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Lai YY, Horta RDS, Almendros A, Ha PWY, Giuliano A. L-LOP/LOPP for the treatment of canine gastrointestinal/hepatosplenic lymphoma. Front Vet Sci 2024; 11:1373180. [PMID: 38846784 PMCID: PMC11153818 DOI: 10.3389/fvets.2024.1373180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/30/2024] [Indexed: 06/09/2024] Open
Abstract
Canine gastrointestinal (GI) and hepatosplenic (HS) high-grade (large cell) lymphomas are uncommon forms of canine lymphomas, with a very poor response to chemotherapy and a very poor prognosis. Currently, there are no established effective chemotherapy protocols for canine GI/HS lymphomas. This case series aimed to retrospectively evaluate the efficacy of lomustine-based protocols L-LOP (L-asparaginase, lomustine, vincristine, and prednisolone) and L-LOPP (with the addition of procarbazine) for treatment of canine GI/HS lymphomas. Medical records of dogs with cytologically or histologically diagnosed lymphoma at CityU Veterinary Medical Centre from 2019 to 2022 were retrospectively reviewed. The L-LOP/LOPP treatment protocol was well tolerated with rare severe adverse events. Median progression-free survival for GI and HS lymphoma was 56 days (range, 10-274 days) and 57 days (range 8-135 days) respectively; while median survival time for GI and HS lymphoma was 93 days (range 10-325 days) and 210 days (range 8-240 days) respectively.
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Affiliation(s)
- Yu Ying Lai
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Rodrigo dos Santos Horta
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Angel Almendros
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- CityU Veterinary Medical Centre, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Patrick W. Y. Ha
- CityU Veterinary Medical Centre, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Antonio Giuliano
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- CityU Veterinary Medical Centre, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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2
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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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3
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Veluvolu S, Willcox JL, Skorupski KA, Al-Nadaf S, Rebhun R, Wittenburg L. Fractionated oral dosing and its effect on cyclophosphamide pharmacokinetics in dogs with high-grade multicentric lymphoma. Vet Comp Oncol 2023; 21:20-27. [PMID: 36057542 PMCID: PMC9928601 DOI: 10.1111/vco.12856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/09/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022]
Abstract
Cyclophosphamide (CP) is an alkylating agent commonly included in multi-drug treatment protocols for canine cancer. As a prodrug, CP requires hepatic metabolism for activation to the intermediate compound 4-hydroxycyclophosphamide (4-OHCP) which then spontaneously forms alkylating phosphoramide mustard. CP is frequently administered in a fractionated manner, with the total dose given over multiple days. CP is reported to cause auto-induction of metabolism in humans, with faster CP clearance and relatively increased 4-OHCP formation following fractionated versus bolus dosing, however canine pharmacokinetic studies of CP dose fractionation are lacking. The study objective was to evaluate the pharmacokinetics of fractionated oral CP dosing at a dose of 200-250 mg/m2 over 3 to 4 days in a prospectively identified population of cancer-bearing dogs. Plasma concentrations of CP and 4-OHCP were measured by ultra-high performance liquid chromatography tandem-mass spectrometry in eight dogs following the first and last doses to assess for auto-induction of CP metabolism. No significant difference in the rate of CP elimination between first and last doses were detected (0.73 ± 0.46 vs. 1.22 ± 0.5 h-1 ; p = .125). Additionally, no significant difference in dose-normalized 4-OHCP exposure was identified between first and last doses (5.9 ± 2.1 vs. 7.9 ± 6.4 h × ng/ml; p = .936). These results suggest that fractionated dosing may not increase exposure to the active metabolite of CP in dogs as it does in humans. As such, standard bolus dosing and fractionated dosing may be equivalent in terms of bio-activation of CP in dogs administered a dose of 200-250 mg/m2 .
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Affiliation(s)
- Sridhar Veluvolu
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA
| | - Jennifer L. Willcox
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA,Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
| | - Katherine A. Skorupski
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA,Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
| | - Sami Al-Nadaf
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA,Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
| | - Robert Rebhun
- William R Pritchard Veterinary Medical Teaching Hospital,
School of Veterinary Medicine, University of California – Davis, Davis, CA,
USA,Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
| | - Luke Wittenburg
- Department of Surgical and Radiological Sciences, School of
Veterinary Medicine, University of California – Davis, Davis, CA, USA
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4
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Iwaki Y, Gagnon J, MacDonald-Dickinson V. Incidence of Sterile Hemorrhagic Cystitis in Dogs Treated with Cyclophosphamide and Low-Dose Furosemide. J Am Anim Hosp Assoc 2022; 58:85-90. [PMID: 35195711 DOI: 10.5326/jaaha-ms-7169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 11/11/2022]
Abstract
Cyclophosphamide is a commonly used chemotherapy in the treatment of lymphoma. It can cause sterile hemorrhagic cystitis (SHC), and furosemide is used to decrease the incidence of SHC. The aim of this study is to evaluate the incidence of SHC in dogs treated with a bolus maximum tolerated dose of oral cyclophosphamide and oral furosemide at a dose of 1 mg/kg. Medical records were reviewed to determine the incidence of SHC, dose and number of oral cyclophosphamide treatments, and the dose of furosemide. Other side effects from cyclophosphamide were also recorded. Eighty-one client-owned dogs that received a single oral maximum tolerated dose of cyclophosphamide concurrent with oral furosemide as part of a chemotherapy protocol for lymphoma were included in the study. A total of 252 doses of cyclophosphamide were administered to 81 dogs. The median dose of cyclophosphamide was 239.3 mg/m2. The median dose of furosemide was 1.08 mg/kg. SHC was suspected in 2 dogs (2.46%). Concurrent use of furosemide at a dose of 1 mg/kg with cyclophosphamide yields a similar incidence of SHC than using a higher dose of furosemide as previously reported.
