniel Vos
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - MacKenzie Pellin
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - David M Vail
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin.,Barbara A. Suran Comparative Oncology Institute, University of Wisconsin-Madison, Madison, Wisconsin
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31
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Boyé P, Floch F, Serres F, Geeraert K, Clerson P, Siomboing X, Bergqvist M, Sack G, Tierny D. Evaluation of serum thymidine kinase 1 activity as a biomarker for treatment effectiveness and prediction of relapse in dogs with non-Hodgkin lymphoma. J Vet Intern Med 2019; 33:1728-1739. [PMID: 31129922 PMCID: PMC6639481 DOI: 10.1111/jvim.15513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 05/01/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Serum thymidine kinase 1 (sTK1) activity is closely correlated with DNA synthesis. OBJECTIVES Evaluate sTK1 activity as a biomarker for treatment response and early detection of relapse in dogs with lymphoma. ANIMALS Ninety-seven client-owned dogs with naive or relapsed lymphoma and 23 healthy dogs. METHODS Prospective study. Serum TK1 activity measured by refined ELISA-based method (DiviTum assay, Biovica International) before treatment, at clinical response, and every 4 weeks until relapse or last follow-up. RESULTS Serum TK1 activity was ≤20 Du/L in 96% (22/23) of healthy dogs. Pretreatment sTK1 activity was >20 Du/L in 88% (85/97) dogs with lymphoma. At clinical response, sTK1 activity was significantly lower in dogs with complete (CR, n = 36) versus partial (PR, n = 29) response (P < .0001). Sensitivity (Se) and specificity (Sp) of sTK1 activity for detecting nonfully responders were 76% and 100%, respectively, with cutoff of 119.5 Du/L (AUC, 0.90; 95%-CI, 0.81-0.98; P < .0001). In dogs with CR, a 5-fold increase in sTK1 activity at a 4-week interval predicted relapse at the subsequent 4-week assessment with a Se 50% and Sp 94% (AUC, 0.72; 95%-CI, 0.55-0.90; P = .02). An increase of sTK1 activity (>2.7-fold value measured at clinical response) predicted relapse at subsequent 4-week assessment with a Se 61% and Sp 88% (AUC, 0.79; 95%-CI, 0.64-0.95; P = .004). CONCLUSIONS AND CLINICAL IMPORTANCE Monitoring sTK1 activity could help to detect complete responders and early disease progression in dogs with lymphoma.
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Affiliation(s)
- Pierre Boyé
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France.,OCR (Oncovet-Clinical-Research), Loos, France
| | - Franck Floch
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France
| | - François Serres
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France.,OCR (Oncovet-Clinical-Research), Loos, France
| | - Kévyn Geeraert
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France
| | | | | | | | | | - Dominique Tierny
- Department of Medical Oncology, Oncovet, Villeneuve d'Ascq, France.,OCR (Oncovet-Clinical-Research), Loos, France
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33
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Motegi T, Tomiyasu H, Goto-Koshino Y, Takahashi M, Hiyoshi-Kanemoto S, Fujino Y, Ohno K, Tsuimoto H. Prognostic value of CD44 variant isoform expression in dogs with multicentric high-grade B-cell lymphoma. Am J Vet Res 2018; 79:961-969. [PMID: 30153061 DOI: 10.2460/ajvr.79.9.961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prognostic value of CD44 variant isoform expression in dogs with multicentric high-grade B-cell lymphoma (BCL). ANIMALS 45 dogs with multicentric BCL and 10 healthy control Beagles. PROCEDURES The medical record database of a veterinary teaching hospital was searched to identify dogs with BCL that were treated between November 2005 and April 2015. Information regarding overall response to chemotherapy, progression-free survival (PFS) time, and overall survival time was extracted from each record. Archived lymph node aspirate specimens from dogs with BCL and lymph node aspirate specimens from the 10 control dogs underwent real-time PCR analysis to determine mRNA expression of CD44 variant isoforms of exons 3, 6, and 7 and the CD44 whole isoform. For each isoform, mRNA expression was compared between dogs with BCL and control dogs. The mean relative expression of each isoform was used to classify dogs with BCL into either a high- or low-expression group, and overall response rate, PFS time, and overall survival time (ie, indices of prognosis) were compared between the 2 groups. RESULTS For all isoforms evaluated, mean relative mRNA expression for dogs with BCL was numerically lower than that for control dogs. Dogs with BCL and high CD44 isoform expression had a lower overall response rate, median PFS time, and median overall survival time, compared with dogs with BCL and low CD44 isoform expression. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, for dogs with BCL, high expression of exons 3, 6, and 7 was associated with a poor prognosis.
