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Meuten TK, Dean GA, Thamm DH. Review: The PI3K-AKT-mTOR signal transduction pathway in canine cancer. Vet Pathol 2024; 61:339-356. [PMID: 37905509 DOI: 10.1177/03009858231207021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Tumors in dogs and humans share many similar molecular and genetic features, incentivizing a better understanding of canine neoplasms not only for the purpose of treating companion animals, but also to facilitate research of spontaneously developing tumors with similar biologic behavior and treatment approaches in an immunologically competent animal model. Multiple tumor types of both species have similar dysregulation of signal transduction through phosphatidylinositol 3-kinase (PI3K), protein kinase B (PKB; AKT), and mechanistic target of rapamycin (mTOR), collectively known as the PI3K-AKT-mTOR pathway. This review aims to delineate the pertinent aspects of the PI3K-AKT-mTOR signaling pathway in health and in tumor development. It will then present a synopsis of current understanding of PI3K-AKT-mTOR signaling in important canine cancers and advancements in targeted inhibitors of this pathway.
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Thamm DH. Novel Treatments for Lymphoma. Vet Clin North Am Small Anim Pract 2024; 54:477-490. [PMID: 38199913 DOI: 10.1016/j.cvsm.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Lymphoma is a common disease in companion animals. While conventional chemotherapy has the potential to induce remission and prolong life, relapse is common and novel treatments are needed to improve outcome. This review discusses recent modifications/adjustments to conventional standard of care therapy for canine and feline lymphoma, options for treatment or relapsed/refractory disease, and cutting-edge immunotherapy and small molecule-based approaches that are in varying stages of regulatory approval.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523-1620 USA.
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Saba CF, Fan TM, Phillips BS, Wright ZM, Thamm DH. Alternating rabacfosadine and doxorubicin for treatment of naïve canine lymphoma. Vet Comp Oncol 2024. [PMID: 38616055 DOI: 10.1111/vco.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/20/2024] [Accepted: 03/22/2024] [Indexed: 04/16/2024]
Abstract
The current standard of care treatment for canine lymphoma is a multi-agent, CHOP-based chemotherapy protocol. Single agent doxorubicin (DOX) is less burdensome; however, multi-agent chemotherapy protocols are often superior. The recently approved drug rabacfosadine (RAB, Tanovea) provides an attractive option for combination therapy with DOX, as both drugs demonstrate efficacy against lymphoma and possess different mechanisms of action. A previous study evaluating alternating RAB/DOX reported an overall response rate (ORR) of 84%, with a median progression-free survival time (PFS) of 194 days. The aim of this prospective trial was to evaluate the same protocol in an additional population of dogs. Fifty-nine dogs with treatment naïve lymphoma were enrolled. RAB (1.0 mg/kg IV) was alternated with DOX (30 mg/m2 IV) every 21 days for up to six total treatments (3 cycles). Response assessment and adverse event (AE) evaluation were performed every 21 days using VCOG criteria. The ORR was 93% (79% CR, 14% PR). The median time to maximal response was 21.5 days; median PFS was 199 days. T cell immunophenotype and lack of treatment response were predictive of inferior outcomes. AEs were mostly gastrointestinal. Six dogs developed presumed or confirmed pulmonary fibrosis; four were grade 5. One dog experienced grade 3 extravasation injury with RAB that resolved with supportive treatment. These data mirror those of the previously reported RAB/DOX study, and support the finding that alternating RAB/DOX is a reasonable treatment option for canine lymphoma.
