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Hawkes C, Morris J, Bavcar S, Wilkie C, Ray S, Auquier C, Benjamin S, Massó JB, Bottin S, Davies O, Desmas-Bazelle I, Einhorn A, Figueroa-Gonzalez C, Holenova K, Kritsotalaki E, Peak K, Smallwood K, Treggiari E, Valenti P, de la Virgen MG, Fournier Q. Comparison of CHOP-19 and CHOP-25 for treatment of peripheral nodal B-cell lymphoma in dogs: A European multicenter retrospective cohort study. J Vet Intern Med 2024. [PMID: 39422460 DOI: 10.1111/jvim.17222] [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: 05/29/2024] [Accepted: 10/01/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND Peripheral nodal B-cell lymphomas (PNBCL) represent the most common presentation of lymphomas in dogs. Multiagent CHOP (C = cyclophosphamide, H = hydroxydaunorubicin [Doxorubicin], O = Oncovin, P = prednisolone)-based chemotherapy protocols have been widely accepted as gold standard 1st-line treatment. CHOP-25 and CHOP-19 are most commonly prescribed but have never been directly compared. OBJECTIVES Our primary aim was to compare outcomes of dogs diagnosed with PNBCL, treated using a 1st-line CHOP-19 or CHOP-25 protocol. A secondary objective was to determine the impact of protocol-related variables on outcomes. ANIMALS Five hundred two dogs from 16 European oncology referral centers. One hundred fifty-five dogs were treated with CHOP-19 and 347 dogs with CHOP-25. METHODS Retrospective, multicentric cohort study of dogs diagnosed with PNBCL between 2014 and 2021. RESULTS The 6-month, 1-year, and median progression-free survival (PFS) were 56.5% (95% confidence interval [CI], 49.2-65.0), 14.1% (95% CI, 9.4-21.0), and 196 days (95% CI, 176-233) with CHOP-19; and 56.4% (95% CI, 51.4-61.9), 17% (95% CI, 13.4-21.6), and 209 days (95% CI, 187-224) with CHOP-25. The 1-year, 2-year and median overall survival (OS) were 36.9% (95% CI, 29.7-46.0), 13.5% (95% CI, 8.6-21.1), and 302 days (95% CI, 249-338) with CHOP-19; and 42.8% (95% CI, 37.7-48.7), 15.4% (95% CI, 11.7-20.4), and 321 days (95% CI, 293-357) with CHOP-25. No significant difference in PFS and OS was found between the 2 protocols. CONCLUSIONS AND CLINICAL IMPORTANCE Our study confirmed similar outcomes for dogs with PNBCL treated with 1st-line CHOP-19 or CHOP-25. Both protocols therefore could be used as a standard of care in future trials.
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Affiliation(s)
- Charles Hawkes
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, United Kingdom
| | | | - Spela Bavcar
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, United Kingdom
- Small Animal Specialist Hospital, North Ryde, New South Wales, Australia
| | | | - Surajit Ray
- University of Glasgow, Glasgow, United Kingdom
| | | | | | - Juan Borrego Massó
- Hospital Aúna Especialidades Veterinarias IVC-Evidensia, Valencia, Spain
| | | | - Owen Davies
- Bristol Vet Specialists, Bristol, United Kingdom
| | | | - Anat Einhorn
- Koret School of Veterinary Medicine, Rehovot, Israel
| | | | - Katerina Holenova
- Wear Referrals, Bradbury, United Kingdom
- Pride Veterinary Referrals, Derby, United Kingdom
| | | | - Kerry Peak
- Anderson Moores, Winchester, United Kingdom
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Kim TH, Song WJ, Ryu MO, Kim HT, Nam A, Youn HY. Clinical Outcome of Multicentric Lymphoma Treated with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone (CHOP) in Small Breed Dogs. Animals (Basel) 2024; 14:2994. [PMID: 39457924 PMCID: PMC11503739 DOI: 10.3390/ani14202994] [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: 08/10/2024] [Revised: 10/10/2024] [Accepted: 10/15/2024] [Indexed: 10/28/2024] Open
Abstract
Lymphoma is one of the most common malignant tumors in dogs. Combination chemotherapy with vincristine, cyclophosphamide, doxorubicin, and prednisolone (CHOP) is the most effective treatment for multicentric lymphoma. Previous studies have evaluated the response of large dogs to CHOP treatment and identified prognostic factors; however, studies on small dogs are lacking. In this study, we investigated the outcomes and prognostic factors for small dogs with multicentric lymphoma treated with CHOP. The responses of patients to CHOP treatment were assessed, and 54.3% were evaluated as being in complete remission (CR), 31.4% in partial remission (PR), and 14.3% in no remission (NR). The overall response rate was 85.7%. The median survival times for CR, PR, and NR patients were 683 days (85-1496 days), 241 days (15-777 days), and 119 days (61-308 days), respectively. Among the CR patients, survival was longer under the following conditions: age under 10 years (p = 0.011), no cardiovascular heart disease (p = 0.046), and no history of hospitalization due to side effects from chemotherapy (p = 0.002). These results might help clinicians build treatment plans for multicentric lymphoma in small breed dogs.
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Affiliation(s)
- Tae-Hee Kim
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea; (T.-H.K.); (M.-O.R.)
| | - Woo-Jin Song
- Laboratory of Veterinary Internal Medicine and Research Institute of Veterinary Medicine, College of Veterinary Medicine, Jeju National University, Jeju 63243, Republic of Korea;
| | - Min-Ok Ryu
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea; (T.-H.K.); (M.-O.R.)
| | - Hyun-Tae Kim
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Aryung Nam
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul 05029, Republic of Korea
| | - Hwa-Young Youn
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea; (T.-H.K.); (M.-O.R.)