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34
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Al-Nadaf S, Rebhun RB, Curran KM, Venable RO, Skorupski KA, Willcox JL, Burton JH. Retrospective analysis of doxorubicin and prednisone as first-line therapy for canine B-cell lymphoma. BMC Vet Res 2018; 14:356. [PMID: 30458771 PMCID: PMC6245930 DOI: 10.1186/s12917-018-1688-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/06/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A doxorubicin (DOX)-based chemotherapy protocol, CHOP, is the most effective treatment for canine high-grade B-cell lymphoma; however, the cost and time requirements associated with this protocol are not feasible for many pet owners. An alternative treatment option is the use of DOX, the most effective drug, in combination with prednisone. Prior studies with single-agent DOX included dogs with T-cell lymphoma, a known negative prognostic factor, which may have resulted in shorter reported survival times than if dogs with B-cell lymphoma were analyzed separately. The purpose of this study was to evaluate the outcome of dogs with high-grade B-cell lymphoma when treated with DOX and prednisone with or without L-asparaginase (L-ASP). Identification of prognostic factors was of secondary interest. RESULTS Thirty-three dogs were included in the study; 31 dogs were evaluable for response with an overall response rate of 84%. The median progression free survival (PFS) and overall survival (OS) were 147 days and 182 days, respectively. The one-year survival fraction was 23%. No variable other than protocol completion was found to be significant for either PFS or OS including historical prognostic factors such as substage, thrombocytopenia, and body weight. CONCLUSIONS Dogs with high-grade B-cell lymphoma treated with DOX and prednisone with or without L-ASP have similar response rates, PFS, and OS to prior studies that did not differentiate between lymphoma immunophenotype. This protocol is not a replacement for CHOP; however, it is an alternative if time and cost are factors, while providing therapeutic benefit greater than prednisone alone.
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Affiliation(s)
- Sami Al-Nadaf
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Robert B Rebhun
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Kaitlin M Curran
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | | | - Katherine A Skorupski
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Jennifer L Willcox
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Jenna H Burton
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
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35
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Morgan E, O'Connell K, Thomson M, Griffin A. Canine T cell lymphoma treated with lomustine, vincristine, procarbazine, and prednisolone chemotherapy in 35 dogs. Vet Comp Oncol 2018; 16:622-629. [DOI: 10.1111/vco.12430] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/02/2018] [Accepted: 07/04/2018] [Indexed: 12/12/2022]
Affiliation(s)
- E. Morgan
- Department of Oncology; Animal Referral Hospital Brisbane; Brisbane Australia
| | - K. O'Connell
- Department of Oncology; Animal Referral Hospital Brisbane; Brisbane Australia
| | - M. Thomson
- Department of Oncology; Animal Referral Hospital Brisbane; Brisbane Australia
| | - A. Griffin
- Department of Oncology; Animal Referral Hospital Brisbane; Brisbane Australia
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Harding K, Bergman N, Smith A, Lindley S, Szivek A, Milner R, Brawner W, Lejeune A. Response rate to a single dose of vinblastine administered to dogs with treatment-naive multicentric lymphoma. Vet Comp Oncol 2018; 16:636-641. [PMID: 30117260 DOI: 10.1111/vco.12433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 12/12/2022]
Abstract
Vincristine is included in vincristine, cyclophosphamide, doxorubicin and prednisone (CHOP) chemotherapy protocols, which are the gold-standard treatment for high-grade canine lymphoma. Vincristine can result in relatively high rates of gastrointestinal toxicity, whereas vinblastine is generally well tolerated and thus may represent an under-utilized and minimally toxic alternative to vincristine. Our objective was to determine the response rate and toxicity associated with a single dose of vinblastine administered to dogs with treatment-naïve, intermediate to large-cell, multicentric lymphoma. Twenty client-owned dogs were enrolled with signed owner consent. A Simon's minimax, phase II, two-stage trial was performed to