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Affiliation(s)
- Corey F Saba
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Timothy M Fan
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Brenda S Phillips
- Veterinary Specialty Hospital of San Diego, San Diego, California, USA
| | | | - Douglas H Thamm
- Colorado State University Flint Animal Cancer Center, Fort Collins, Colorado, USA
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Thamm DH. Editorial. Vet Comp Oncol 2024; 22:1. [PMID: 38287647 DOI: 10.1111/vco.12963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/31/2024]
Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
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Schlein LJ, Brill SA, Brady RV, Farrell KB, Rose BJ, Meuten TK, Jordan CT, Thamm DH. Parthenolide As a Therapeutic for Disseminated Canine Neoplasms. J Pharmacol Exp Ther 2024; 388:774-787. [PMID: 38135509 PMCID: PMC10877710 DOI: 10.1124/jpet.123.001851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
This study provides a unique translational research opportunity to help both humans and dogs diagnosed with diseases that carry dismal prognoses in both species: histiocytic sarcoma (HS), hemangiosarcoma (HSA), and disseminated mastocytosis/mast cell tumor (MCT). Although exceedingly rare in humans, these so called "orphan diseases" are relatively more common in dogs. For these and other more commonplace cancers like lymphoma (Lym), dogs are an excellent translational model for human disease due to remarkably similar disease biology. In this study, assays were performed to assess the therapeutic potential of parthenolide (PTL), a known canonical nuclear factor kappa B (NF-κB) signaling inhibitor with additional mechanisms of antineoplastic activity, including alteration of cellular reduction-oxidation balance. Canine cell lines and primary cells are sensitive to PTL and undergo dose-dependent apoptosis after exposure to drug. PTL exposure also leads to glutathione depletion, reactive oxygen species generation, and NF-κB inhibition in canine cells. Standard-of-care therapeutics broadly synergize with PTL. In two canine HS cell lines, expression of NF-κB pathway signaling partners is downregulated with PTL therapy. Preliminary data suggest that PTL inhibits NF-κB activity of cells and extends survival time in a mouse model of disseminated canine HS. These data support further investigation of compounds that can antagonize canonical NF-κB pathway signaling in these cancers and pave the way for clinical trials of PTL in affected dogs. As dogs are an excellent natural disease model for these cancers, these data will ultimately improve our understanding of their human disease counterparts and hopefully improve care for both species. SIGNIFICANCE STATEMENT: Disseminated neoplasms in human and canine cancers are challenging to treat, and novel therapeutic approaches are needed to improve outcomes. Parthenolide is a promising treatment for histiocytic sarcoma, hemangiosarcoma, and mast cell neoplasia.
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Affiliation(s)
- Lisa J Schlein
- Flint Animal Cancer Center (L.J.S., S.A.B., R.V.B., K.B.F., B.J.R., T.K.M., D.H.T.) and Cell and Molecular Biology Graduate Program (L.J.S., S.A.B., R.V.B.), Colorado State University, Fort Collins, Colorado; and Anschutz Medical Campus, University of Colorado, Aurora, Colorado (C.T.J.)
| | - Samuel A Brill
- Flint Animal Cancer Center (L.J.S., S.A.B., R.V.B., K.B.F., B.J.R., T.K.M., D.H.T.) and Cell and Molecular Biology Graduate Program (L.J.S., S.A.B., R.V.B.), Colorado State University, Fort Collins, Colorado; and Anschutz Medical Campus, University of Colorado, Aurora, Colorado (C.T.J.)
| | - Rachel V Brady
- Flint Animal Cancer Center (L.J.S., S.A.B., R.V.B., K.B.F., B.J.R., T.K.M., D.H.T.) and Cell and Molecular Biology Graduate Program (L.J.S., S.A.B., R.V.B.), Colorado State University, Fort Collins, Colorado; and Anschutz Medical Campus, University of Colorado, Aurora, Colorado (C.T.J.)
| | - Kristen B Farrell
- Flint Animal Cancer Center (L.J.S., S.A.B., R.V.B., K.B.F., B.J.R., T.K.M., D.H.T.) and Cell and Molecular Biology Graduate Program (L.J.S., S.A.B., R.V.B.), Colorado State University, Fort Collins, Colorado; and Anschutz Medical Campus, University of Colorado, Aurora, Colorado (C.T.J.)