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Busser S, Blackwood L, Pereira C, Chase-Topping M, Bavcar S, Fournier Q. Impact of 10% Dose Reductions and Duration of Treatment Delays in the Management of Chemotherapy-Induced Neutropenia in Dogs Treated With Common Chemotherapy Protocols: A Single-Centre Experience. Vet Comp Oncol 2024. [PMID: 39168816 DOI: 10.1111/vco.13004] [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: 12/06/2023] [Revised: 07/23/2024] [Accepted: 08/08/2024] [Indexed: 08/23/2024]
Abstract
Neutropenia is a common chemotherapy-associated adverse event (AE) in dogs and a significant cause of decreased relative dose intensity. Dose reductions (DRs) and treatment delays (TDs) are frequently applied to decrease the risk of further neutropenic events (NEs) and AEs, but there is no standardised approach. The two main objectives of this retrospective study were to determine: (1) the failure rate of a 10% DR to prevent a subsequent inadequate absolute neutrophil count (ANC), defined as a nadir ANC <0.75 × 109/L or pretreatment ANC <1.5 × 109/L; and (2) if the duration of TDs due to pretreatment neutropenia affects the occurrence of subsequent NEs. A total of 1056 chemotherapy treatments were recorded for 128 dogs that developed at least one NE. In 75 of 124 (60.5%, 95% CI: 51.2%-69%) evaluable NEs, a nadir ANC of ≥0.75 × 109/L and pretreatment ANC of ≥1.5 × 109/L were achieved after a single 10% chemotherapy DR, while a 10% DR failed to prevent a subsequent inadequate ANC in the remaining 49/124 (39.5%, 95% CI: 30.1%-48.3%). The only variable associated with failure was the drug prescribed. DR failure occurred in 22/39 (56.4%, 95% CI: 40.9%-70.6%) lomustine DRs, 14/27 (51.9%, 95% CI: 33.9%-69.2%) cyclophosphamide DRs, but only 2/22 (9.1%, 95% CI: 2.5%-27.8%) doxorubicin DRs and 2/24 (8.3%, 95% CI: 2.3%-25.8%) vincristine DRs. Seventy-three evaluable TDs (mean: 5 days, SD ± 2.2 days) were prescribed. There was no association between TD duration and subsequent NEs (p = 0.11).
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Affiliation(s)
- Suzanne Busser
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, UK
| | - Laura Blackwood
- The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, UK
| | | | | | - Spela Bavcar
- Small Animal Specialist Hospital, North Ryde, New South Wales, Australia
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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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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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6
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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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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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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: 12] [Impact Index Per Article: 12.0] [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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Sheng R, Clarke D, Laver T, Meichner K, Northrup N, Tarigo J. Prognostic significance of CD25 expression in dogs with a noninvasive diagnosis of B-cell lymphoma treated with CHOP chemotherapy. Vet Comp Oncol 2023; 21:28-35. [PMID: 36111442 DOI: 10.1111/vco.12857] [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: 05/23/2022] [Revised: 08/03/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
Prior studies have identified high CD25 expression in canine diffuse large B-cell lymphoma as a negative prognostic indicator. The objective of this retrospective study was to evaluate CD25 expression as a prognostic indicator in dogs with B-cell lymphoma (BCL) diagnosed with commonly used noninvasive diagnostics (cytology and flow cytometry [FC]) and treated with CHOP chemotherapy. Lymph node aspirates from 57 dogs with cytologic diagnosis of lymphoma composed of intermediate to large lymphocytes were analysed with FC. Percentage of neoplastic B-cells expressing CD25 and median fluorescence intensity (MFI) of CD25 were measured. Relationships of CD25 percent positivity and MFI to progression free survival (PFS) and survival time were evaluated. Median survival time (MST) of all dogs was 272 days (95% CI, 196-348 days) and median PFS was 196 days (95% CI, 172-220 days). Higher percentage of B-cells positive for CD25 was associated with decreased risk of death in multivariable analysis (p = .02). Dogs with higher CD25 positivity had longer MST and PFS than dogs with lower CD25 positivity (318 days versus 176 days and 212 days versus 148 days, respectively), but these differences were not significant. CD25 MFI was not significantly associated with outcome. Based on the results of this study, the association of CD25 expression and prognosis in dogs with BCL diagnosed using noninvasive methods should be interpreted with caution. Further evaluation, with studies that include histopathologic differentiation of lymphoma subtypes, is needed.
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Affiliation(s)
- Richard Sheng
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - Dawn Clarke
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - Travis Laver
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - Kristina Meichner
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - Nicole Northrup
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - Jaime Tarigo
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
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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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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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12
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Fonghem P, Pisitkun T, Rattanapinyopituk K, Sirivisoot S, Rungsipipat A. Investigation of proteomic profiles in canine lymphoma using tandem mass tag-based quantitative proteomics approach. Vet World 2022; 15:1333-1340. [PMID: 35765478 PMCID: PMC9210836 DOI: 10.14202/vetworld.2022.1333-1340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Specific tumor biomarkers are useful for the early diagnosis of cancer or can predict the recurrence of neoplastic disease in humans and animals. Lymphoma in dogs could be classified into B-, T-, and NK-cell origins. T-cell lymphoma has the worst prognosis with a shorter survival time and disease-free interval. This study aimed to identify the differential serum protein expressions of canine B- and T-cell lymphomas compared with healthy dogs using a tandem mass tag (TMT)-based quantitative proteomics. Materials and Methods: Serum samples were collected from 20 untreated canine lymphomas (14 B-cells and 6 T-cells) and four healthy control dogs. Sera peptides from each sample were processed for TMT 10-plex tagging and analyzed using liquid chromatography-mass spectrometry (MS). Differential proteome profiling was then compared between lymphoma and control. Results: We discovered 20 elevated and 14 decreased serum proteins in the lymphoma group relative to the healthy group. Six candidate increased proteins in canine lymphomas were beta-actin cytoplasmic 1 (ACTB, p=0.04), haptoglobin (p=0.002), beta-2 microglobulin (aaaaaaaa2M, p=0.007), beta-2 glycoprotein 1 (APOH, p=0.03), metalloproteinase inhibitor 1 (TIMP-1, p=0.03), and CD44 antigen (p=0.02). When compared between B- and T-cell lymphomas, B-cell phenotypes had upregulated immunoglobulin (Ig) heavy chain V region GOM (p=0.02), clusterin (p=0.01), apolipoprotein C1 (APOC1, p=0.05), and plasminogen (p=0.02). Conclusion: These findings were investigated quantitative serum proteomes between B- and T-cell lymphomas using TMT-based MS. ACTB, aaaaaaaa2M, APOH, TIMP-1, CD44 antigen, Ig heavy chain V region GOM, and APOC1 are novel candidate proteins and might serve as a lymphoma biomarker in dogs. However, evaluation with an increased sample size is needed to confirm their diagnostic and prognostic ability.