test the efficacy of vinblastine administered at 2 mg/m2 IV followed by a pilot trial of vinblastine at 2.5 mg/m2 . No dogs were administered concurrent steroids or other chemotherapy. One out of 14 dogs receiving vinblastine at 2 mg/m2 demonstrated a partial response. Three out of five dogs demonstrated a partial response to vinblastine at 2.5 mg/m2 . Gastrointestinal toxicity was infrequent and low grade for both groups. The majority of dogs (80%) in the 2.5 mg/m2 dosing group developed neutropenia 1-week post administration. Vinblastine was well tolerated but minimally efficacious at a dose of 2 mg/m2 IV in dogs with treatment-naive, multicentric lymphoma. Because of poor response rates, treatment at this dose is not recommended. A small subset of dogs administered 2.5 mg/m2 had significantly improved response rates (P = 0.04), suggesting that higher doses may have improved efficacy, although further research is indicated to confirm these preliminary findings.
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Affiliation(s)
- K Harding
- University of Florida Small Animal Hospital, Gainesville, Florida
| | - N Bergman
- Wilford and Kate Bailey Small Animal Teaching Hospital, Auburn University, Auburn, Alabama
| | - A Smith
- Wilford and Kate Bailey Small Animal Teaching Hospital, Auburn University, Auburn, Alabama
| | - S Lindley
- Wilford and Kate Bailey Small Animal Teaching Hospital, Auburn University, Auburn, Alabama
| | - A Szivek
- University of Florida Small Animal Hospital, Gainesville, Florida
| | - R Milner
- University of Florida Small Animal Hospital, Gainesville, Florida
| | - W Brawner
- Wilford and Kate Bailey Small Animal Teaching Hospital, Auburn University, Auburn, Alabama
| | - A Lejeune
- University of Florida Small Animal Hospital, Gainesville, Florida
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Ambrosius LA, Dhawan D, Ramos-Vara JA, Ruple A, Knapp DW, Childress MO. Quantification and prognostic value of programmed cell death ligand-1 expression in dogs with diffuse large B-cell lymphoma. Am J Vet Res 2018; 79:643-649. [DOI: 10.2460/ajvr.79.6.643] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Moore AS, Frimberger AE. Usefulness of chemotherapy for the treatment of very elderly dogs with multicentric lymphoma. J Am Vet Med Assoc 2018; 252:852-859. [DOI: 10.2460/javma.252.7.852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fournier Q, Serra J, Handel I, Lawrence J. Impact of Pretreatment Neutrophil Count on Chemotherapy Administration and Toxicity in Dogs with Lymphoma Treated with CHOP Chemotherapy. J Vet Intern Med 2018; 32:384-393. [PMID: 29205493 PMCID: PMC5787211 DOI: 10.1111/jvim.14895] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 10/26/2017] [Accepted: 11/06/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Prechemotherapy absolute neutrophil count (ANC) cutoffs are arbitrary and vary across institutions and clinicians. Similarly, subjective guidelines are utilized for the administration of prophylactic antibiotics in neutropenic dogs. OBJECTIVES To evaluate the impact of various ANC cutoffs on chemotherapy administration in dogs with lymphoma treated with CHOP chemotherapy and to determine whether an association between prechemotherapy ANC and subsequent toxicity exists. The secondary objective was to evaluate a currently used ANC cutoff to indicate prescription of prophylactic antibiotics. ANIMALS Dogs diagnosed with lymphoma treated with CHOP chemotherapy (n = 64). METHODS Six hundred and fifteen ANCs were stratified into 6 classes. The 3 ANC cutoffs 1.5 × 103 /μL, 2.0 × 103 /μL, and 2.5 × 103 /μL were assessed. The presence of an association between prechemotherapy ANC class and toxicity was determined. Afebrile neutropenic dogs with ANC <1.5 × 103 /μL but above the criteria for prophylactic antibiotics were evaluated. RESULTS Chemotherapy was not administered in 7% of visits with an ANC cutoff of 1.5 × 103 /μL; chemotherapy would not have been administered in 10% and 16% of visits with an ANC cutoff of 2.0 × 103 /μL or 2.5 × 103 /μL, respectively. There was no association among the 3 lower prechemotherapy ANC classes and toxicity. All dogs with ANC 0.75-1.5 × 103 /μL recovered spontaneously without medical intervention. CONCLUSION AND CLINICAL IMPORTANCE The number of dose delays was minimized with a prechemotherapy ANC cutoff of 1.5 × 103 /μL, and the prechemotherapy ANC class 1.5-1.99 × 103 /μL was not associated with an increased toxicity. Further investigation of an ANC cutoff near 0.75 × 103 /μL in which to prescribe prophylactic antibiotics is indicated.
