Long-term outcome associated with intratumoral chemotherapy with cisplatin for cutaneous tumors in equidae: 573 cases (1995–2004)

Concomitant melanoma and keratoma affecting the equine digit: clinical, pathological, and long-term follow-up findings

BACKGROUND

This case report details a long-term follow-up of a hoof melanoma with dermo-epidermal activity (resembling Spreading Superficial Melanoma (SSM)) in a bay horse with a history of a right front hoof keratoma. Melanomas involving the horse's foot are seldom reported and usually diagnosed as anaplastic melanomas based on signalment and post-mortem examination. The clinical-pathological characteristics of the foot melanoma in this bay horse are consistent with SSM-like described in humans, which is considered an intermediate malignant tumour attending their biological behaviour. However, a definitive diagnosis is limited by the single case and the lack of references in horses.

CASE PRESENTATION

A 12-year-old bay Andalusian gelding underwent keratoma removal on the lateral aspect of the hoof wall. A partial resection of the hoof wall was performed for this purpose. Additionally, a plaque-like, hyperkeratotic pigmented lesion, 2 × 2X0,4 cm in size, was observed at the lateral aspect of the coronary band and was also resected for histopathological examination. Microscopically, a melanocytic tumour, characterised by small nests of large polygonal or epithelioid cells infiltrating the basal and suprabasal epidermis, the dermo - epidermal junction, and the superficial dermis, was observed. The neoplastic cells exhibited large euchromatic nuclei, prominent nucleoli, moderate pleomorphism and 4 mitotic figures per 2,37mm2; variable amounts of dark granules (melanin) were present in the cytoplasm, as well as in numerous peritumoral macrophages. The immunophenotype of the tumour cells was PNL2 +  +  + , S100 +  + , AE1/AE3-. A diagnosis of melanoma with dermo-epidermal junction and marked intraepidermal activity (consistent with superficial spreading melanoma) was made. A magnetic resonance imaging (MRI) performed, revealed no further invasion into surrounding structures. Treatment was based on surgical resection and multiple local chemotherapy sessions with cisplatin were applied. The biopsies obtained after treatment showed partial regression of the tumour and different stages of healing. After 26 months of follow-up, there was no signs of malignant spreading into surrounding structures including the pedal bone and distal metastasis but a dark - coloured area persists over the lateral aspect of the coronary band.

CONCLUSIONS

This case presents a concomitant keratoma and melanoma with dermo - epidermal activity, resembling a spreading superficial melanoma. After a follow - up of 26 months the horse remains healthy and sound providing new information for clinicians and pathologists. Despite the poor prognosis associated with foot malignant melanocytic tumours, it is important that an early and accurate diagnosis is reached through different diagnostic modalities such as advanced imaging techniques and histopathology. Additionally, these findings demonstrate that the current classification and prognosis for equine foot melanomas are insufficient.

Lymphoma & Myeloproliferative Disease

Lymphoma and myeloproliferative diseases in horses are relatively uncommon. The clinical signs, prognosis, and treatment options depend upon the anatomic location and subtype. Significant gaps in knowledge remain regarding prevalence, pathogenesis of different subtypes, antemortem diagnostic tests, response to treatment, and standardized treatment protocols. However, treatment options are available, accessible on the farm, and could improve quality of life and prolong survival.

What Is the Evidence Behind Sarcoid Treatments?

Despite the ubiquitous nature of sarcoids, robust data regarding the selection of treatment modalities are scarce, with many treatments having little or no published data to support their use. Treatment options are numerous and vary with the location and type of sarcoid, treatment accessibility, and the financial status of the owner. Many treatments are expensive and time-consuming, and some have health and safety implications. It is this author's belief that, based on the limited evidence base, appropriate treatment options vary with the location and type of the sarcoid, and no one treatment is universally appropriate.

Squamous Cell Carcinomas in Horses: An Update of the Aetiopathogenesis and Treatment Options

Squamous cell carcinomas are a very common tumor type in horses, and are found in a variety of dermatologic and non-dermatologic locations. Metastasis is common, even at the first presentation of the disease, and a full staging workup is therefore strongly recommended to direct treatment and assist with prognostication. Wide surgical excision remains the treatment of choice in most cases, but recurrence is common, and adjunctive therapy may be indicated to improve the long-term prognosis.

Chemotherapeutics in Equine Practice

Chemotherapy is the treatment of cancerous cells through the use of cytotoxic drugs. Whilst the use of systemic (intravenous) chemotherapy in equine practice is generally limited to the management of lymphoma, cytotoxic drugs are commonly used in the treatment of accessible skin tumors, either by topical application in the form of ointments or injected intralesionally. These drugs should be employed with caution due to the risk of serious adverse effects. In addition, extreme caution should be followed when preparing, handling, administering, and disposing them, due to their carcinogenic, mutagenic, and teratogenic properties.