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Affiliation(s)
- Piyanoot Fonghem
- Center of Excellence for Companion Animal Cancer, Department of Veterinary Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Trairak Pisitkun
- Center of Excellence in Systems Biology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kasem Rattanapinyopituk
- Center of Excellence for Companion Animal Cancer, Department of Veterinary Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Sirintra Sirivisoot
- Center of Excellence for Companion Animal Cancer, Department of Veterinary Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Anudep Rungsipipat
- Center of Excellence for Companion Animal Cancer, Department of Veterinary Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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Rocha MDCP, Garnica TK, Fukumasu H, Ramirez RA, Pazzini JM, Sueiro FAR, Paiva FND, Nardi ABD. Acute phase protein and vitamin D concentration in dogs with multicentric lymphoma. CIÊNCIA ANIMAL BRASILEIRA 2022. [DOI: 10.1590/1809-6891v23e-72650e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract This study aimed to evaluate the serum concentration of vitamin D (25-Hydroxyvitamin D) and acute phase proteins (APPs; alpha-1 acid glycoprotein, haptoglobin, transferrin, ceruloplasmin, albumin, IgA, IgG and alpha-1 - antitrypsin) as potential biomarkers for prognostic and therapy response in dogs with multicentric lymphoma submitted to the CHOP (Cyclophosphamide, Doxorubicin, Vincristine and Prednisone) chemotherapy protocol. Thirteen dogs with multicentric lymphoma classified as high grade by cytology were included in the treatment group (GL), while ten healthy dogs were included in the control group (GC). Serum was collected in the weeks T0, T5 and T10 of CHOP chemotherapy protocol, for the GL group, and in a single collection, for the GC group. All the collected samples were evaluated for the APPs and vitamin D concentrations through electrophoresis and chemiluminescence methods, respectively. Diagnostic and staging tests were performed for all the dogs in the GL group, and included cytopathology, histopathology and immunohistochemistry of the affected lymph node. Of these dogs, 9 achieved a complete response and 4 a partial response to the treatment. Data analysis was performed with the R software. The results demonstrated that serum concentrations of IgA, haptoglobin and α1-acid glycoprotein were significantly different between the groups and also between the different chemotherapy times analyzed (p<0.05), indicating that these proteins can be considered as sensitive biomarkers for lymphoma in dogs. Furthermore, the α1-acid glycoprotein showed prognostic value for the disease, with 63% specificity. However, vitamin D concentration was not correlated with prognosis of the dogs with lymphoma.
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Rocha MDCP, Garnica TK, Fukumasu H, Ramirez RA, Pazzini JM, Sueiro FAR, Paiva FND, Nardi ABD. Concentração de proteínas de fase aguda e vitamina D em cães com linfoma multicêntrico. CIÊNCIA ANIMAL BRASILEIRA 2022. [DOI: 10.1590/1809-6891v23e-72650p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivou-se caracterizar a concentração sérica da vitamina D e das PFAs (Proteínas de Fase Aguda) (alfa-1 glicoproteína ácida, haptoglobina, transferrina, ceruloplasmina, albumina, IgA, IgG e alfa-1 – antitripsina) em cães com linfoma multicêntrico, submetidos ao tratamento quimioterápico com protocolo CHOP (Ciclofosfamida, Doxorrubicina, Vincristina e Prednisona), determinando o valor prognóstico desses marcadores para a doença. Foram avaliadas as concentrações séricas das PFAs, através do método da eletroforese e as concentrações da vitamina D, através da quimioluminescência em dois grupos experimentais, um grupo de 13 cães com linfoma multicêntrico classificados como alto grau pela citologia (GL) durante as semanas T0, T5 e T10 do tratamento com protocolo quimioterápico antineoplásico e em um grupo de 10 animais saudáveis para compor o grupo controle (GC), em coleta única. Para isso, foi realizado o diagnóstico, estadiamento e avaliação de resposta terapêutica dos 13 pacientes com linfoma multicêntrico através de técnicas de citopatologia, histopatologia, imuno-histoquímica do linfonodo periférico acometido. Foi observado que 9 pacientes tiveram resposta completa e 4 pacientes tiveram resposta parcial ao tratamento. Os dados foram analisados através do software R. Os resultados indicam que as diferenças entre as variáveis IgA, haptoglobina e α1-glicoproteína ácida foram significativas entre os grupos, e entre os diferentes momentos da quimioterapia (p< 0,05), indicando que podem ser marcadores sensíveis ao linfoma em cães. A α1-glicoproteína ácida apresentou valor prognóstico para o linfoma, com 63% de especificidade. Porém a vitamina D não apresentou valor prognóstico para o linfoma multicêntrico em cães.