| | - Barbara J Rose
- Flint Animal Cancer Center (L.J.S., S.A.B., R.V.B., K.B.F., B.J.R., T.K.M., D.H.T.) and Cell and Molecular Biology Graduate Program (L.J.S., S.A.B., R.V.B.), Colorado State University, Fort Collins, Colorado; and Anschutz Medical Campus, University of Colorado, Aurora, Colorado (C.T.J.)
| | - Travis K Meuten
- Flint Animal Cancer Center (L.J.S., S.A.B., R.V.B., K.B.F., B.J.R., T.K.M., D.H.T.) and Cell and Molecular Biology Graduate Program (L.J.S., S.A.B., R.V.B.), Colorado State University, Fort Collins, Colorado; and Anschutz Medical Campus, University of Colorado, Aurora, Colorado (C.T.J.)
| | - Craig T Jordan
- Flint Animal Cancer Center (L.J.S., S.A.B., R.V.B., K.B.F., B.J.R., T.K.M., D.H.T.) and Cell and Molecular Biology Graduate Program (L.J.S., S.A.B., R.V.B.), Colorado State University, Fort Collins, Colorado; and Anschutz Medical Campus, University of Colorado, Aurora, Colorado (C.T.J.)
| | - Douglas H Thamm
- Flint Animal Cancer Center (L.J.S., S.A.B., R.V.B., K.B.F., B.J.R., T.K.M., D.H.T.) and Cell and Molecular Biology Graduate Program (L.J.S., S.A.B., R.V.B.), Colorado State University, Fort Collins, Colorado; and Anschutz Medical Campus, University of Colorado, Aurora, Colorado (C.T.J.)
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Burton JH, Johnston SA, Vail DM, Eickhoff JC, Sykes KF, Brown JR, Shen L, Gervassi A, Page RL, Willcox JL, Al-Nadaf S, Willis AL, Biggs D, Ralston J, Mok I, Kurzman ID, Huelsmeyer MK, Hayim R, Smith BM, Thamm DH. Design of a randomized, placebo-controlled study evaluating efficacy and safety of a cancer preventative vaccine in dogs. Vet Immunol Immunopathol 2024; 267:110691. [PMID: 38056066 DOI: 10.1016/j.vetimm.2023.110691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/06/2023] [Accepted: 11/24/2023] [Indexed: 12/08/2023]
Abstract
Preventative anti-cancer vaccination strategies have long been hampered by the challenge of targeting the diverse array of potential tumor antigens, with successes to date limited to cancers with viral etiologies. Identification and vaccination against frameshift neoantigens conserved across multiple species and tumor histologies is a potential cancer preventative strategy currently being investigated. Companion dogs spontaneously develop cancers at a similar incidence to those in people and are a complementary comparative patient population for the development of novel anti-cancer therapeutics. In addition to an intact immune system with tumors that arise in an autochthonous tumor microenvironment, dogs also have a shorter lifespan and temporally compressed tumor natural history as compared to humans, which allows for more rapid evaluation of safety, immunogenicity, and efficacy of cancer vaccination strategies. Here we describe the study protocol for the Vaccination Against Canine Cancer Study (VACCS), the largest interventional cancer clinical trial conducted in companion dogs to date. In addition to safety and immunogenicity, the primary endpoint of VACCS is the cumulative incidence (CI) of dogs developing malignant neoplasia of any type at the end of the study period. Secondary endpoints include changes in incidence of specific tumor types, survival times following neoplasia diagnosis, and all-cause mortality.