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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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6
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An JH, Song WJ, Li Q, Bhang DH, Youn HY. 3D-culture models as drug-testing platforms in canine lymphoma and their cross talk with lymph node-derived stromal cells. J Vet Sci 2021; 22:e25. [PMID: 33908202 PMCID: PMC8170217 DOI: 10.4142/jvs.2021.22.e25] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/04/2021] [Accepted: 02/01/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Malignant lymphoma is the most common hematopoietic malignancy in dogs, and relapse is frequently seen despite aggressive initial treatment. In order for the treatment of these recurrent lymphomas in dogs to be effective, it is important to choose a personalized and sensitive anticancer agent. To provide a reliable tool for drug development and for personalized cancer therapy, it is critical to maintain key characteristics of the original tumor. OBJECTIVES In this study, we established a model of hybrid tumor/stromal spheroids and investigated the association between canine lymphoma cell line (GL-1) and canine lymph node (LN)-derived stromal cells (SCs). METHODS A hybrid spheroid model consisting of GL-1 cells and LN-derived SC was created using ultra low attachment plate. The relationship between SCs and tumor cells (TCs) was investigated using a coculture system. RESULTS TCs cocultured with SCs were found to have significantly upregulated multidrug resistance genes, such as P-qp, MRP1, and BCRP, compared with TC monocultures. Additionally, it was revealed that coculture with SCs reduced doxorubicin-induced apoptosis and G2/M cell cycle arrest of GL-1 cells. CONCLUSIONS SCs upregulated multidrug resistance genes in TCs and influenced apoptosis and the cell cycle of TCs in the presence of anticancer drugs. This study revealed that understanding the interaction between the tumor microenvironment and TCs is essential in designing experimental approaches to personalized medicine and to predict the effect of drugs.
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Affiliation(s)
- Ju Hyun An
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Woo Jin Song
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Jeju National University, Jeju 63243, Korea
| | - Qiang Li
- Department of Veterinary Medicine, College of Agriculture, Yanbian University, Yanji 133000, China
| | - Dong Ha Bhang
- Department of Molecular Cell Biology, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon 16419, Korea.
| | - Hwa Young Youn
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea.
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7
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Boyé P, Serres F, Floch F, Fournel-Fleury C, Tierny D. Prognostic value of pretreatment plasma D-dimer level in dogs with intermediate to high-grade non-Hodgkin lymphoma. Vet Comp Oncol 2020; 19:44-52. [PMID: 32643242 DOI: 10.1111/vco.12629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 01/22/2023]
Abstract
Pretreatment D-dimer levels have been reported to predict survival in several types of malignancies in human patients. The objective of this study was to evaluate the prognostic value of pretreatment D-dimer level in dogs with intermediate to high-grade non-Hodgkin lymphoma (NHL). In a prospective, randomized, double-blind study of F14512 vs etoposide phosphate, we assessed the prognostic value of pretreatment plasma D-dimer level in 48 client-owned dogs diagnosed with intermediate to high-grade NHL. The correlation between pretreatment plasma D-dimer level and various clinical features, progression-free survival (PFS) and overall survival (OS) was analysed. The median value of pretreatment plasma D-dimer level was 0.4 μg/mL (range: 0.1-14.3 μg/mL). High pretreatment plasma D-dimer level (>0.5 μg/mL) was detected in 44% (21/48) of dogs. High D-dimer levels were not correlated with naive vs relapsed lymphoma, clinical stage, substage, immunophenotype or treatment group. D-dimer levels >0.5 μg/mL were significantly associated with inferior median PFS (54 vs 104 days, P = .011) and OS (93 vs 169 days, P = .003). In the multivariate analysis, high D-dimer levels remained an independent predictor for worse PFS (HR: 3.21, 95% CI: 1.57-6.56, P = .001) and OS (HR: 3.87, 95% CI: 1.88-7.98; P < .001). This study suggests that pretreatment plasma D-dimer level can serve as a predictor of prognosis in dogs with intermediate to high-grade NHL. Further studies are warranted to confirm these findings.
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Affiliation(s)
- Pierre Boyé
- OCR (Oncovet-Clinical-Research), Parc Eurasanté, Loos, France.,Oncovet, Villeneuve d'Ascq, France
| | - François Serres
- OCR (Oncovet-Clinical-Research), Parc Eurasanté, Loos, France.,Oncovet, Villeneuve d'Ascq, France
| | | | | | - Dominique Tierny
- OCR (Oncovet-Clinical-Research), Parc Eurasanté, Loos, France.,Oncovet, Villeneuve d'Ascq, France
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8
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Taylor A, Finotello R, Vilar-Saavedra P, Couto CG, Benigni L, Lara-Garcia A. Clinical characteristics and outcome of dogs with presumed primary renal lymphoma. J Small Anim Pract 2019; 60:663-670. [PMID: 31364180 DOI: 10.1111/jsap.13059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 05/28/2019] [Accepted: 06/17/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To characterise the presentation, clinicopathologic data and outcome of 29 dogs with presumed primary renal lymphoma. MATERIALS AND METHODS Retrospective analysis of medical records of dogs with suspected primary renal lymphoma from 11 institutions. RESULTS All dogs were substage b, and lethargy and gastrointestinal signs were common presenting complaints, as were azotaemia (n=25; 86%) and erythrocytosis (n=15; 51%) on biochemical testing. Ultrasonography typically revealed bilateral renal lesions (n=23; 79%), renomegaly (n=22; 76%) and abdominal lymphadenopathy (n=14; 48%). Chemotherapy was the only treatment in 23 dogs, of which 11 responded, all considered partial responses. For all dogs the median progression-free survival and median overall survival times were 10 days (range: 1 to 126) and 12 days (range: 1 to 212), respectively, and for dogs that responded to chemotherapy 41 days (range: 10 to 126) and 47 days (range: 10 to 212), respectively. CLINICAL SIGNIFICANCE Primary renal lymphoma in dogs appears to be associated with a poor prognosis and short-lived response to chemotherapy.