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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: 3] [Impact Index Per Article: 1.0] [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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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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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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Veluvolu S, Pellin M, Vos N. Evaluation of neutrophilia as a prognostic factor in dogs with multicentric lymphoma treated with a cyclophosphamide, doxorubicin, vincristine, and prednisone-based chemotherapy protocol. J Am Vet Med Assoc 2021; 259:494-502. [PMID: 34388019 DOI: 10.2460/javma.259.5.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether, in dogs with naïve multicentric lymphoma, neutrophilia at the time of initial diagnosis was associated with progression-free survival time (PFST) or overall response rate (ie, percentage of dogs with a complete or partial remission) and whether the initial neutrophil-to-lymphocyte ratio was associated with PFST. ANIMALS 30 dogs with multicentric lymphoma and neutrophilia (including 16 treated with a cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP]-based protocol) and 37 historical control dogs without neutrophilia treated with a CHOP-based protocol. PROCEDURES Medical records were reviewed, and PFSTs and responses were documented. RESULTS Median PFST for the 16 dogs with neutrophilia treated with a CHOP-based protocol (70 days; range, 0 to 296 days) was significantly shorter than that for the 37 control dogs without neutrophilia (184.5 days; range, 23 to 503 days), and the overall response rate for dogs with neutrophilia (12/16 [75%]) was significantly lower than the rate for dogs without neutrophilia (36/37 [97%]). However, when all dogs in the study and control populations were considered together, the neutrophil-to-lymphocyte ratio at the time of diagnosis was not significantly associated with PFST. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that neutrophilia at the time of initial diagnosis may suggest a poorer prognosis in dogs with multicentric lymphoma. Prospective investigation into the role of neutrophils in the peripheral circulation and tumor microenvironment of cancer-bearing patients is warranted.
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Troedson K, Ignatenko N, Fejos C, Zablotski Y, Hirschberger J. Maintenance treatment in relapsed canine lymphoma after a short L-CHOP protocol. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:185-194. [PMID: 34157760 DOI: 10.1055/a-1481-7066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE A number of different rescue protocols for relapsed canine multicentric large-cell lymphoma have been described. The aim of this pilot study was to evaluate the efficacy of a maintenance treatment in dogs that experienced a second complete remission after a short L-CHOP-rescue protocol. MATERIAL AND METHODS Included in the study were dogs experiencing the first lymphoma relapse during a treatment-free period which were treated with a short L-CHOP protocol, achieved a complete remission and were afterwards treated with a continuous maintenance phase (MP) protocol. The L-CHOP protocol consisted of weekly treatments, with at least 3 additional treatments following complete remission. Thereafter the MP protocol with 2-week treatment intervals was conducted. It consisted of alternating oral home administration of different alkylating agents and one intravenously administered cytotoxic agent of a different mechanism of action. The dogs were presented either every 4 or 6 weeks for intravenous treatment and at this time a complete blood count was performed. The durations of the first remission, disease-free interval and overall survival time were evaluated. RESULTS A total of 20 dogs were included in the study. A median of 7 weekly applications were given before the treatment was switched to the MP protocol. During MP, 14 dogs were treated intravenously every 6 weeks and 6 dogs every 4 weeks. Haematological adverse events were mainly mild. During the L-CHOP-protocol, one septic event occurred, and 2 dogs were hospitalized due to gastrointestinal adverse events. No patient required hospitalization during the MP. Fifteen dogs completed at least one cycle in the MP and a median of 8.5 chemotherapeutic treatments were administered. The median disease-free interval was 264 days and the median overall survival time was 737 days. CONCLUSION AND CLINICAL RELEVANCE The protocol was generally well tolerated. Since 5 patients showed disease progression during the first cycle of the MP, dogs should ideally be evaluated for minimal residual disease before being switched to the MP. The case number in the presented study was low and the treatment relatively heterogeneous. Therefore, more dogs have to be treated with the proposed protocol before general recommendations can be made.
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Affiliation(s)
- Karin Troedson
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, LMU Munich
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Tagawa M, Shimbo G, Uemura A, Matsumoto K. Cardiomyopathy in a dog with multicentric lymphoma following treatment with several anthracyclines. Open Vet J 2021; 11:6-10. [PMID: 33898277 PMCID: PMC8057218 DOI: 10.4314/ovj.v11i1.2] [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: 11/12/2020] [Accepted: 12/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background Canine lymphoma is one of the most frequently occurring malignant neoplasms in dogs. Anthracycline-based chemotherapy for the treatment of canine lymphoma is very effective; however, there is not enough evidence for the development of cardiac toxicity using several anthracyclines as chemotherapeutic agents. Case Description An 8-year-old, castrated, mixed-breed dog was diagnosed with multicentric lymphoma and received multi-agent chemotherapy. Complete remission was achieved, but the patient had a relapse of lymphoma. After third-line chemotherapy with epirubicin, the patient was diagnosed with dilated cardiomyopathy. The total cumulative doses of doxorubicin, mitoxantrone, and epirubicin were 125, 8, and 125 mg/m2, respectively. Although the patient was treated with cardiac drugs and clinically stabilized, the patient had a relapse of lymphoma and died shortly after the diagnosis of cardiomyopathy. Conclusion The patient was suspected to have anthracycline-induced cardiomyopathy. Further studies are required to establish prevention and management strategies for dogs receiving potentially cardiotoxic therapies, such as anthracyclines.