Potent drug delivery enhancement of betulinic acid and NVX-207 into equine skin in vitro - a comparison between a novel oxygen flow-assisted transdermal application device and microemulsion gels

BACKGROUND

Gray horses are predisposed to equine malignant melanoma (EMM) with advancing age. Depending on the tumor's location and size, they can cause severe problems (e.g., defaecation, urination, feeding). A feasible therapy for EMM has not yet been established and surgical excision can be difficult depending on the location of the melanoma. Thus, an effective and safe therapy is needed. Naturally occurring betulinic acid (BA), a pentacyclic triterpene and its synthetic derivate, NVX-207 (3-acetyl-betulinic acid-2-amino-3-hydroxy-2-hydroxymethyl-propanoate) are known for their cytotoxic properties against melanomas and other tumors and have already shown good safety and tolerability in vivo. In this study, BA and NVX-207 were tested for their permeation potential into equine skin in vitro in Franz-type diffusion cell (FDC) experiments after incubation of 5 min, 30 min and 24 h, aiming to use these formulations for prospective in vivo studies as a treatment for early melanoma stages. Potent permeation was defined as reaching or exceeding the half maximal inhibitory concentrations (IC50) of BA or NVX-207 for equine melanoma cells in equine skin samples. The active ingredients were either dissolved in a microemulsion (ME) or in a microemulsion gel (MEG). All of the formulations were transdermally applied but the oil-in-water microemulsion was administered with a novel oxygen flow-assisted (OFA) applicator (DERMADROP TDA).

RESULTS

All tested formulations exceeded the IC50 values for equine melanoma cells for BA and NVX-207 in equine skin samples, independently of the incubation time NVX-207 applied with the OFA applicator showed a significant time-dependent accumulation and depot-effect in the skin after 30 min and 24 h (P < 0.05).

CONCLUSIONS

All tested substances showed promising results. Additionally, OFA administration showed a significant accumulation of NVX-207 after 30 min and 24 h of incubation. Further in vivo trials with OFA application are recommended.

Enteric associated T-cell lymphoma in a mule

A 25-year-old female mule weighing 336 kg was referred with a history of lethargy, abdominal discomfort, anorexia, and constipation in the previous 24 hours. On admission, decreased intestinal borborygmi and distended small intestinal loops were detected by auscultation and rectal palpation, respectively. On rectal examination a firm, irregular surface, and pedunculated mass were detected in the middle-caudal region of the abdomen. Transrectal ultrasonography revealed the mass was highly vascularized with heterogeneous tissue density. On exploratory celiotomy two neoplastic masses were observed, one in the jejunoileal junction obstructing the intestinal flow and the second in the dorsal part of the jejunal mesentery, unable to be exposed and resected. An enterectomy was conducted, and the intestinal mass was removed. The mass was pale with hemorrhagic areas and 12 cm in diameter. Histopathology and immunohistochemistry confirmed a diagnosis of enteric associated T cell lymphoma subtype 2. The mule died suddenly 43 days later.

Investigation of integrated time nanosecond pulse irreversible electroporation against spontaneous equine melanoma

Introduction

Integrated time nanosecond pulse irreversible electroporation (INSPIRE) is a novel tumor ablation modality that employs high voltage, alternating polarity waveforms to induce cell death in a well-defined volume while sparing the underlying tissue. This study aimed to demonstrate the in vivo efficacy of INSPIRE against spontaneous melanoma in standing, awake horses.

Methods

A custom applicator and a pulse generation system were utilized in a pilot study to treat horses presenting with spontaneous melanoma. INSPIRE treatments were administered to 32 tumors across 6 horses and an additional 13 tumors were followed to act as untreated controls. Tumors were tracked over a 43-85 day period following a single INSPIRE treatment. Pulse widths of 500ns and 2000ns with voltages between 1000 V and 2000 V were investigated to determine the effect of these variables on treatment outcomes.

Results

Treatments administered at the lowest voltage (1000 V) reduced tumor volumes by 11 to 15%. Higher voltage (2000 V) treatments reduced tumor volumes by 84 to 88% and eliminated 33% and 80% of tumors when 500 ns and 2000 ns pulses were administered, respectively.

Discussion

Promising results were achieved without the use of chemotherapeutics, the use of general anesthesia, or the need for surgical resection in regions which are challenging to keep sterile. This novel therapeutic approach has the potential to expand the role of pulsed electric fields in veterinary patients, especially when general anesthesia is contraindicated, and warrants future studies to demonstrate the efficacy of INSPIRE as a solid tumor treatment.