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Affiliation(s)
- A Taylor
- Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK
| | - R Finotello
- Institute of Veterinary Science, University of Liverpool, Liverpool, L69 3GH, UK
| | - P Vilar-Saavedra
- College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, 48824, USA
| | - C G Couto
- Couto Veterinary Consultants, Hilliard, Ohio, 43026, USA
| | - L Benigni
- Youliv4 Veterinary Imaging, London, N11 1RH, UK
| | - A Lara-Garcia
- Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK
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9
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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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10
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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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12
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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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13
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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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14
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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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15
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Davies O, Szladovits B, Polton G, Garden OA, Leo C, Lara-Garcia A. Prognostic significance of clinical presentation, induction and rescue treatment in 42 cases of canine centroblastic diffuse large B-cell multicentric lymphoma in the United Kingdom. Vet Comp Oncol 2017; 16:276-287. [PMID: 29271043 DOI: 10.1111/vco.12378] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 10/16/2017] [Accepted: 11/18/2017] [Indexed: 12/28/2022]
Abstract
Canine lymphoma is a heterogeneous group of diseases and many previous studies have evaluated the response of a mixed population of lymphoma cases to one specific treatment protocol. The aim of this retrospective study was to describe the outcome and prognostic factors in 42 cases of multicentric centroblastic diffuse large B-cell lymphoma treated with either a COP-type (35%) or CHOP-type (64%) induction chemotherapy. The objective response rate to induction therapy was 94%; entire dogs had a greater rate of complete vs partial remissions than neutered dogs (P = .017). Median progression-free survival for the first remission (PFS1) was 182 days; absence of anaemia at diagnosis (P = .002) and pretreatment neutrophil:lymphocyte ratio (NLR) below 9.44 (P = .015) were independently predictive of longer PFS1. Fifty-eight percent of dogs received rescue protocols with an objective response rate of 81%; 31% of dogs received further rescue protocols (up to a total of 5) and the median number of protocols administered were 2. Median overall survival (OS) was 322 days, the 1-year survival rate was 38% and the 2-year survival rate was 9%. Lymphocyte:monocyte ratio above 1.43 (P = .031), NLR below 11.44 (P = .009), the combination of induction and rescue therapy (P = .030) and the total number of doxorubicin doses used (P = .002) were independently predictive of longer OS. Use of a COP-type protocol induction compared with CHOP did not undermine OS providing doxorubicin was used as rescue therapy.
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Affiliation(s)
- O Davies
- Highcroft Veterinary Referrals, Bristol, UK
| | - B Szladovits
- Department of Pathobiology & Population Sciences, Royal Veterinary College, University of London, Hatfield, UK
| | - G Polton
- North Downs Specialist Referrals, Bletchingley, UK
| | - O A Garden
- Department of Clinical Studies - Philadelphia, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, Pennsylvania
| | - C Leo
- Istituto Veterinario di Novara, Granozzo con Monticello, Novara, Italy
| | - A Lara-Garcia
- Queen Mother Hospital for Animals, Royal Veterinary College, University of London, North Mymms, UK
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16
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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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17
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Boyé P, Serres F, Marescaux L, Hordeaux J, Bouchaert E, Gomes B, Tierny D. Dose escalation study to evaluate safety, tolerability and efficacy of intravenous etoposide phosphate administration in 27 dogs with multicentric lymphoma. PLoS One 2017; 12:e0177486. [PMID: 28505195 PMCID: PMC5432161 DOI: 10.1371/journal.pone.0177486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/27/2017] [Indexed: 12/31/2022] Open
Abstract
Comparative oncology has shown that naturally occurring canine cancers are of valuable and translatable interest for the understanding of human cancer biology and the characterization of new therapies. This work was part of a comparative oncology project assessing a new, clinical-stage topoisomerase II inhibitor and comparing it with etoposide in dogs with spontaneous lymphoma with the objective to translate findings from dogs to humans. Etoposide is a topoisomerase II inhibitor widely used in various humans' solid and hematopoietic cancer, but little data is available concerning its potential antitumor efficacy in dogs. Etoposide phosphate is a water-soluble prodrug of etoposide which is expected to be better tolerated in dogs. The objectives of this study were to assess the safety, the tolerability and the efficacy of intravenous etoposide phosphate in dogs with multicentric lymphoma. Seven dose levels were evaluated in a traditional 3+3 phase I design. Twenty-seven owned-dogs with high-grade multicentric lymphoma were enrolled and treated with three cycles of etoposide phosphate IV injections every 2 weeks. Adverse effects were graded according to the Veterinary Cooperative Oncology Group criteria. A complete end-staging was realized 45 days after inclusion. The maximal tolerated dose was 300 mg/m2. At this dose level, the overall response rate was 83.3% (n = 6, 3 PR and 2 CR). Only a moderate reversible gastrointestinal toxicity, no severe myelotoxicity and no hypersensitivity reaction were reported at this dose level. Beyond the characterization of etoposide clinical efficacy in dogs, this study underlined the clinical and therapeutic homologies between dog and human lymphomas.