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Affiliation(s)
- Michihito Tagawa
- Veterinary Medical Center, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Genya Shimbo
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Akiko Uemura
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Kotaro Matsumoto
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
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Klimiuk P, Łopuszyński W, Bulak K, Brzana A. Evaluation of the Proliferative Activity of Diffuse Large B-Cell Lymphoma (DLBCL) in Dogs with Respect to Patient Eligibility for Anthracycline-Based Chemotherapy. Animals (Basel) 2021; 11:ani11041183. [PMID: 33924252 PMCID: PMC8074745 DOI: 10.3390/ani11041183] [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: 02/27/2021] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Canine lymphomas usually have aggressive behavior, but respond well to chemotherapy. Despite proper diagnosis and numerous available therapeutic regimens, it is difficult to determine the prognosis and choose the optimal method of treatment in each individual patient. Diffuse large B-cell lymphoma is the most commonly diagnosed histological subtype of canine lymphoma and is treated with anthracyclines alone or in combination with other chemotherapeutics. A new diagnostic marker of prognostic and predictive value is topoisomerase IIα, which also constitutes a molecular target for anti-cancer drugs belonging to the group of topoisomerase IIα inhibitors including anthracyclines. Proliferative activity was estimated in samples of enlarged lymph nodes in dogs with diffuse large B-cell lymphoma based on mitotic count and immunohistochemical evaluation of topoisomerase IIα and Ki67 antigen expression with a view to qualifying patients for anthracycline-base chemotherapy. It has been shown that higher levels of topoisomerase IIα expression corresponded to a higher mitotic count but not to Ki67 index. These results indicate that an immunohistochemical evaluation of topoisomerase IIα expression can be used to develop a diagnostic-clinical protocol for the treatment of dogs with diffuse large B-cell lymphoma using anthracycline-based chemotherapy. Abstract Different types of canine lymphoma respond differently to chemotherapy and have different prognoses. Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma in dogs. Topoisomerase II alpha (TOPIIα) protein has been shown to be a proliferation marker associated with prognostic significance. The aim of the study was to determine the relationship between TOPIIα expression, mitotic count (MC), and Ki67 antigen index in DLBCL in dogs, taking into account the applicability of these parameters to select the chemotherapy protocol with emphasis on the use of anthracycline drugs. Samples of formalin-fixed paraffin-embedded lymph nodes from 34 dogs with DLBCL were immunohistochemically labelled with anti-TOPIIα and Ki67. The number of positive cells and the intensity of the reaction were taken into account in order to assess TOPIIα expression. MC was estimated in the hematoxylin and eosin-stained slides in the area of 2.37 mm2. Positive association between TOPIIα and MC, but no association between TOPIIα and Ki67 was found. It can be concluded that the immunohistochemical determination of TOPIIα as a molecular target for drugs from the anthracycline group may be used in association with MC to establish a diagnostic-clinical protocol for selecting dogs with DLBCL for treatment with anthracycline drugs.
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Affiliation(s)
- Paweł Klimiuk
- Veterinary Diagnostic Laboratory VetDiagnostyka, 20-418 Lublin, Poland
- Correspondence: ; Tel.: +48-510-141-271
| | - Wojciech Łopuszyński
- Sub-Department of Pathomorphology and Forensic Veterinary Medicine, Department and Clinic of Animal Internal Diseases, University of Life Sciences in Lublin, 20-601 Lublin, Poland; (W.Ł.); (K.B.)
| | - Kamila Bulak
- Sub-Department of Pathomorphology and Forensic Veterinary Medicine, Department and Clinic of Animal Internal Diseases, University of Life Sciences in Lublin, 20-601 Lublin, Poland; (W.Ł.); (K.B.)
| | - Adam Brzana
- Regional Veterinary Inspectorate in Opole, Regional Veterinary Laboratory, 45-836 Opole, Poland;
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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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23
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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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Bohannan Z, Pudupakam RS, Koo J, Horwitz H, Tsang J, Polley A, Han EJ, Fernandez E, Park S, Swartzfager D, Qi NSX, Tu C, Rankin WV, Thamm DH, Lee HR, Lim S. Predicting likelihood of in vivo chemotherapy response in canine lymphoma using ex vivo drug sensitivity and immunophenotyping data in a machine learning model. Vet Comp Oncol 2020; 19:160-171. [PMID: 33025640 PMCID: PMC7894155 DOI: 10.1111/vco.12656] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 02/06/2023]
Abstract
We report a precision medicine platform that evaluates the probability of chemotherapy drug efficacy for canine lymphoma by combining ex vivo chemosensitivity and immunophenotyping assays with computational modelling. We isolated live cancer cells from fresh fine needle aspirates of affected lymph nodes and collected post‐treatment clinical responses in 261 canine lymphoma patients scheduled to receive at least 1 of 5 common chemotherapy agents (doxorubicin, vincristine, cyclophosphamide, lomustine and rabacfosadine). We used flow cytometry analysis for immunophenotyping and ex vivo chemosensitivity testing. For each drug, 70% of treated patients were randomly selected to train a random forest model to predict the probability of positive Veterinary Cooperative Oncology Group (VCOG) clinical response based on input variables including antigen expression profiles and treatment sensitivity readouts for each patient's cancer cells. The remaining 30% of patients were used to test model performance. Most models showed a test set ROC‐AUC > 0.65, and all models had overall ROC‐AUC > 0.95. Predicted response scores significantly distinguished (P < .001) positive responses from negative responses in B‐cell and T‐cell disease and newly diagnosed and relapsed patients. Patient groups with predicted response scores >50% showed a statistically significant reduction (log‐rank P < .05) in time to complete response when compared to the groups with scores <50%. The computational models developed in this study enabled the conversion of ex vivo cell‐based chemosensitivity assay results into a predicted probability of in vivo therapeutic efficacy, which may help improve treatment outcomes of individual canine lymphoma patients by providing predictive estimates of positive treatment response.