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Affiliation(s)
- Q. Fournier
- Royal (Dick) School of Veterinary StudiesRoslin InstituteThe University of EdinburghRoslinUK
| | - J.‐C. Serra
- Royal (Dick) School of Veterinary StudiesRoslin InstituteThe University of EdinburghRoslinUK
| | - I. Handel
- Royal (Dick) School of Veterinary StudiesRoslin InstituteThe University of EdinburghRoslinUK
| | - J. Lawrence
- Royal (Dick) School of Veterinary StudiesRoslin InstituteThe University of EdinburghRoslinUK
- Present address:
Lawrence is presently affiliated with Department of Veterinary Clinical SciencesCollege of Veterinary MedicineUniversity of MinnesotaSaint PaulMN
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Childress MO, Ramos-Vara JA, Ruple A. Retrospective analysis of factors affecting clinical outcome following CHOP-based chemotherapy in dogs with primary nodal diffuse large B-cell lymphoma. Vet Comp Oncol 2017; 16:E159-E168. [PMID: 29152834 DOI: 10.1111/vco.12364] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 12/14/2022]
Abstract
Numerous factors are known to affect the prognosis of dogs with chemotherapy-treated lymphomas. However, prognostic factors for dogs with specific subtypes of lymphoma are less clearly defined. The objective of this study was to identify prognostic factors for dogs receiving CHOP-based chemotherapy for primary nodal diffuse large B-cell lymphoma (DLBCL). Medical records of dogs treated for DLBCL at the Purdue Veterinary Teaching Hospital (PUVTH) from 2006 to 2016 were reviewed. Factors potentially related to prognosis were analysed using multivariable statistical methods. Ninety-eight dogs were included in the study. Best overall response to chemotherapy was complete remission in 80 dogs (81.6%) and partial remission in 18 dogs (18.4%). Median progression-free survival (PFS) for the entire population was 252 days (range 19-1068). Factors significantly associated with achieving partial (rather than complete) remission following CHOP included presence of thrombocytopenia at diagnosis (OR 6.88; 95% CI 1.98-23.93; P = .002), baseline serum globulin concentration (OR 2.63; 95% CI 1.03-6.75; P = .044), and age at diagnosis (OR 1.36; 95% CI 1.08-1.71; P = .009). Factors significantly associated with PFS in the lowest quartile (≤93 days) included presence of thrombocytopenia at diagnosis (OR 8.72; 95% CI 1.54-49.33; P = .014), age at diagnosis (OR 1.47; 95% CI 1.12-1.94; P = .005), and baseline neutrophil count (OR 1.18; 95% CI 1.02-1.37; P = .025). Presence of thrombocytopenia, greater age, higher neutrophil count, and higher serum globulin concentration all may be associated with a particularly poor outcome in dogs receiving CHOP-based chemotherapy for DLBCL.