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Affiliation(s)
- Pierre Boyé
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
- Oncovet, SIRIC ONCOLille, Villeneuve d’Ascq, France
| | - François Serres
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
- Oncovet, SIRIC ONCOLille, Villeneuve d’Ascq, France
| | | | - Juliette Hordeaux
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
| | - Emmanuel Bouchaert
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
| | - Bruno Gomes
- Institut de Recherche Pierre Fabre, Toulouse, France
| | - Dominique Tierny
- Oncovet-Clinical-Research (OCR), SIRIC ONCOLille, Parc Eurasanté, Loos, France
- Oncovet, SIRIC ONCOLille, Villeneuve d’Ascq, France
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18
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Lautscham EM, Kessler M, Ernst T, Willimzig L, Neiger R. Comparison of a CHOP-LAsp-based protocol with and without maintenance for canine multicentric lymphoma. Vet Rec 2017; 180:303. [DOI: 10.1136/vr.104077] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2016] [Indexed: 11/03/2022]
Affiliation(s)
- E. M. Lautscham
- Small Animal Clinic Hofheim; Katharina-Kemmler-Str. 7 Hofheim 65719 Germany
| | - M. Kessler
- Small Animal Clinic Hofheim; Katharina-Kemmler-Str. 7 Hofheim 65719 Germany
| | - T. Ernst
- Small Animal Clinic Hofheim; Katharina-Kemmler-Str. 7 Hofheim 65719 Germany
| | - L. Willimzig
- Small Animal Clinic Hofheim; Katharina-Kemmler-Str. 7 Hofheim 65719 Germany
| | - R. Neiger
- Small Animal Clinic, Internal Medicine, Justus-Liebig-University Giessen; Frankfurter Str. 126 Giessen 35392 Germany
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19
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Marconato L, Polton GA, Sabattini S, Dacasto M, Garden OA, Grant I, Hendrickx T, Henriques J, Lubas G, Morello E, Stefanello D, Comazzi S. Conformity and controversies in the diagnosis, staging and follow-up evaluation of canine nodal lymphoma: a systematic review of the last 15 years of published literature. Vet Comp Oncol 2016; 15:1029-1040. [DOI: 10.1111/vco.12244] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 04/20/2016] [Accepted: 04/30/2016] [Indexed: 12/14/2022]
Affiliation(s)
| | - G. A. Polton
- North Downs Specialist Referrals; Bletchingley UK
| | - S. Sabattini
- Department of Veterinary Medical Sciences; University of Bologna; Bologna Italy
| | - M. Dacasto
- Department of Comparative Biomedicine and Food Science; University of Padua; Padua Italy
| | - O. A. Garden
- Department of Clinical Science and Services; Immune Regulation Laboratory, Royal Veterinary College; London UK
- Queen Mother Hospital for Animals; Royal Veterinary College; Hatfield UK
| | - I. Grant
- Small Animal Clinical Sciences; School of Veterinary Medicine, University of Glasgow; Glasgow UK
| | | | - J. Henriques
- Hospital Veterinário Berna, OnevetGroup; Lisboa Portugal
| | - G. Lubas
- Department of Veterinary Sciences; University of Pisa; Pisa Italy
| | - E. Morello
- Department of Veterinary Sciences; University of Turin; Turin Italy
| | - D. Stefanello
- Department of Veterinary Medicine; University of Milan; Milan Italy
| | - S. Comazzi
- Department of Veterinary Medicine; University of Milan; Milan Italy
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20
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Desmas I, Burton JH, Post G, Kristal O, Gauthier M, Borrego JF, Di Bella A, Lara-Garcia A. Clinical presentation, treatment and outcome in 31 dogs with presumed primary colorectal lymphoma (2001-2013). Vet Comp Oncol 2016; 15:504-517. [DOI: 10.1111/vco.12194] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 09/28/2015] [Accepted: 10/13/2015] [Indexed: 12/16/2022]
Affiliation(s)
- I. Desmas
- Royal veterinary College; Hatfield UK
| | - J. H. Burton
- Flint Animal Cancer Center; Department of Clinical Sciences, Colorado State University; Fort Collins CO USA
| | - G. Post
- The Veterinary Cancer Center; Norwalk CT USA
| | - O. Kristal
- Chavat Daat Veterinary Speciality Center; Beit Berl Israel
| | - M. Gauthier
- Mississauga Oakville Veterinary Emergency Hospital and Referral Services; Oakville ON Canada
| | - J. F. Borrego
- School of Veterinary Medicine; University of Madison-Wisconsin; Madison WI USA
| | - A. Di Bella
- Vets Now Referrals; Medicine Service; Glasgow UK
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21
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22
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Poggi A, Miniscalco B, Morello E, Gattino F, Delaude A, Ferrero Poschetto L, Aresu L, Gelain ME, Martini V, Comazzi S, Riondato F. Prognostic significance of Ki67 evaluated by flow cytometry in dogs with high-grade B-cell lymphoma. Vet Comp Oncol 2016; 15:431-440. [PMID: 26792094 DOI: 10.1111/vco.12184] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/02/2015] [Accepted: 09/05/2015] [Indexed: 11/30/2022]
Abstract
Ki67 can discriminate between high- and low-grade canine lymphomas, but its prognostic role in specific subtypes of the neoplasm is unknown. We assessed the prognostic significance of Ki67% (percentage of Ki67-positive cells), evaluated by flow cytometry, in 40 dogs with high-grade B-cell lymphoma, treated with a modified Wisconsin-Madison protocol (UW-25). The following variables were investigated for association with lymphoma specific survival (LSS) and relapse free interval (RFI): Ki67%, breed, sex, age, stage, substage, complete remission (CR). By multivariate analysis, Ki67% (P = 0.009) and achievement of CR (P = 0.001) were independent prognostic factors for LSS. Dogs with intermediate Ki67% (20.1-40%) presented longer LSS and RFI (median = 866 and 428 days, respectively) than dogs with low (median = 42 days, P < 0.001; median = 159 days, P = 0.014) or high (median = 173 days, P = 0.038; median = 100 days, P = 0.126) values. Determination of Ki67 is a prognostic tool that improves the clinical usefulness of flow cytometric analysis in canine high-grade B-cell lymphoma.