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Affiliation(s)
| | | | - Jamin Koo
- ImpriMed, Inc., Palo Alto, California, USA.,ImpriMed Korea, Inc., Seoul, Republic of Korea.,Department of Chemical Engineering, Hongik University, Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | | - Chantal Tu
- SAGE Veterinary Centers, Dublin, California, USA
| | | | - Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
| | - Hye-Ryeon Lee
- ImpriMed, Inc., Palo Alto, California, USA.,ImpriMed Korea, Inc., Seoul, Republic of Korea
| | - Sungwon Lim
- ImpriMed, Inc., Palo Alto, California, USA.,ImpriMed Korea, Inc., Seoul, Republic of Korea
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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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Fournier Q, Serra JC, Williams C, Bavcar S. Chemotherapy-induced diarrhoea in dogs and its management with smectite: Results of a monocentric open-label randomized clinical trial. Vet Comp Oncol 2020; 19:25-33. [PMID: 32562450 DOI: 10.1111/vco.12631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/20/2022]
Abstract
Chemotherapy-induced diarrhoea (CID) is a frequent chemotherapy adverse event in dogs. Yet, there is currently no consensus regarding its management. Smectite is a natural medical clay, widely used in the treatment of acute diarrhoea in humans. The objectives of this study were to assess the efficacy of smectite in the management of CID in dogs, and to collect epidemiological data on CID. For each episode of diarrhoea, dogs were randomized into two management groups: Smectite group, receiving smectite at 0.5 g/kg PO per day divided in two to three doses initiated at the start of CID; control group, without initial medication. In both groups, rescue metronidazole was prescribed if CID progressed or was not improved within 48 hours. Sixty dogs were recruited and received 426 chemotherapy administrations between June 2017 and March 2019. The incidence rate of CID was 110/426 (25.8%, 95% CI: 21.7%-30.2%), and significantly differed between the chemotherapeutic drugs administered (P < .001). Metronidazole was administered in 5/54 events (9.3%, 95% CI: 3.1%-20.3%) in the smectite group and in 40/56 events (71.4%, 95% CI: 57.5%-82.3%) in the control group (P < .001). The time to resolution of diarrhoea was shorter (P < .001) in the smectite group (median: 19.5 hours, interquartile range [IQR]: 13.5-32 hours) compared with the control group (median: 53 hours, IQR: 31.5-113.5 hours). The results of this study support the administration of smectite in the first-line management of CID in dogs.
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Affiliation(s)
- Quentin Fournier
- Hospital for Small Animals, The University of Edinburgh, Royal (Dick) School of Veterinary Studies and Roslin Institute, Roslin, UK
| | - Juan-Carlos Serra
- Hospital for Small Animals, The University of Edinburgh, Royal (Dick) School of Veterinary Studies and Roslin Institute, Roslin, UK
| | - Claire Williams
- Hospital for Small Animals, The University of Edinburgh, Royal (Dick) School of Veterinary Studies and Roslin Institute, Roslin, UK
| | - Spela Bavcar
- Hospital for Small Animals, The University of Edinburgh, Royal (Dick) School of Veterinary Studies and Roslin Institute, Roslin, UK
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27
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Willcox JL, Belanger C, Burton JH, Yu L, Ueda Y, Visser LC, Skorupski K, Stern JA. Intramuscular Diphenhydramine Does Not Affect Acute Doxorubicin Infusion-Related Arrhythmia Number or Severity in a Prospective Crossover Study in Canine Lymphoma: A Pilot Study. Front Vet Sci 2020; 7:368. [PMID: 32766291 PMCID: PMC7379900 DOI: 10.3389/fvets.2020.00368] [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: 02/12/2020] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Doxorubicin (DOX) is one of the most effective chemotherapeutics for canine high-grade lymphoma. In addition to dose-dependent chronic cardiotoxicity, DOX can trigger acute cardiac arrhythmias during drug infusion. Diphenhydramine premedication is commonly used, as histamine release is a proposed mechanism for DOX-associated arrhythmogenesis. Hypothesis/Objectives: The study objectives were to evaluate the incidence and severity of DOX infusion-related cardiac arrhythmias in dogs with high-grade lymphoma and evaluate the effect of diphenhydramine premedication on arrhythmia frequency and severity during and after DOX infusion. Animals: Twenty-two client-owned dogs with cytologically/histopathologically confirmed high-grade lymphoma were recruited, of which 19 were enrolled and 9 completed the study. Methods: Dogs were screened by echocardiogram and concurrent electrocardiogram for this randomized prospective crossover study. Group A received no premedication for DOX #1 and was premedicated with diphenhydramine for DOX #2; Group B received diphenhydramine with DOX #1 and no premedication for DOX #2. For both visits, Holter monitor data were collected for 1 h pre-DOX and 3 h post-DOX administration. Results: Nineteen dogs were enrolled and 9 dogs [Group A (5), Group B (4)] completed the protocol. There was no statistical difference between the DOX alone and DOX + diphenhydramine when evaluating the total number of ventricular premature complexes (VPCs, P = 0.34), change in VPCs/hour (P = 0.25), total number of atrial premature complexes (APCs, P = 0.5), change in APCs/hour (P = 0.06), or ventricular arrhythmia severity score (P > 0.99). Conclusions and clinical importance: This study demonstrates that in these dogs with rigorous pretreatment cardiovascular screening, DOX infusion did not induce significant arrhythmias. Furthermore, these data suggest that, with this screening approach, diphenhydramine may not alter the arrhythmia number or severity in canine DOX recipients.
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Affiliation(s)
- Jennifer Lindley Willcox
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Catherine Belanger
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Jenna Hart Burton
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Lydia Yu
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Yu Ueda
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Lance C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Katherine Skorupski
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Joshua A Stern
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
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28
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Jark P, Fracacio C, Anai L, Silva M, Calazans S, Senhorello I, Costa M, Sequeira J, Sueiro F. Histopathological and immunophenotypical characterization of canine multicentric lymphoma in Brazil: a study of 203 cases. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The immunophenotype is regarded as an independent prognostic factor in high-grade lymphomas, seeing that lymphomas of T-cell origin are associated with shorter survival time. Although a number of studies have evaluated the immunophenotypical profile of lymphoma in the USA and Europe, Brazilian research on the matter remains scarce. Exact characterization of the histopathological type is crucial to establish proper treatment and prognosis. This study evaluated the database of immunohistochemistry laboratories that perform immunophenotyping of canine lymphoma in Brazil. A total of 203 cases of multicentric lymphoma were classified according to the WHO classification. Immunophenotyping was able to identify 71.4% lymphomas of B-cell line, 27.1% of T-cell line and 1.5% of non-B cells and non-T cell lines. Diffuse large B-cell lymphoma was the most common with 59.1% of the cases. Among T-cell lymphomas, lymphoblastic was the most common (11.33% of the cases). Even though canine lymphomas tend to be high-grade, indolent lymphomas comprised 11.82% of the cases and T-zone lymphoma was the most prevalent (8.86%). The immunophenotype of multicentric lymphoma in Brazil is similar to those in other parts of the world, which suggests similar etiologic factors to the development of this disease.