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Affiliation(s)
- M O Childress
- Departments of Veterinary Clinical Sciences (Childress) and Comparative Pathobiology (Ramos-Vara, Ruple), College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - J A Ramos-Vara
- Departments of Veterinary Clinical Sciences (Childress) and Comparative Pathobiology (Ramos-Vara, Ruple), College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - A Ruple
- Departments of Veterinary Clinical Sciences (Childress) and Comparative Pathobiology (Ramos-Vara, Ruple), College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
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Treggiari E, Elliott JW, Baines SJ, Blackwood L. Temozolomide alone or in combination with doxorubicin as a rescue agent in 37 cases of canine multicentric lymphoma. Vet Comp Oncol 2017; 16:194-201. [PMID: 28766920 DOI: 10.1111/vco.12335] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 05/28/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022]
Affiliation(s)
- E. Treggiari
- Small Animal Teaching Hospital; University of Liverpool, School of Veterinary Science; Neston Cheshire UK
- Willows Veterinary Centre and Referral Service; Solihull West Midlands UK
| | - J. W. Elliott
- Small Animal Teaching Hospital; University of Liverpool, School of Veterinary Science; Neston Cheshire UK
- Willows Veterinary Centre and Referral Service; Solihull West Midlands UK
| | - S. J. Baines
- Willows Veterinary Centre and Referral Service; Solihull West Midlands UK
| | - L. Blackwood
- Small Animal Teaching Hospital; University of Liverpool, School of Veterinary Science; Neston Cheshire UK
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Abstract
Uterine lymphoma is rare in the dog, in other animal species, and in humans. The lymphoma in the two female dogs presented as a primary tumour of uterine tissue and was classified as diffuse centroblastic B cell lymphoma. Terminally, the uterine lymphoma metastasized to various organs in one of the dogs, despite chemotherapy. This case study describes a very rare form of canine lymphoma and suggests to include lymphoma in the differential diagnoses in bitches with uterine masses.
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Boyé P, Serres F, Marescaux L, Hordeaux J, Bouchaert E, Gomes B, Tierny D. Dose escalation study to evaluate safety, tolerability and efficacy of intravenous etoposide phosphate administration in 27 dogs with multicentric lymphoma. PLoS One 2017; 12:e0177486. [PMID: 28505195 PMCID: PMC5432161 DOI: 10.1371/journal.pone.0177486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/27/2017] [Indexed: 12/31/2022] Open
Abstract
Comparative oncology has shown that naturally occurring canine cancers are of valuable and translatable interest for the understanding of human cancer biology and the characterization of new therapies. This work was part of a comparative oncology project assessing a new, clinical-stage topoisomerase II inhibitor and comparing it with etoposide in dogs with spontaneous lymphoma with the objective to translate findings from dogs to humans. Etoposide is a topoisomerase II inhibitor widely used in various humans' solid and hematopoietic cancer, but little data is available concerning its potential antitumor efficacy in dogs. Etoposide phosphate is a water-soluble prodrug of etoposide which is expected to be better tolerated in dogs. The objectives of this study were to assess the safety, the tolerability and the efficacy of intravenous etoposide phosphate in dogs with multicentric lymphoma. Seven dose levels were evaluated in a traditional 3+3 phase I design. Twenty-seven owned-dogs with high-grade multicentric lymphoma were enrolled and treated with three cycles of etoposide phosphate IV injections every 2 weeks. Adverse effects were graded according to the Veterinary Cooperative Oncology Group criteria. A complete end-staging was realized 45 days after inclusion. The maximal tolerated dose was 300 mg/m2. At this dose level, the overall response rate was 83.3% (n = 6, 3 PR and 2 CR). Only a moderate reversible gastrointestinal toxicity, no severe myelotoxicity and no hypersensitivity reaction were reported at this dose level. Beyond the characterization of etoposide clinical efficacy in dogs, this study underlined the clinical and therapeutic homologies between dog and human lymphomas.