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Affiliation(s)
- A Poggi
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - B Miniscalco
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - E Morello
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - F Gattino
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - A Delaude
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | | | - L Aresu
- Department of Comparative Biomedicine and Food Science, University of Padua, Legnaro, Italy
| | - M E Gelain
- Department of Comparative Biomedicine and Food Science, University of Padua, Legnaro, Italy
| | - V Martini
- Department of Veterinary Sciences and Public Health, University of Milan, Milan, Italy
| | - S Comazzi
- Department of Veterinary Sciences and Public Health, University of Milan, Milan, Italy
| | - F Riondato
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
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23
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van Stee LL, Boston SE, Singh A, Romanelli G, Rubio-Guzman A, Scase TJ. Outcome and Prognostic Factors for Canine Splenic Lymphoma Treated by Splenectomy (1995-2011). Vet Surg 2015; 44:976-82. [PMID: 26426095 DOI: 10.1111/vsu.12405] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess the outcome of canine splenic lymphoma treated with splenectomy and to evaluate prognostic factors, including involvement of other sites, adjuvant chemotherapy, and the effect of World Health Organization (WHO) histological classification of canine malignant lymphoma. DESIGN Multi-institutional, retrospective study. ANIMALS Client-owned dogs (n = 28). METHODS Medical records (1995-2011) of dogs with a histological diagnosis of splenic lymphoma and treated by splenectomy submitted by Veterinary Society of Surgical Oncology members were reviewed. Included were dogs treated with or without adjuvant therapy. Overall survival, disease-free interval, and cause of death were determined. Prognostic factors and the WHO histological classification of canine malignant lymphoma were evaluated with respect to outcome. RESULTS Dogs with splenic lymphoma treated by splenectomy had a 1-year survival rate of 58.8%, after which no animals died of their disease. B cell lymphoma held a better prognosis for survival than other variants of splenic lymphoma. Marginal zone lymphoma and mantle cell lymphoma were the most common B cell lymphoma subtypes in our study. Hemoabdomen and clinical signs related to splenic lymphoma, including abdominal distention, lethargy, and anorexia, were poor prognostic indicators, whereas disease confined to the spleen was a positive prognostic indicator. Pre- or postoperative adjuvant chemotherapy did not provide a survival benefit. CONCLUSION Based on our sample population, splenectomy alone was an effective treatment for splenic lymphoma in cases with disease confined to the spleen. Chemotherapy may not improve survival in cases of lymphoma restricted to the spleen.
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Affiliation(s)
- Lucinda L van Stee
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Sarah E Boston
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Ameet Singh
- Department of Clinical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | | | | | - Tim J Scase
- Bridge Pathology Ltd., Bristol, United Kingdom
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24
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Tierny D, Serres F, Segaoula Z, Bemelmans I, Bouchaert E, Pétain A, Brel V, Couffin S, Marchal T, Nguyen L, Thuru X, Ferré P, Guilbaud N, Gomes B. Phase I Clinical Pharmacology Study of F14512, a New Polyamine-Vectorized Anticancer Drug, in Naturally Occurring Canine Lymphoma. Clin Cancer Res 2015; 21:5314-23. [PMID: 26169968 DOI: 10.1158/1078-0432.ccr-14-3174] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 07/04/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE F14512 is a new topoisomerase II inhibitor containing a spermine moiety that facilitates selective uptake by tumor cells and increases topoisomerase II poisoning. F14512 is currently in a phase I/II clinical trial in patients with acute myeloid leukemia. The aim of this study was to investigate F14512 potential in a new clinical indication. Because of the many similarities between human and dog lymphomas, we sought to determine the tolerance, efficacy, pharmacokinetic/pharmacodynamic (PK/PD) relationship of F14512 in this indication, and potential biomarkers that could be translated into human trials. EXPERIMENTAL DESIGN Twenty-three dogs with stage III-IV naturally occurring lymphomas were enrolled in the phase I dose-escalation trial, which consisted of three cycles of F14512 i.v. injections. Endpoints included safety and therapeutic efficacy. Serial blood samples and tumor biopsies were obtained for PK/PD and biomarker studies. RESULTS Five dose levels were evaluated to determine the recommended dose. F14512 was well tolerated, with the expected dose-dependent hematologic toxicity. F14512 induced an early decrease of tumoral lymph node cells, and a high response rate of 91% (21/23) with 10 complete responses, 11 partial responses, 1 stable disease, and 1 progressive disease. Phosphorylation of histone H2AX was studied as a potential PD biomarker of F14512. CONCLUSIONS This trial demonstrated that F14512 can be safely administered to dogs with lymphoma resulting in strong therapeutic efficacy. Additional evaluation of F14512 is needed to compare its efficacy with standards of care in dogs, and to translate biomarker and efficacy findings into clinical trials in humans.
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Affiliation(s)
- Dominique Tierny
- Oncovet Clinical Research, SIRIC ONCOLille, Avenue Paul Langevin, Villeneuve d'Ascq, France
| | - François Serres
- Oncovet Clinical Research, SIRIC ONCOLille, Avenue Paul Langevin, Villeneuve d'Ascq, France
| | - Zacharie Segaoula
- Oncovet Clinical Research, SIRIC ONCOLille, Avenue Paul Langevin, Villeneuve d'Ascq, France. Inserm, UMR-S1172, Jean Pierre Aubert Research Centre, Lille, France. Université de Lille, Lille, France
| | - Ingrid Bemelmans
- Oncovet Clinical Research, SIRIC ONCOLille, Avenue Paul Langevin, Villeneuve d'Ascq, France
| | - Emmanuel Bouchaert
- Oncovet Clinical Research, SIRIC ONCOLille, Avenue Paul Langevin, Villeneuve d'Ascq, France
| | - Aurélie Pétain
- Institut de Recherche Pierre Fabre, Oncology Pharmacokinetics, Toulouse, France
| | - Viviane Brel
- Institut de Recherche Pierre Fabre, Experimental Oncology Research Center, Toulouse, France
| | - Stéphane Couffin
- Institut de Recherche Pierre Fabre, Pharmacokinetics, Bel Air de Campans, Castres, France
| | - Thierry Marchal
- UPSP 2011-03-101, Interaction Cellules Environnement, Campus Vétérinaire de VetAgro-Sup, Marcy l'Etoile, France
| | - Laurent Nguyen
- Institut de Recherche Pierre Fabre, Oncology Pharmacokinetics, Toulouse, France
| | - Xavier Thuru
- Inserm, UMR-S1172, Jean Pierre Aubert Research Centre, Lille, France. Université de Lille, Lille, France
| | - Pierre Ferré
- Institut de Recherche Pierre Fabre, Oncology Pharmacokinetics, Toulouse, France
| | - Nicolas Guilbaud
- Institut de Recherche Pierre Fabre, Experimental Oncology Research Center, Toulouse, France
| | - Bruno Gomes
- Institut de Recherche Pierre Fabre, Experimental Oncology Research Center, Toulouse, France.