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Affiliation(s)
- P.C. Jark
- Universidade Brazil, Brazil; Universidade Estadual Paulista, Brazil
| | | | - L.A. Anai
- Universidade Estadual Paulista, Brazil
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29
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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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30
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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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31
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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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32
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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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34
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Tel-eVax: a genetic vaccine targeting telomerase for treatment of canine lymphoma. J Transl Med 2018; 16:349. [PMID: 30537967 PMCID: PMC6290499 DOI: 10.1186/s12967-018-1738-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/07/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND we have recently shown that Tel-eVax, a genetic vaccine targeting dog telomerase (dTERT) and based on Adenovirus (Ad)/DNA Electro-Gene-Transfer (DNA-EGT) technology can induce strong immune response and increase overall survival (OS) of dogs affected by multicentric Diffuse Large B cell Lymphoma (DLBCL) when combined to COP therapy in a double-arm study. Here, we have utilized a clinically validated device for veterinary electroporation called Vet-ePorator™, based on Cliniporator™ technology currently utilized and approved in Europe for electrochemotherapy applications and adapted to electrogenetransfer (EGT). METHODS 17 dogs affected by DLBCL were vaccinated using two Ad vector injections (Prime phase) followed by DNA-EGT (Boost phase) by means of a Vet-ePorator™ device and treated in the same time with a 27-week Madison Wisconsin CHOP protocol. The immune response was measured by ELISA assays using pool of peptides. RESULTS No significant adverse effects were observed. The OS of vaccine/CHOP animals was 64.5 weeks, in line with the previous study. Dogs developed antibodies against the immunizing antigen. CONCLUSIONS Tel-eVax in combination with CHOP is safe and immunogenic in lymphoma canine patients. These data confirm the therapeutic efficacy of dTERT vaccine and hold promise for the treatment of dogs affected by other cancer types. More importantly, our findings may translate to human clinical trials and represent new strategies for cancer treatment.
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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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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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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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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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Hume KR, Sylvester SR, Borlle L, Balkman CE, McCleary-Wheeler AL, Pulvino M, Casulo C, Zhao J. Metabolic Abnormalities Detected in Phase II Evaluation of Doxycycline in Dogs with Multicentric B-Cell Lymphoma. Front Vet Sci 2018. [PMID: 29536017 PMCID: PMC5834767 DOI: 10.3389/fvets.2018.00025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Doxycycline has antiproliferative effects in human lymphoma cells and in murine xenografts. We hypothesized that doxycycline would decrease canine lymphoma cell viability and prospectively evaluated its clinical tolerability in client-owned dogs with spontaneous, nodal, multicentric, substage a, B-cell lymphoma, not previously treated with chemotherapy. Treatment duration ranged from 1 to 8 weeks (median and mean, 3 weeks). Dogs were treated with either 10 (n = 6) or 7.5 (n = 7) mg/kg by mouth twice daily. One dog had a stable disease for 6 weeks. No complete or partial tumor responses were observed. Five dogs developed grade 3 and/or 4 metabolic abnormalities suggestive of hepatopathy with elevations in bilirubin, ALT, ALP, and/or AST. To evaluate the absorption of oral doxycycline in our study population, serum concentrations in 10 treated dogs were determined using liquid chromatography tandem mass spectrometry. Serum levels were variable and ranged from 3.6 to 16.6 µg/ml (median, 7.6 µg/ml; mean, 8.8 µg/ml). To evaluate the effect of doxycycline on canine lymphoma cell viability in vitro, trypan blue exclusion assay was performed on canine B-cell lymphoma cell lines (17-71 and CLBL) and primary B-cell lymphoma cells from the nodal tissue of four dogs. A doxycycline concentration of 6 µg/ml decreased canine lymphoma cell viability by 80%, compared to matched, untreated, control cells (mixed model analysis, p < 0.0001; Wilcoxon signed rank test, p = 0.0313). Although the short-term administration of oral doxycycline is not associated with the remission of canine lymphoma, combination therapy may be worthwhile if future research determines that doxycycline can alter cell survival pathways in canine lymphoma cells. Due to the potential for metabolic abnormalities, close monitoring is recommended with the use of this drug in tumor-bearing dogs. Additional research is needed to assess the tolerability of chronic doxycycline therapy.
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Affiliation(s)
- Kelly R Hume
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Skylar R Sylvester
- College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Lucia Borlle
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Cheryl E Balkman
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Angela L McCleary-Wheeler
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Mary Pulvino
- Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, United States
| | - Carla Casulo
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
| | - Jiyong Zhao
- Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY, United States.,Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
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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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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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Villarnovo D, McCleary-Wheeler AL, Richards KL. Barking up the right tree: advancing our understanding and treatment of lymphoma with a spontaneous canine model. Curr Opin Hematol 2017; 24:359-366. [PMID: 28426554 PMCID: PMC5553274 DOI: 10.1097/moh.0000000000000357] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Spontaneous lymphoma in pet dogs is increasingly recognized as an ideal model for studying the disease in humans and for developing new targeted therapeutics for patients. Increasing interest by funding agencies, the private sector, and multidisciplinary academic collaborations between different disciplines and sectors now enables large knowledge gaps to be addressed and provides additional proof-of-concept examples to showcase the significance of the canine model. RECENT FINDINGS The current review addresses the rationale for a canine lymphoma model including the valuable role it can play in drug development, serving as a link between mouse xenograft models and human clinical trials and the infrastructure that is now in place to facilitate these studies. Research in this field has focused on filling in the gaps to make the canine lymphoma model more robust. These advances have included work on biomarkers, detection of minimal residual disease, expansion of genomic and proteomic data, and immunotherapy. SUMMARY Incorporating pet dogs into the drug development pipeline can improve the efficiency and predictability of preclinical models and decrease the time and cost required for a therapeutic target to be translated into clinical benefit.