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Affiliation(s)
- Pierre Boyé
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
- Oncovet, SIRIC ONCOLille, Villeneuve d’Ascq, France
| | - François Serres
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
- Oncovet, SIRIC ONCOLille, Villeneuve d’Ascq, France
| | | | - Juliette Hordeaux
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
| | - Emmanuel Bouchaert
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
| | - Bruno Gomes
- Institut de Recherche Pierre Fabre, Toulouse, France
| | - Dominique Tierny
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
- Oncovet, SIRIC ONCOLille, Villeneuve d’Ascq, France
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Thamm DH, Vail DM, Post GS, Fan TM, Phillips BS, Axiak-Bechtel S, Elmslie RS, Klein MK, Ruslander DA. Alternating Rabacfosadine/Doxorubicin: Efficacy and Tolerability in Naïve Canine Multicentric Lymphoma. J Vet Intern Med 2017; 31:872-878. [PMID: 28370378 PMCID: PMC5435064 DOI: 10.1111/jvim.14700] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/13/2017] [Accepted: 02/23/2017] [Indexed: 01/18/2023] Open
Abstract
Background Standard of care treatment for multicentric lymphoma in dogs remains doxorubicin (DOX)‐based combination chemotherapy, but owners may hesitate to commit the time and financial resources to complete such a protocol, typically requiring 12–16 visits. Rabacfosadine (RAB), a double prodrug of the nucleotide analog 9‐(2‐phosphonylmethoxyethyl) guanine, has substantial single‐agent activity in dogs with lymphoma, and a different mechanism of action than DOX. Hypothesis/Objectives Our objective was to evaluate the efficacy and adverse effect (AE) profile of alternating doses of RAB and DOX in dogs with naïve multicentric lymphoma. Animals Fifty‐four dogs with previously untreated lymphoma. Methods Open‐label, multicenter prospective clinical trial. Dogs received alternating RAB (1.0 mg/kg IV weeks 0, 6, 12) and DOX (30 mg/m2 IV weeks 3, 9, 15). Dogs that achieved complete response (CR) were followed by monthly evaluations. Complete clinicopathological evaluation and assessment of remission and AEs were performed every 21 days. Results The overall response rate was 84% (68%; CR; 16%; partial response [PR)]. The overall median progression‐free interval (PFI) was 194 days (216 for CR and 63 for PR). Most AEs were mild and self‐limiting: gastrointestinal and hematologic AEs were most common. Thirteen dogs experienced dermatologic AEs, and 2 dogs developed grade 5 pulmonary fibrosis. Conclusions and Clinical Importance Alternating RAB/DOX generally was well tolerated and resulted in PFIs comparable to standard DOX‐based multi‐agent protocols, with fewer treatment visits. Most adverse events were mild or moderate and self‐limiting. Further studies are warranted to explore long‐term outcome and other RAB chemotherapy combinations.
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Affiliation(s)
- D H Thamm
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, CO.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO.,Developmental Therapeutics Program, Comprehensive Cancer Center, University of Colorado, Aurora, CO
| | - D M Vail
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
| | - G S Post
- The Veterinary Cancer Center, Norwalk, CT
| | - T M Fan
- College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL
| | - B S Phillips
- Veterinary Specialty Hospital of San Diego, San Diego, CA
| | - S Axiak-Bechtel
- College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - R S Elmslie
- Veterinary Referral Center of Colorado, Englewood, CO
| | - M K Klein
- Southern Arizona Veterinary Specialty and Emergency Center, Tucson, AZ
| | - D A Ruslander
- Veterinary Specialty Hospital of the Carolinas, Cary, NC
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Sato M, Yamazaki J, Goto-Koshino Y, Setoguchi A, Takahashi M, Baba K, Fujino Y, Ohno K, Tsujimoto H. Minimal residual disease in canine lymphoma: An objective marker to assess tumour cell burden in remission. Vet J 2016; 215:38-42. [DOI: 10.1016/j.tvjl.2016.05.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 05/12/2016] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