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25
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Klopfleisch R, Kohn B, Gruber AD. Mechanisms of tumour resistance against chemotherapeutic agents in veterinary oncology. Vet J 2015; 207:63-72. [PMID: 26526523 DOI: 10.1016/j.tvjl.2015.06.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 06/23/2015] [Accepted: 06/30/2015] [Indexed: 12/17/2022]
Abstract
Several classes of chemotherapy drugs are used as first line or adjuvant treatment of the majority of tumour types in veterinary oncology. However, some types of tumour are intrinsically resistant to several anti-cancer drugs, and others, while initially sensitive, acquire resistance during treatment. Chemotherapy often significantly prolongs survival or disease free interval, but is not curative. The exact mechanisms behind intrinsic and acquired chemotherapy resistance are unknown for most animal tumours, but there is increasing knowledge on the mechanisms of drug resistance in humans and a few reports on molecular changes in resistant canine tumours have emerged. In addition, approaches to overcome or prevent chemotherapy resistance are becoming available in humans and, given the overlaps in molecular alterations between human and animal tumours, these may also be relevant in veterinary oncology. This review provides an overview of the current state of research on general chemotherapy resistance mechanisms, including drug efflux, DNA repair, apoptosis evasion and tumour stem cells. The known resistance mechanisms in animal tumours and the potential of these findings for improving treatment efficacy in veterinary oncology are also explored.
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Affiliation(s)
- R Klopfleisch
- Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertag-Straße 15, 14163 Berlin, Germany.
| | - B Kohn
- Small Animal Clinic, Freie Universität Berlin, Oertzenweg 19 b, 14163 Berlin, Germany
| | - A D Gruber
- Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertag-Straße 15, 14163 Berlin, Germany
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26
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Riccardo F, Aurisicchio L, Impellizeri JA, Cavallo F. The importance of comparative oncology in translational medicine. Cancer Immunol Immunother 2015; 64:137-48. [PMID: 25548094 PMCID: PMC11029667 DOI: 10.1007/s00262-014-1645-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 12/15/2014] [Indexed: 12/20/2022]
Abstract
Human cancer is so complex that in vivo preclinical models are needed if effective therapies are to be developed. Naturally occurring cancers in companion animals are therefore a great resource, as shown by the remarkable growth that comparative oncology has seen over the last 30 years. Cancer has become a leading cause of death in companion animals now that more pets are living long enough to develop the disease. Furthermore, more owners are seeking advanced and novel therapies for their pets as they are very much considered family members. Living in the same environments, pets and humans are often afflicted by the same types of cancer which show similar behavior and, in some species, express the same antigen molecules. The treatment of pet tumors using novel therapies is of compelling translational significance.
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Affiliation(s)
- Federica Riccardo
- Department of Molecular Biotechnologies and Health Sciences, Molecular Biotechnology Center, University of Turin, Via Nizza, 52, 10126 Turin, Italy
| | | | | | - Federica Cavallo
- Department of Molecular Biotechnologies and Health Sciences, Molecular Biotechnology Center, University of Turin, Via Nizza, 52, 10126 Turin, Italy
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27
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Zandvliet M, Teske E, Schrickx J. Multi-drug resistance in a canine lymphoid cell line due to increased P-glycoprotein expression, a potential model for drug-resistant canine lymphoma. Toxicol In Vitro 2014; 28:1498-506. [DOI: 10.1016/j.tiv.2014.06.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 03/13/2014] [Accepted: 06/19/2014] [Indexed: 10/25/2022]
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28
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Gavazza A, Lubas G, Fridman A, Peruzzi D, Impellizeri JA, Luberto L, Marra E, Roscilli G, Ciliberto G, Aurisicchio L. Safety and efficacy of a genetic vaccine targeting telomerase plus chemotherapy for the therapy of canine B-cell lymphoma. Hum Gene Ther 2014; 24:728-38. [PMID: 23902422 DOI: 10.1089/hum.2013.112] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Client-owned pet dogs represent exceptional translational models for advancement of cancer research because they reflect the complex heterogeneity observed in human cancer. We have recently shown that a genetic vaccine targeting dog telomerase reverse transcriptase (dTERT) and based on adenovirus DNA electro-gene-transfer (Ad/DNA-EGT) technology can induce strong cell-mediated immune responses against this tumor antigen and increase overall survival of dogs affected by B-cell lymphosarcoma (LSA) in comparison with historical controls when combined with a cyclophosphamide, vincristine, and prednisone (COP) chemotherapy regimen. Here, we have conducted a double-arm clinical trial with an extended number of LSA patients, measured the antigen-specific immune response, and evaluated potential toxic effects of the immunotherapy along with a follow-up of patients survival for 3.5 years. The immune response was measured by enzyme-linked immunospot assay. The expression of dTERT was quantified by quantitative polymerase chain reaction. Changes in hematological parameters, local/systemic toxicity or organic dysfunction and fever were monitored over time during the treatment. dTERT-specific cell-mediated immune responses were induced in almost all treated animals. No adverse effects were observed in any dog patient that underwent treatment. The overall survival time of vaccine/COP-treated dogs was significantly increased over the COP-only cohort (>76.1 vs. 29.3 weeks, respectively, p<0.0001). There was a significant association between dTERT expression levels in LSA cells and overall survival among vaccinated patients. In conclusion, Ad/DNA-EGT-based cancer vaccine against dTERT in combination with COP chemotherapy is safe and significantly prolongs the survival of LSA canine patients. These data confirm the therapeutic efficacy of dTERT vaccine and support the evaluation of this approach for other cancer types as well as the translation of this approach to human clinical trials.