Programmed Cell Death-Ligand 1 (PD-L1) Immunohistochemical Expression in Equine Melanocytic Tumors

Currently available treatments for equine melanocytic tumors have limitations, mainly due to mass localization and dimension, or the presence of metastases. Therefore, a search for new therapies is necessary. Programmed cell death-ligand 1 (PD-L1) is expressed by several tumors, blocking T cell-mediated elimination of the tumor cells by binding to programmed cell death protein 1 (PD-1). A novel therapeutic approach using PD-1/PD-L1 blockade in human melanoma resulted in tumor regression and prolonged tumor-free survival. This study aimed to evaluate the immunohistochemical expression of PD-L1 in equine melanocytic tumors. A total of 77 melanocytic tumors were classified as benign or malignant and evaluated by extension of labeling. A total of 59.7% of the tumors showed >50% of immunolabeled cells. Regarding malignant tumors, 24/38 tumors presented >50% of labeled cells, 13 tumors presented between 25-50% and one tumor presented <10%. Regarding benign tumors, 22/39 tumors presented >50% of labeled cells, nine tumors presented 25-50%, three tumors presented 10-25%, two tumors presented <10% and three tumors did not present expression. Our results suggest that PD-L1 blockade may be a potential target for immunotherapy in equine melanocytic tumors and that future clinical research trials into the clinical efficacy of the anti-PD-L1 antibody are necessary.

Equine Melanocytic Tumors: A Narrative Review

Adult grey horses have a high incidence of melanocytic tumors. This article narratively reviews the role of some genetic features related to melanoma formation in horses, such as STX17 mutation, ASIP or MITF alterations, and the link between the graying process and the development of these tumors. A clear system of clinical and pathological classification of melanocytic tumors in naevus, dermal melanoma, dermal melanomatosis and anaplastic malignant melanoma is provided. Clinical and laboratorial methods of diagnosing are listed, with fine needle aspiration and histopathology being the most relevant. Relevance is given to immunohistochemistry, describing potentially important diagnostic biomarkers such as RACK1 and PNL2. Different therapeutical options available for equine practitioners are mentioned, with surgery, chemotherapy and electroporation being the most common. This article also elucidatesnew fields of research, perspectives, and new therapeutic targets, such as CD47, PD-1 and COX-2 biomarkers.

Management of equine sarcoids

Sarcoids are the most common cutaneous neoplasm of the horse, arising as a result of a neoplastic proliferation of fibroblasts associated with infection with bovine papillomavirus, most notably types 1 and 2. Although they do not metastasise, they are locally invasive and aggressive, and can lead to important welfare concerns, interfere with tack and therefore impede athleticism, and undoubtedly lead to a reduction in the value of affected horses. This review discusses the evidence behind the most commonly used treatments for equine sarcoids. The most commonly used treatments are discussed. No one treatment is universally successful, and there are many treatments with varying level of scientific evaluation and reported success rates.

Interventions for treatment of cutaneous melanoma in horses: a structured literature review

Several therapies have been developed to treat equine cutaneous melanoma, but formal comparisons among different treatment options are currently unavailable. It was our intent to assess the efficacy of different treatment protocols and the quality of the studies based on the original published data, and summarize the knowledge concerning the outcome after equine cutaneous melanoma management. This structured review followed PRISMA procedure to search for treatment protocols on equine cutaneous melanoma published from 1960 until June 2021. Studies were assessed for the risk of bias. A descriptive analysis was performed, considering the disease control rate, the recurrence rate of the tumor, comorbidities, need for anesthesia, and horses' welfare. Twenty-three studies were included, from which the treatment outcomes of 173 horses were assessed. The homogeneity of the included trials was low. The percentages of each treatment arm achieving a partial response and curative effects accounted for 93.1% (surgical intervention), 90% (medication), and 39.4% (immunotherapies), respectively. A variable efficacy of different therapies of equine cutaneous melanoma was observed. Surgical intervention performed the best from the perspective of local antitumor effects alone. This literature review and descriptive analysis can serve as a source to assist in designing quality therapy research and can potentially aid in providing a clinical treatment reference for equine cutaneous melanoma.

Hematological, serum biochemical results, and treatment approach of an Arabian mare with squamous cell carcinoma of the vulva - case report

ABSTRACT A 20-year-old Arabian mare, was brought to the obstetrics and gynecology clinic with the complaint of an unknown wound in the genital area. Although the mare's general condition was good, examination of the genital area revealed a wide-open wound in the vulva and posterior vagina, characterized by fibrotic growth. The biopsy sample was sent to the pathology laboratory. A diagnosis of squamous cell carcinoma (SCC) was made after histopathological examination. Blood samples for serum biochemistry and hematological tests were collected from the jugular vein. Hematological and serum biochemical findings are generally used to diagnose diseases in animals and humans. Hematological and serum biochemical findings are important with genital SCC. Therefore, the findings of these values are given in this case report.

Effects of Topically Applied Betulinic Acid and NVX-207 on Melanocytic Tumors in 18 Horses

Simple Summary

Melanomas are skin tumors of the pigment-producing melanocytes. Equine melanomas are among the most frequently diagnosed tumors affecting grey horses. The melanocytic tumors progress to malignancy in more than two-thirds of cases. Previous laboratory experiments and studies with horses utilizing the naturally occurring betulinic acid (BA) and its derivative NVX-207 showed promising results with respect to the topical (epicutaneous) treatment of equine melanoma. Therefore, the aim of this feasibility study was to gain first insights into the effect and safety of BA and NVX-207 in eighteen horses with early-stage melanocytic tumors after a 13-week-long topical application. The topical treatment was convenient and safe. Compared to a placebo, the data suggest a positive treatment effect from topical application of BA and NVX-207 on equine melanomas toward the end of the treatment period. However, the time period studied was too short to conclusively prove this. Further advancement of the investigational medicinal products studied herein could lead to an effective, topical and marketable novel drug which helps to relieve suffering and, consequently, improve the welfare of equine skin cancer patients.