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Marconato L, Polton GA, Sabattini S, Dacasto M, Garden OA, Grant I, Hendrickx T, Henriques J, Lubas G, Morello E, Stefanello D, Comazzi S. Conformity and controversies in the diagnosis, staging and follow-up evaluation of canine nodal lymphoma: a systematic review of the last 15 years of published literature. Vet Comp Oncol 2016; 15:1029-1040. [DOI: 10.1111/vco.12244] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 04/20/2016] [Accepted: 04/30/2016] [Indexed: 12/14/2022]
Affiliation(s)
| | - G. A. Polton
- North Downs Specialist Referrals; Bletchingley UK
| | - S. Sabattini
- Department of Veterinary Medical Sciences; University of Bologna; Bologna Italy
| | - M. Dacasto
- Department of Comparative Biomedicine and Food Science; University of Padua; Padua Italy
| | - O. A. Garden
- Department of Clinical Science and Services; Immune Regulation Laboratory, Royal Veterinary College; London UK
- Queen Mother Hospital for Animals; Royal Veterinary College; Hatfield UK
| | - I. Grant
- Small Animal Clinical Sciences; School of Veterinary Medicine, University of Glasgow; Glasgow UK
| | | | - J. Henriques
- Hospital Veterinário Berna, OnevetGroup; Lisboa Portugal
| | - G. Lubas
- Department of Veterinary Sciences; University of Pisa; Pisa Italy
| | - E. Morello
- Department of Veterinary Sciences; University of Turin; Turin Italy
| | - D. Stefanello
- Department of Veterinary Medicine; University of Milan; Milan Italy
| | - S. Comazzi
- Department of Veterinary Medicine; University of Milan; Milan Italy
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Hiyoshi-Kanemoto S, Goto-Koshino Y, Fukushima K, Takahashi M, Kanemoto H, Uchida K, Fujino Y, Ohno K, Tsujimoto H. Detection of circulating tumor cells using GeneScan analysis for antigen receptor gene rearrangements in canine lymphoma patients. J Vet Med Sci 2016; 78:877-81. [PMID: 26888583 PMCID: PMC4905848 DOI: 10.1292/jvms.15-0433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The presence of circulating tumor cells (CTCs) serves as a prognostic marker and
indicator of disease relapse, as well as a means of evaluating treatment efficacy in human
and canine lymphoma patients. As an extension of our previous study for the construction
of clinically useful GeneScan system, we utilized the GeneScan system for detecting CTCs
in canine lymphoma patients. Samples from the primary lesion and peripheral blood
mononuclear cells (PBMCs) were obtained from 32 dogs with lymphoma at initial diagnosis.
All samples were subjected to polymerase chain reaction (PCR) for antigen receptor gene
rearrangements (PARR) followed by GeneScan analysis. Common clonal rearrangements with
identical amplified fragments were detected in both the primary lesion and PBMCs in 19 of
the 32 dogs (59.4%). However, the detection rate of CTCs varied among the anatomical
classification of lymphoma studied. GeneScan analysis following PARR would facilitate
studies on determining the clinical significance of CTCs in canine lymphoma patients.
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Affiliation(s)
- Saaya Hiyoshi-Kanemoto
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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Curran K, Thamm DH. Retrospective analysis for treatment of naïve canine multicentric lymphoma with a 15-week, maintenance-free CHOP protocol. Vet Comp Oncol 2015; 14 Suppl 1:147-55. [DOI: 10.1111/vco.12163] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 06/18/2015] [Accepted: 07/01/2015] [Indexed: 12/24/2022]
Affiliation(s)
- K. Curran
- Flint Animal Cancer Center; Colorado State University; Fort Collins CO USA
| | - D. H. Thamm
- Flint Animal Cancer Center; Colorado State University; Fort Collins CO USA
- Cell and Molecular Biology Graduate Program; Colorado State University; Fort Collins CO USA
- Developmental Therapeutics Program; Comprehensive Cancer Center, University of Colorado; Aurora CO USA
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Wang S, Lee J, Liao A. Chemotherapy-induced neutropenia is associated with prolonged remission duration and survival time in canine lymphoma. Vet J 2015; 205:69-73. [DOI: 10.1016/j.tvjl.2015.04.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
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