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Affiliation(s)
- Alessandra Gavazza
- University of Pisa, Department of Veterinary Sciences, San Piero a Grado 56122, Pisa, Italy
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29
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Laberke S, Zenker I, Hirschberger J. Mesna and furosemide for prevention of cyclophosphamide-induced sterile haemorrhagic cystitis in dogs - a retrospective study. Vet Rec 2014; 174:250. [DOI: 10.1136/vr.101574] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- S. Laberke
- Clinic of Small Animal Medicine; Ludwig Maximilian University Munich; Veterinärstr. 13 80539 Munich Germany
| | - I. Zenker
- University of California, Davis School of Veterinary Medicine; Department of Radiation Oncology; 1 Shields Avenue Davis CA 95616 USA
| | - J. Hirschberger
- Clinic of Small Animal Medicine; Ludwig Maximilian University Munich; Veterinärstr. 13 80539 Munich Germany
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30
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Aresu L, Martini V, Rossi F, Vignoli M, Sampaolo M, Aricò A, Laganga P, Pierini A, Frayssinet P, Mantovani R, Marconato L. Canine indolent and aggressive lymphoma: clinical spectrum with histologic correlation. Vet Comp Oncol 2013; 13:348-62. [DOI: 10.1111/vco.12048] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 05/10/2013] [Accepted: 05/23/2013] [Indexed: 02/01/2023]
Affiliation(s)
- L. Aresu
- Department of Comparative Biomedicine and Food Science; University of Padova; Legnaro Italy
| | - V. Martini
- Department of Veterinary Sciences and Public Health; University of Milan; Milan Italy
| | - F. Rossi
- Centro Oncologico Veterinario; Sasso Marconi Italy
| | - M. Vignoli
- Clinica Veterinaria dell'Orologio; Sasso Marconi Italy
| | - M. Sampaolo
- Centro Oncologico Veterinario; Sasso Marconi Italy
| | - A. Aricò
- Department of Comparative Biomedicine and Food Science; University of Padova; Legnaro Italy
| | - P. Laganga
- Centro Oncologico Veterinario; Sasso Marconi Italy
| | - A. Pierini
- Centro Oncologico Veterinario; Sasso Marconi Italy
| | | | - R. Mantovani
- Department of Agronomy Food Natural Resources Animals & Environment; University of Padova; Legnaro Italy
| | - L. Marconato
- Centro Oncologico Veterinario; Sasso Marconi Italy
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31
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Hematopoietic Tumors. WITHROW AND MACEWEN'S SMALL ANIMAL CLINICAL ONCOLOGY 2013. [PMCID: PMC7161412 DOI: 10.1016/b978-1-4377-2362-5.00032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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32
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Statham-Ringen KA, Selting KA, Lattimer JC, Henry CJ, Green JA, Bryan JN, Jia F, Lewis MR. Evaluation of a B-cell leukemia-lymphoma 2-specific radiolabeled peptide nucleic acid-peptide conjugate for scintigraphic detection of neoplastic lymphocytes in dogs with B-cell lymphoma. Am J Vet Res 2012; 73:681-8. [PMID: 22533400 DOI: 10.2460/ajvr.73.5.681] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate use of a radiolabeled peptide nucleic acid-peptide conjugate (RaPP) targeting B-cell leukemia-lymphoma 2 (BCL2) mRNA for scintigraphic detection of neoplastic lymphocytes in dogs with B-cell lymphoma and to assess associations among RaPP uptake, time to tumor progression (TTP), and BCL2 mRNA expression. ANIMALS 11 dogs with B-cell lymphoma and 1 clinically normal dog. PROCEDURES Scintigraphic images were acquired 1 hour after IV injection of the RaPP. Regions of interest (ROIs) were drawn around lymph nodes, liver, and spleen; ROI intensity (relative to that of an equally sized region of muscle in the same image) was measured. Each ROI was also subjectively categorized as positive or negative for increased RaPP uptake. Expression of BCL2 mRNA was determined via quantitative reverse transcriptase PCR assay of a lymph node sample from dogs with lymphoma. Associations among imaging results, TTP, and BCL2 mRNA expression were evaluated. RESULTS Increased RaPP uptake was detected in affected tissues of dogs with lymphoma. Dogs with superficial cervical lymph node ROIs categorized as negative (n = 8) for increased RaPP uptake had a significantly longer TTP than did dogs for which this ROI was considered positive (2). Measured intensity of mandibular and superficial cervical lymph node ROIs was negatively associated with TTP. Associations among BCL2 mRNA and ROI intensity or TTP were not significant. CONCLUSIONS AND CLINICAL RELEVANCE Increased RaPP uptake at mandibular or superficial cervical lymph node ROIs may be a negative prognostic indicator in dogs with lymphoma. A larger investigation is needed to determine clinical value of the RaPP for disease detection and prognostication.
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Affiliation(s)
- Kimberly A Statham-Ringen
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
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Flory AB, Rassnick KM, Erb HN, Garrett LD, Northrup NC, Selting KA, Phillips BS, Locke JE, Chretin JD. Evaluation of factors associated with second remission in dogs with lymphoma undergoing retreatment with a cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy protocol: 95 cases (2000–2007). J Am Vet Med Assoc 2011; 238:501-6. [DOI: 10.2460/javma.238.4.501] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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34
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Sato M, Yamazaki J, Goto-Koshino Y, Takahashi M, Fujino Y, Ohno K, Tsujimoto H. Evaluation of Cytoreductive Efficacy of Vincristine, Cyclophosphamide, and Doxorubicin in Dogs with Lymphoma by Measuring the Number of Neoplastic Lymphoid Cells with Real-Time Polymerase Chain Reaction. J Vet Intern Med 2011; 25:285-91. [DOI: 10.1111/j.1939-1676.2011.0686.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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35
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Sorenmo K, Overley B, Krick E, Ferrara T, LaBlanc A, Shofer F. Outcome and toxicity associated with a dose-intensified, maintenance-free CHOP-based chemotherapy protocol in canine lymphoma: 130 cases. Vet Comp Oncol 2010; 8:196-208. [PMID: 20691027 DOI: 10.1111/j.1476-5829.2010.00222.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
A dose-intensified/dose-dense chemotherapy protocol for canine lymphoma was designed and implemented at the Veterinary Hospital of the University of Pennsylvania. In this study, we describe the clinical characteristics, prognostic factors, efficacy and toxicity in 130 dogs treated with this protocol. The majority of the dogs had advanced stage disease (63.1% stage V) and sub-stage b (58.5%). The median time to progression (TTP) and lymphoma-specific survival were 219 and 323 days, respectively. These results are similar to previous less dose-intense protocols. Sub-stage was a significant negative prognostic factor for survival. The incidence of toxicity was high; 53.9 and 45% of the dogs needed dose reductions and treatment delays, respectively. Dogs that required dose reductions and treatment delays had significantly longer TTP and lymphoma-specific survival times. These results suggest that dose density is important, but likely relative, and needs to be adjusted according to the individual patient's toxicity for optimal outcome.