Abstract

The naturally occurring betulinic acid (BA) and its derivative NVX-207 induce apoptosis in equine melanoma cells in vitro. After topical application, high concentrations of the substances can be reached in healthy equine skin. With the aim to investigate the effect and safety of topically applied BA and NVX-207 in horses with melanocytic tumors, the longitudinal, prospective, randomized, double-blind, placebo-controlled study protocol included eighteen Lipizzaner mares with early-stage cutaneous melanoma assigned to three groups. Melanocytic lesions were topically treated either with a placebo, 1% BA or 1% NVX-207 twice a day for 91 days. Caliper measurements, clinical examinations and blood tests were performed to assess the effects and safety of the medication. The topical treatment was convenient and safe. The volumes of tumors treated with BA were significantly reduced over time as compared to tumors treated with the placebo from day 80 of the study. Although treatment with NVX-207 seemed to decrease tumor volume, these results did not reach statistical significance. The findings must be regarded as preliminary due to the limited group size and need to be replicated in a larger cohort with modified pharmaceutical test formulations. Accordingly, the treatment protocol cannot yet be recommended in its current form.

Surgical excision of a malignant metastatic melanoma located in a skeletal muscle of the lateral thorax of a horse

BACKGROUND

A 20-year-old grey Warmblood gelding that had history of dermal melanomatosis.

OBJECTIVE

To report surgical treatment of a 6-cm large malignant metastatic melanoma located in the cutaneous trunci muscle of the left lateral thorax of a horse.

METHODS

A 20-year-old grey Warmblood gelding was referred for evaluation of a large, rapidly growing, thoracic mass. Clinical examination revealed an ovoid, firm, non-painful, movable mass, approximately 6 cm in diameter, located in the cutaneous trunci muscle of the left lateral thorax. Multiple melanocytic nodules were also found at the perianal region and ventral tail. Rectal examination, ultrasonography and endoscopy of the respiratory tract revealed no melanomas internally. Haematological and biochemical values were within normal limits. Surgical excision of both the thoracic mass and perianal nodules was the treatment of choice. Histopathology of the distant thoracic mass confirmed the diagnosis of malignant metastatic melanoma secondary to the perineal lesions that were confirmed as dermal melanomatosis.

RESULTS

The horse recovered uneventfully. Up until 3 years post surgery there was no tumour regrowth at the excision sites.

CONCLUSION

Surgical excision of the metastatic melanoma was performed and considered successful, with no gross evidence of tumour reoccurrence. Despite the fact that surgical excision is considered a treatment option regarding equine dermal melanomatosis, there is no previously published study proposing surgical removal of distant malignant metastatic melanocytic masses. This is the first report of a successful surgical excision of a large (6 cm) metastatic melanocytic tumour from the skeletal muscle of the lateral thorax of a horse.

In vitro assessment of triterpenoids NVX-207 and betulinyl-bis-sulfamate as a topical treatment for equine skin cancer

Equine sarcoid (ES) is the most prevalent skin tumor in equids worldwide. Additionally, aging grey horses frequently suffer from equine malignant melanoma (EMM). Current local therapies targeting these skin tumors remain challenging. Therefore, more feasible topical treatment options should be considered. In order to develop a topical therapy against ES and EMM, betulinyl-bis-sulfamate and NVX-207, derivatives of the naturally occurring betulin and betulinic acid, respectively, were evaluated for their antiproliferative (crystal violet staining assay), cytotoxic (MTS assay) and apoptotic (AnnexinV staining, cell cycle investigations) effects on primary ES cells, EMM cells and equine dermal fibroblasts in vitro. The more potent derivative was assessed for its in vitro penetration and permeation on isolated equine skin within 30 min and 24 h using Franz-type diffusion cells and HPLC analysis. Betulinyl-bis-sulfamate and NVX-207 inhibited the proliferation and metabolism in ES cells, EMM cells and fibroblasts significantly (p < 0.001) in a time- and dose-dependent manner. NVX-207 had superior anticancer effects compared to betulinyl-bis-sulfamate. Both compounds led to the externalization of phosphatidylserines on the cell membrane and DNA fragmentation, demonstrating that the effective mode of action was apoptosis. After 48 h of treatment with NVX-207, the number of necrotic cells was less than 2% in all cell types. Detected amounts of NVX-207 in the different skin layers exceeded the half-maximal inhibitory concentrations calculated by far. Even though data obtained in vitro are auspicious, the results are not unconditionally applicable to the clinical situation. Consequently, in vivo studies are required to address the antitumoral effects of topically applied NVX-207 in ES and EMM patients.