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Affiliation(s)
- Dania Villarnovo
- aDepartment of Biomedical Sciences bDepartment of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca cSandra and Edward Meyer Cancer Center dDivision of Hematology/Oncology, Weill Cornell Medicine, New York, New York, USA
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Moore EL, Vernau W, Rebhun RB, Skorupski KA, Burton JH. Patient characteristics, prognostic factors and outcome of dogs with high-grade primary mediastinal lymphoma. Vet Comp Oncol 2017; 16:E45-E51. [PMID: 28660709 DOI: 10.1111/vco.12331] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/02/2017] [Accepted: 05/09/2017] [Indexed: 02/05/2023]
Abstract
The goals of this retrospective study were to determine the patient characteristics of dogs with high-grade primary mediastinal lymphoma and to determine outcome and associated prognostic factors. A total of 42 dogs were identified, in which 36 received treatment and had follow-up information available. The most common clinical signs included lethargy, anorexia and polyuria/polydipsia. Hypercalcemia and pleural effusion were common findings at diagnosis. The phenotype was almost exclusively T-cell, most often in association with lymphoblastic cytomorphology as defined by the World Health Organization (WHO) lymphoma classification scheme. The overall progression-free survival (PFS) and overall survival (OS) were 133 and 183 days, respectively. Treatment with a CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) protocol was associated with an improved PFS (144 days) and OS (194 days) when compared with dogs that received other medical therapies (P = .005 and P = .002, respectively); the absence of pleural effusion at diagnosis was associated with an increased OS but not PFS. These results suggest that while the prognosis for dogs with mediastinal lymphoma is poor, survival may be improved with treatment using a CHOP-based protocol.
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Affiliation(s)
- E L Moore
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - W Vernau
- Department of Pathology, Microbiology & Immunology, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - R B Rebhun
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - K A Skorupski
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - J H Burton
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California
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Wilson-Robles H, Budke CM, Miller T, Dervisis N, Novosad A, Wright Z, Thamm DH, Vickery K, Burgess K, Childress M, Lori J, Saba C, Rau S, Silver M, Post G, Reeds K, Gillings S, Schleis S, Stein T, Brugmann B, DeRegis C, Smrkovski O, Lawrence J, Laver T. Geographical differences in survival of dogs with non-Hodgkin lymphoma treated with a CHOP based chemotherapy protocol. Vet Comp Oncol 2017; 15:1564-1571. [PMID: 28419683 DOI: 10.1111/vco.12302] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/07/2016] [Accepted: 12/12/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND In humans geographical differences in the incidence and presentation of various cancers have been reported. However, much of this information has not been collected in veterinary oncology. AIM The purpose of this study was to determine if a geographic difference in progression free survival exists for dogs with lymphoma treated within the US. MATERIALS AND METHODS Medical records of 775 cases of canine lymphoma from 3 US regions (west, south and north), treated with CHOP chemotherapy, were retrospectively evaluated. Cases were collected from referral institutions and were required to have received at least one doxorubicin treatment and have follow up information regarding time to progression. RESULTS Significant differences in sex (p = 0.05), weight (p = 0.049), stage (p < 0.001), immunophenotype (p = <0.001), and number of doxorubicin doses (p = 0.001) were seen between regions. Upon univariate analysis, progression free survival (PFS) differed by region (p = 0.006), stage (p = 0.009), sub-stage (p = 0.0005), and immunophenotype (p = 0.001). A multivariable Cox regression model showed that dogs in the western region had a significantly shorter PFS when compared to the south and east. CONCLUSION PFS was significantly affected by stage, sub-stage and phenotype.
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Affiliation(s)
- H Wilson-Robles
- Small Animal Clinical Sciences Department, College of Veterinary Medicine, Texas A&M University, College Station, Texas
| | - C M Budke
- Veterinary Integrative Biosciences Department, College of Veterinary Medicine, Texas A&M University, College Station, Texas
| | - T Miller
- Small Animal Clinical Sciences Department, College of Veterinary Medicine, Texas A&M University, College Station, Texas
| | - N Dervisis
- Small Animal Clinical Sciences Department, Veterinary Medical Center, Michigan State University, East Lansing, Michigan
| | - A Novosad
- Sugar Land Veterinary Specialists and Emergency Care, Sugar Land, Texas
| | - Z Wright
- VCA Animal Diagnostic Clinic, Dallas, Texas
| | - D H Thamm
- Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado
| | - K Vickery
- Hope Veterinary Specialists, Malvern, Pennsylvania
| | - K Burgess
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - M Childress
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - J Lori
- Animal Emergency and Specialty Center, Parker, Colorado
| | - C Saba
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | - S Rau
- Metropolitan Veterinary Associates, Norristown, Pennsylvania
| | - M Silver
- New England Veterinary Oncology Group, Waltham, Massachusetts
| | - G Post
- Department of Oncology, The Veterinary Cancer Center, Norwalk, Connecticut
| | - K Reeds
- Veterinary Clinical Sciences Department, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, Oklahoma
| | - S Gillings
- Summit Veterinary Referral Center, Tacoma, Washington
| | - S Schleis
- Clinical Sciences Department, College of Veterinary Medicine, Auburn University, Auburn, Alabama
| | - T Stein
- Medical Sciences Department, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - B Brugmann
- Veterinary Clinical Sciences Department, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - C DeRegis
- Pieper Memorial Veterinary Center, Middletown, Connecticut
| | - O Smrkovski
- Small Animal Clinical Sciences Department, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - J Lawrence
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | - T Laver
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
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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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Affiliation(s)
- Antony S. Moore
- Veterinary Oncology Consultants; Wauchope New South Wales 2446 Australia
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Goodman IH, Moore AS, Frimberger AE. Treatment of canine non-indolent T cell lymphoma using the VELCAP-TSC protocol: A retrospective evaluation of 70 dogs (2003–2013). Vet J 2016; 211:39-44. [DOI: 10.1016/j.tvjl.2016.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/28/2016] [Accepted: 03/03/2016] [Indexed: 01/19/2023]
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