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Affiliation(s)
- Karin Sorenmo
- Department of Clinical Studies, School of Veterinary Medicine of the University of Pennsylvania, Philadelphia, PA 19104, USA.
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36
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Rassnick KM, Bailey DB, Malone EK, Intile JL, Kiselow MA, Flory AB, Barlow LL, Balkman CE, Barnard SM, Waite AH. Comparison between l-CHOP and an l-CHOP protocol with interposed treatments of CCNU and MOPP (l-CHOP-CCNU-MOPP) for lymphoma in dogs. Vet Comp Oncol 2010; 8:243-53. [DOI: 10.1111/j.1476-5829.2010.00224.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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37
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Meyer A, Eberle N, Bullerdiek J, Nolte I, Simon D. High-mobility group B1 proteins in canine lymphoma: prognostic value of initial and sequential serum levels in treatment outcome following combination chemotherapy. Vet Comp Oncol 2010; 8:127-37. [PMID: 20579326 DOI: 10.1111/j.1476-5829.2010.00216.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Elevated high-mobility group box 1 (HMGB1) levels have been demonstrated in different human neoplasias. Information on serum HMGB1 before and during chemotherapy is lacking, as is data pertaining to its prognostic significance. The aim of this study was to characterize serum HMGB1 level in dogs with lymphoma and to assess its influence on the outcome following chemotherapy. Serum HMGB1 concentrations were measured in 16 dogs with lymphoma before treatment (W1) and on weeks 2 (W2), 6 (W6) and 12 (W12) of treatment with chemotherapy. Initial serum HMGB1 levels were significantly higher than HMGB1concentrations in control dogs and the levels in W2, W6 and W12. HMGB1-W1 concentrations were lower in dogs achieving complete remission than that in the single dog with partial remission. The ratio W12/W6 exhibited significant influence on remission duration. In these dogs with lymphoma, serum HMGB1 was elevated in comparison with that in controls. Initial serum HMGB1 level and its modulation during treatment may possess prognostic value.
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Affiliation(s)
- A Meyer
- Center for Human Genetics, University of Bremen, Leobener Str. ZHG, Bremen, Germany
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A vaccine targeting telomerase enhances survival of dogs affected by B-cell lymphoma. Mol Ther 2010; 18:1559-67. [PMID: 20531395 DOI: 10.1038/mt.2010.104] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Canine cancers occur with an incidence similar to that of humans and share many features with human malignancies including histological appearance, tumor genetics, biological behavior, and response to conventional therapies. As observed in humans, the telomerase reverse transcriptase (TERT) activity is largely confined to tumor tissues and absent in the majority of normal dog tissues. Therefore, dog TERT (dTERT) can constitute a valid target for translational cancer immunotherapy. We have evaluated the ability of adenovirus serotype 6 (Ad6) and DNA electroporation (DNA-EP) to induce immune responses against dTERT in dogs affected by malignant lymphoma (ML). The vaccine was combined with standard chemotherapy regimen [cyclophosphamide, vincristine, prednisone (COP)]. dTERT-specific immune response was induced in 13 out of 14 treated animals (93%) and remained detectable and long-lasting with the absence of autoimmunity or other side effects. Most interestingly, the survival time of vaccine/Chemo-treated dogs was significantly increased over historic controls of Chemo-treated animals (>97.8 versus 37 weeks, respectively, P = 0.001). Our results show that Ad6/DNA-EP-based cancer vaccine against dTERT overcomes host immune tolerance, should be combined with chemotherapy, induces long-lasting immune responses, and significantly prolongs the survival of ML canine patients. These data support further evaluation of this approach in human clinical trials.
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Yamazaki J, Takahashi M, Setoguchi A, Fujino Y, Ohno K, Tsujimoto H. Monitoring of Minimal Residual Disease (MRD) after Multidrug Chemotherapy and Its Correlation to Outcome in Dogs with Lymphoma: A Proof-of-Concept Pilot Study. J Vet Intern Med 2010; 24:897-903. [DOI: 10.1111/j.1939-1676.2010.0536.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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40
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Gentz EJ, Richard MJ, Stuart LD. Splenic lymphoma in a short-beaked echidna (Tachyglossus aculeatus). Aust Vet J 2009; 87:273-4. [PMID: 19573150 DOI: 10.1111/j.1751-0813.2009.00445.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 23-year-old, male short-beaked echidna (Tachyglossus aculeatus) housed at a North American zoo was successfully treated for flea-associated anaemia, but subsequently died. Cause of death was presumptive septicaemia secondary to splenic lymphoma. This is only the fifth case of neoplasia reported in this monotreme species, and the first from outside of Australia.
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Affiliation(s)
- E J Gentz
- Albuquerque Biological Park, Albuquerque, New Mexico 87104, USA.
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41
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Chun R. Lymphoma: Which Chemotherapy Protocol and Why? Top Companion Anim Med 2009; 24:157-62. [DOI: 10.1053/j.tcam.2009.03.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Accepted: 03/21/2009] [Indexed: 11/11/2022]
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42
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Rassnick K, Moore A, Collister K, Northrup N, Kristal O, Chretin J, Bailey D. Efficacy of Combination Chemotherapy for Treatment of Gastrointestinal Lymphoma in Dogs. J Vet Intern Med 2009; 23:317-22. [DOI: 10.1111/j.1939-1676.2008.0270.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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43
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Gavazza A, Sacchini F, Lubas G, Gugliucci B, Valori E. Clinical, laboratory, diagnostic and prognostic aspects of canine lymphoma: a retrospective study. ACTA ACUST UNITED AC 2009. [DOI: 10.1007/s00580-008-0799-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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