Topical treatment of equine sarcoids with imiquimod 5% cream or Sanguinaria canadensis and zinc chloride - an open prospective study

BACKGROUND

Equine sarcoids are the most prevalent skin neoplasm in horses worldwide. Although several treatments are available, none are consistently effective and recurrence is common.

OBJECTIVES

To evaluate the efficacy and safety of topical imiquimod 5% cream and Sanguinaria canadensis + zinc chloride for treatment of equine sarcoids and investigate possible systemic effects on distant untreated sarcoids.

ANIMALS/TUMOURS

Twenty-five client-owned horses with a total of 164 tumours were included in the study. Fifty-seven tumours were treated and 107 tumours were left untreated.

METHODS AND MATERIALS

Skin biopsy samples were collected from a minimum of one tumour per horse and the rest were diagnosed based on clinical appearance as likely sarcoids. Imiquimod 5% (A) was applied three times weekly, while Sanguinaria canadensis + zinc chloride (X) was applied every fourth day after a six day daily initiation phase. Treatment continued until clinical remission or for a maximum of 45 weeks, with a long follow-up period (mean 34 months). Skin biopsy samples of sarcoid lesions were re-taken before treatment termination and at follow-up if the owner gave consent.

RESULTS

Complete remission was recorded in 84.4% (A) and 75.0% (X) of the tumours. Relapse was recorded in 7.3% (A) and 21.4% (X). Spontaneous remission was observed in 1.9% of untreated tumours. No systemic effect on untreated tumours was detected. During treatment varying degrees of local inflammatory reaction were common.

CONCLUSIONS AND CLINICAL RELEVANCE

Both treatments were considered effective and safe. Smaller tumours responded more favourably to treatment. Relapse rate was low and not observed in sarcoids with repeat biopsies before treatment termination.

Evaluation of Locally Injected Mycobacterium Cell Wall Fraction in Horses with Sarcoids

A reformulation of Mycobacterium cell wall fraction immunotherapeutic can be used to successfully treat sarcoids in horses. Sarcoids are reported to be the most common equine skin tumors with tumor type and location influencing the choice of treatment. Wide surgical excision is curative for many tumors, but may not always be feasible. Previous studies have reported sarcoid regression after injection with mycobacterial cell wall immunotherapeutics. A new formulation of the Mycobacterium phlei cell wall fraction immunostimulant (Immunocidin Equine) was used to treat cutaneous tumors in horses. Equids with skin tumors diagnosed as sarcoids were enrolled in the study. Sarcoids were injected at the initial visit with Immunocidin Equine and subsequently at approximately 2-week intervals. Of 17 cases, nine cases were completely resolved at the end of the study period evaluation or at the time of final follow-up (52.9%). Three cases were reported as improved (smaller), but not resolved (17.6%). Three cases were discontinued from the study as the respective masses were growing larger or not resolving (17.6%). One case (5.8%) with two masses had resolution of one mass, whereas the other tumor had a small regrowth 5 months after the last treatment. One case (5.8%) was lost to follow-up. All cases had mild to moderate swelling of the injection site, and some cases had discharge after the second, third, or fourth injections. No serious systemic side effects or complications were encountered during the study.

Betulinic acid shows anticancer activity against equine melanoma cells and permeates isolated equine skin in vitro

BACKGROUND

Equine malignant melanoma (EMM) is a frequently occurring dermoepidermal tumor in grey horses. Currently available therapies are either challenging or inefficient. Betulinic acid (BA), a naturally occurring triterpenoid, is a promising compound for cancer treatment. To evaluate the potential of BA as a topical therapy for EMM, its anticancer effects on primary equine melanoma cells and dermal fibroblasts and its percutaneous permeation through isolated equine skin were assessed in vitro.

RESULTS

BA showed antiproliferative and cytotoxic effects on both primary equine melanoma cells and fibroblasts in a time- and dose-dependent manner. The lowest half-maximal inhibitory concentrations were obtained 96 h after the beginning of drug exposure (12.7 μmol/L and 23.6 μmol/L for melanoma cells eRGO1 and MelDuWi, respectively, in cytotoxicity assay). High concentrations of the compound were reached in the required skin layers in vitro.

CONCLUSION

BA is a promising substance for topical EMM treatment. Further clinical studies in horses are necessary to assess safety and antitumoral effects in vivo.

Treatment Options for Melanoma of Gray Horses

All gray horses inherited a single gene mutation, STX17^G, that unbalances melanocyte behavior to cause graying and propensities to develop vitiligo and melanoma. The coat color genes ASIP^a and MC1R^E add risk such that relative likelihood of melanoma based on pregraying coat color is black > bay > chestnut. Melanomas begin at about 4 years. Locoregional control of melanoma masses depends on surgical removal and/or intralesional chemotherapy (possibly with adjunctive hyperthermia or electroporation). Systemic treatment is not evidence based but immunomodulators (cimetidine, levamisole) and vaccines can be tried.

Update on Cancer Treatment in Exotics

Treatment options for animals with cancer are rapidly expanding, including in exotic animal medicine. Limited information is available about treatment effects in exotic pet species beyond individual case reports. Most cancer treatment protocols in exotic animals are extrapolated from those described in humans, dogs, and cats. This review provides an update on cancer treatment in exotic animal species. The Exotic Species Cancer Research Alliance accumulates clinical cases in a central location with standardized clinical information, with resources to help clinicians find and enter their cases for the collective good of exotic clinicians and their patients.

Periocular Neoplasia in the Horse

Periocular neoplasia is common in horses. Treatment of the periocular skin and ocular adnexal structures can be technically challenging. Common neoplastic conditions, a treatment algorithm, surgical principles, and therapeutic modalities are reviewed. Regardless of the type of neoplasia found or the treatment that is applied, success is most likely when the neoplastic tumor is small.

Equine Hoof Canker: Cell Proliferation and Morphology

Hoof canker is described as progressive pododermatitis of the equine hoof with absent epidermal cornification and extensive proliferation of the dermal papillary body; however, in-depth research on the type of proliferative activity has not yet been reported. The aim of the present study was to determine cell-specific proliferation patterns together with morphological analysis of hoof canker tissue. Tissues removed during surgery from 19 horses presented for treatment of canker were compared with similar postmortem tissues of healthy hooves of 10 horses. Morphological alterations visible in light microscopy were assessed semiquantitatively and graded for severity. Proliferative activity was evaluated by means of anti-PCNA (proliferative cell nuclear antigen) and anti-Ki67 immunohistochemistry. Histologically, canker tissue showed 5 major morphological alterations–the presence of lacunae, vacuoles, giant cells, hemorrhage, and inflammation–not seen in control tissue. Also, there was a notable koilocytotic appearance of keratinocytes in canker tissue. Immunohistochemistry revealed increased levels of PCNA protein expression in keratinocytes and fibroblasts of canker tissue compared with control tissue. In control tissue, keratinocytes showed higher levels of Ki67 compared with canker tissue, while the dermal fibroblasts of both groups showed similar levels of Ki67, indicating similar proliferative activity of less than 3% of total dermal fibroblasts. These results demonstrate that, in contrast to previous reports, there is no evidence for increased proliferative activity of the dermal papillary body associated with hoof canker. Increased levels of PCNA protein expression and morphological alterations indicate that dysregulation of keratinocyte differentiation constitutes a key event in equine hoof canker development.

Gingival Fibrosarcoma in a Horse

A 4-year-old thoroughbred cross mare was referred to the University of Edinburgh Veterinary School Equine Hospital for treatment of a soft tissue tumor on the buccal gingival margin of the rostral right maxillary cheek teeth. The lesion was initially surgically excised and diagnosed as a fibrosarcoma via histopathology. Adjunctive treatment with intralesional cisplatin chemotherapy was begun. The tumor recurred and was repeatedly treated with intralesional cisplatin injections and additional surgical resection over the course of 14 weeks. Despite the initial poor response to treatment, no further regrowth of the tumor occurred 3 months following its final treatment. The horse remained free of visible evidence of tumor nearly 5 years later.

Docetaxel Accumulates in Lymphatic Circulation Following Subcutaneous Delivery Compared to Intravenous Delivery in Rats

BACKGROUND

The circulatory pathway for particles deposited outside of blood capillaries has not been well characterized for non-traditionally-delivered chemotherapeutics.

MATERIALS AND METHODS

Blood and lymph pharmacokinetics of docetaxel (5 mg/kg) and carboplatin (14 and 28 mg/kg) following subcutaneous (s.c.) versus intravenous (i.v.) delivery were determined in a rodent model with catheterizations of both the thoracic lymphatic duct and jugular vein for prolonged synchronous blood and lymph sampling.

RESULTS

Subcutaneous docetaxel demonstrates preferential lymphatic accumulation based on the area under the time-concentration curve (AUC_0-24h) whereas i.v. docetaxel resulted in a greater plasma maximum concentration measured (C_max). The apparent elimination half-life (t_1/2) in lymph for docetaxel is greater following i.v. or s.c. delivery compared to t_1/2 in blood. Carboplatin demonstrates a dose-dependent increase in plasma C_max regardless of delivery route; the total carboplatin exposure over 24 h in lymph and plasma are comparable.

CONCLUSION

Subcutaneous docetaxel achieves lymphatic accumulation greater than that of i.v. delivery.

Electrochemotherapy as a single or adjuvant treatment to surgery of cutaneous sarcoid tumours in horses: a 31-case retrospective study

The aim of our study was to evaluate the efficacy of electrochemotherapy (ECT) with cisplatin as a single or adjuvant treatment for sarcoids in equids. Different treatment options with different success rates were proposed. Thirty-one horses and one donkey with different clinical type, size and location of tumours were treated with ECT as a single treatment (18 animals with 52 tumour nodules) or as adjuvant treatment with marginal surgical excision (14 animals with 18 tumour nodules). In animals treated only with ECT with cisplatin, complete response was obtained in 48/52 (92.3 per cent) nodules and partial response in the other 4 nodules (7.7 per cent). In most cases, one to three sessions, only in two cases four and in one case five sessions, every 4 weeks were needed to obtain the measurable response. During the observation time, only in one case was the recurrence noted 60 months after treatment. Complete response in all 18 tumour nodules treated with surgery and adjuvant ECT was obtained and only one recurrence was noted after 14 months during the observation time. The results of this study show that ECT with cisplatin is an effective, safe, and simple local treatment of sarcoids in equids. According to the tumour size and location, single or combined treatment should be performed.

Malignant Melanoma of the Syrinx and Liver in an African Grey Parrot ( Psittacus erithacus erithacus)

A 20-year-old, female African grey parrot ( Psittacus erithacus erithacus) was examined because of ataxia and weakness. Radiographs were unremarkable, and results of a complete blood cell count revealed leukocytosis and heterophilia. Because of poor response to therapy with meloxicam, doxycycline, and enrofloxacin; deteriorating condition; and poor prognosis, the parrot was euthanatized. Postmortem examination revealed 2 dark red nodules in the liver. No grossly visible mass was observed in the syrinx. Histologic examination of the liver and syrinx revealed similar foci of round, oval, and polygonal cells exhibiting severe pleomorphism, with poorly demarcated cytoplasmic borders and moderate amounts of eosinophilic cytoplasm containing brown to black granules (melanin). The mitotic index was 15. The presence of melanin pigment is consistent with a diagnosis of melanoma at both sites. The multifocal distribution and intravascular invasion indicate metastasis; however, the site of origin was unknown. To our knowledge, this is the first recorded case of melanoma in an avian syrinx.

Integumentary Disorders Including Cutaneous Neoplasia in Older Horses

Few skin diseases specifically or exclusively affect older horses and donkeys. Hypertrichosis (hirsutism) associated with pituitary pars intermedia dysfunction is probably the most recognized and best understood exception and is the most common age-related skin condition in equids. Many other conditions are known to be more serious in older horses. Horses affected with immune-compromising conditions can be more severely affected by infectious diseases of the skin or heavy and pathologically significant parasitism. Neoplasia of the skin is probably more prevalent and worse in older horses, although many of the more serious skin tumors develop initially at a younger age.

In vitro anticancer activity of Betulinic acid and derivatives thereof on equine melanoma cell lines from grey horses and in vivo safety assessment of the compound NVX-207 in two horses

Betulinic acid, a pentacyclic triterpene, and its derivatives are promising compounds for cancer treatment in humans. Melanoma is not only a problem for humans but also for grey horses as they have a high potential of developing melanoma lesions coupled to the mutation causing their phenotype. Current chemotherapeutic treatment carries the risk of adverse health effects for the horse owner or the treating veterinarian by exposure to antineoplastic compounds. Most treatments have low prospects for systemic tumor regression. Thus, a new therapy is needed. In this in vitro study, Betulinic acid and its two derivatives B10 and NVX-207, both with an improved water solubility compared to Betulinic acid, were tested on two equine melanoma cell lines (MelDuWi and MellJess/HoMelZh) and human melanoma (A375) cell line. We could demonstrate that all three compounds especially NVX-207 show high cytotoxicity on both equine melanoma cell lines. The treatment with these compounds lead to externalization of phosphatidylserines on the cell membrane (AnnexinV-staining), DNA-fragmentation (cell cycle analysis) and activation of initiator and effector caspases (Caspase assays). Our results indicate that the apoptosis is induced in the equine melanoma cells by all three compounds. Furthermore, we succeed in encapsulating the most active compound NVX-207 in 2-Hydroxyprolyl-β-cyclodextrine without a loss of its activity. This formulation can be used as a promising antitumor agent for treating grey horse melanoma. In a first tolerability evaluation in vivo the formulation was administered every one week for 19 consecutive weeks and well tolerated in two adult melanoma affected horses.

Local and systemic effect of transfection-reagent formulated DNA vectors on equine melanoma

Background

Equine melanoma has a high incidence in grey horses. Xenogenic DNA vaccination may represent a promising therapeutic approach against equine melanoma as it successfully induced an immunological response in other species suffering from melanoma and in healthy horses. In a clinical study, twenty-seven, grey, melanoma-bearing, horses were assigned to three groups (n = 9) and vaccinated on days 1, 22, and 78 with DNA vectors encoding for equine (eq) IL-12 and IL-18 alone or in combination with either human glycoprotein (hgp) 100 or human tyrosinase (htyr). Horses were vaccinated intramuscularly, and one selected melanoma was locally treated by intradermal peritumoral injection. Prior to each injection and on day 120, the sizes of up to nine melanoma lesions per horse were measured by caliper and ultrasound. Specific serum antibodies against hgp100 and htyr were measured using cell based flow-cytometric assays. An Analysis of Variance (ANOVA) for repeated measurements was performed to identify statistically significant influences on the relative tumor volume. For post-hoc testing a Tukey-Kramer Multiple-Comparison Test was performed to compare the relative volumes on the different examination days. An ANOVA for repeated measurements was performed to analyse changes in body temperature over time. A one-way ANOVA was used to evaluate differences in body temperature between the groups. A p–value < 0.05 was considered significant for all statistical tests applied.

Results

In all groups, the relative tumor volume decreased significantly to 79.1 ± 26.91% by day 120 (p < 0.0001, Tukey-Kramer Multiple-Comparison Test). Affiliation to treatment group, local treatment and examination modality had no significant influence on the results (ANOVA for repeated measurements). Neither a cellular nor a humoral immune response directed against htyr or hgp100 was detected. Horses had an increased body temperature on the day after vaccination.

Conclusions

This is the first clinical report on a systemic effect against equine melanoma following treatment with DNA vectors encoding eqIL12 and eqIL18 and formulated with a transfection reagent. Addition of DNA vectors encoding hgp100 respectively htyr did not potentiate this effect.

Electronic supplementary material

The online version of this article (doi:10.1186/s12917-015-0422-9) contains supplementary material, which is available to authorized users.

Local and systemic effect of transfection-reagent formulated DNA vectors on equine melanoma

Background

Equine melanoma has a high incidence in grey horses. Xenogenic DNA vaccination may represent a promising therapeutic approach against equine melanoma as it successfully induced an immunological response in other species suffering from melanoma and in healthy horses. In a clinical study, twenty-seven, grey, melanoma-bearing, horses were assigned to three groups (n = 9) and vaccinated on days 1, 22, and 78 with DNA vectors encoding for equine (eq) IL-12 and IL-18 alone or in combination with either human glycoprotein (hgp) 100 or human tyrosinase (htyr). Horses were vaccinated intramuscularly, and one selected melanoma was locally treated by intradermal peritumoral injection. Prior to each injection and on day 120, the sizes of up to nine melanoma lesions per horse were measured by caliper and ultrasound. Specific serum antibodies against hgp100 and htyr were measured using cell based flow-cytometric assays. An Analysis of Variance (ANOVA) for repeated measurements was performed to identify statistically significant influences on the relative tumor volume. For post-hoc testing a Tukey-Kramer Multiple-Comparison Test was performed to compare the relative volumes on the different examination days. An ANOVA for repeated measurements was performed to analyse changes in body temperature over time. A one-way ANOVA was used to evaluate differences in body temperature between the groups. A p–value < 0.05 was considered significant for all statistical tests applied.

Results

In all groups, the relative tumor volume decreased significantly to 79.1 ± 26.91% by day 120 (p < 0.0001, Tukey-Kramer Multiple-Comparison Test). Affiliation to treatment group, local treatment and examination modality had no significant influence on the results (ANOVA for repeated measurements). Neither a cellular nor a humoral immune response directed against htyr or hgp100 was detected. Horses had an increased body temperature on the day after vaccination.

Conclusions

This is the first clinical report on a systemic effect against equine melanoma following treatment with DNA vectors encoding eqIL12 and eqIL18 and formulated with a transfection reagent. Addition of DNA vectors encoding hgp100 respectively htyr did not potentiate this effect.

Electronic supplementary material

The online version of this article (doi:10.1186/s12917-015-0414-9) contains supplementary material, which is available to authorized users.

Electrochemotherapy in veterinary oncology: from rescue to first line therapy

Electroporation is a delivery technique that is gaining popularity among the veterinary community due to its low cost, ease of application, and flexibility. It combines the administration of pharmaceutical compounds such as chemotherapy agents, antisense, and plasmids to the application of permeabilizing pulses. This chapter reviews the veterinary results obtained through the delivery of anticancer drugs (electrochemotherapy) and genes (electro-gene therapy).

Malignant melanoma in a grey horse: case presentation and review of equine melanoma treatment options

A 15 year-old grey Thoroughbred gelding presented for investigation of chronic weight loss and recent onset of respiratory difficulty. Clinical examination confirmed tachypnoea with increased respiratory effort. Thoracic ultrasound examination detected pleural effusion. The dyspnoea was related to the large volume of pleural effusion and, following post-mortem examination, to the presence of a large mediastinal mass. Multiple pigmented masses, likely melanomas, were detected peri-anally. Thoracic radiography, cytological examination of the pleural fluid and a fine needle aspirate of a thoracic mass led to a presumptive diagnosis of malignant melanoma and this was confirmed at post mortem examination. Further metastatic spread to the central nervous system and right guttural pouch was also identified. In conclusion this case manifests the potential malignant behaviour of equine melanomas, and a review of proposed therapies for melanoma treatment highlights the therapeutic options and current areas of research.

Equine melanocytic tumors

Melanomas are among the most common skin tumors in horses, with prevalence rates reaching as high as 80% in adult gray horses. Most melanocytic tumors are benign at initial presentation; however, if left untreated, up to two-thirds can progress to overt malignant behavior. Standard local treatment options can be used to treat solitary early-stage lesions but do not address the underlying risk of recurrent tumor formation or the transformation to a malignant phenotype. An understanding of the specific molecular genetic factors associated with tumor formation should lead to targeted therapies that can be used to treat or ideally prevent disease.