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Affiliation(s)
- Jenna H Burton
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 W. Drake Road, Fort Collins, CO 80523, United States
| | - Stephen Albert Johnston
- Calviri, Inc., Phoenix Bioscience Core, 850 North 5th Street, Phoenix, AZ 85004, United States; Center for Innovations in Medicine, Biodesign Institute, Arizona State University, 727 E. Tyler Street, Tempe, AZ 85281, United States
| | - David M Vail
- Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53705, United States; Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, United States
| | - Jens C Eickhoff
- Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, United States
| | - Kathryn F Sykes
- Calviri, Inc., Phoenix Bioscience Core, 850 North 5th Street, Phoenix, AZ 85004, United States
| | - Justin R Brown
- Calviri, Inc., Phoenix Bioscience Core, 850 North 5th Street, Phoenix, AZ 85004, United States
| | - Luhui Shen
- Calviri, Inc., Phoenix Bioscience Core, 850 North 5th Street, Phoenix, AZ 85004, United States
| | - Ana Gervassi
- Calviri, Inc., Phoenix Bioscience Core, 850 North 5th Street, Phoenix, AZ 85004, United States
| | - Rodney L Page
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 W. Drake Road, Fort Collins, CO 80523, United States
| | - Jennifer L Willcox
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, One Shields Avenue, Davis, CA 95616, United States
| | - Sami Al-Nadaf
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, One Shields Avenue, Davis, CA 95616, United States
| | - Amanda L Willis
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 W. Drake Road, Fort Collins, CO 80523, United States
| | - Danielle Biggs
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 W. Drake Road, Fort Collins, CO 80523, United States
| | - Jessica Ralston
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 W. Drake Road, Fort Collins, CO 80523, United States
| | - Irene Mok
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 W. Drake Road, Fort Collins, CO 80523, United States
| | - Ilene D Kurzman
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, United States
| | - Michael K Huelsmeyer
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, United States
| | - Rubi Hayim
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, United States
| | - Brittany M Smith
- Veterinary Center for Clinical Trials, School of Veterinary Medicine, University of California, One Shields Avenue, Davis, CA 95616, United States
| | - Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 W. Drake Road, Fort Collins, CO 80523, United States.
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Schlein LJ, Thamm DH. Immunohistochemical evidence of NF-kB activation in canine lymphomas, histiocytic sarcomas, hemangiosarcomas, and mast cell tumors. Vet Pathol 2024; 61:20-31. [PMID: 37357953 DOI: 10.1177/03009858231180484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Increased or constitutive activation of nuclear factor kappa B (NF-kB) is a feature of many chronic disease processes, including cancer. While NF-kB overactivation has been documented extensively in human oncology, there is a relative paucity of data documenting the same phenomenon in veterinary medicine. To assess NF-kB activity, antibodies to p65 and p100/p52, which are components of NF-kB heterodimers, were first validated for specificity and canine cross-reactivity via Western blot and labeling of immortalized cell pellets. Then, nuclear labeling for these antibodies was assessed via QuPath software in over 200 tumor tissue samples (10 hemangiosarcomas, 94 histiocytic sarcomas, 71 lymphomas, and 28 mast cell tumors) and compared to immunolabeling in appropriate normal tissue counterparts. Greater than 70% of spontaneous canine tumors evaluated in this study had more nuclear p65 and p100/p52 immunoreactivity than was observed in comparable normal cell populations. Specifically, 144/204 (70.58%) of tumors evaluated had positive p65 nuclear labeling and 179/195 (91.79%) had positive p100/p52 nuclear labeling. Surprisingly, greater nuclear p100/p52 reactivity was associated with a longer progression-free survival (PFS) and overall survival (OS) in canine lymphomas. These results provide support and preliminary data to investigate the role of NF-kB signaling in different types of canine cancer.
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Siewert JM, Gustafson DL, Weishaar KM, Galloway AM, Thamm DH. Individualized chemotherapy drug dose escalation in dogs with multicentric lymphoma. J Vet Intern Med 2023; 37:2402-2409. [PMID: 37787577 PMCID: PMC10658528 DOI: 10.1111/jvim.16875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/11/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND This study was performed to determine the ability to escalate drug doses in a 15-week CHOP protocol in dogs with multicentric lymphoma. HYPOTHESIS We hypothesized that at least 50% of dogs could successfully be escalated in at least 1 drug. Secondary aims were to establish objective response rate (ORR), progression-free interval (PFI), and overall survival time (OST). ANIMALS Thirty dogs with newly diagnosed multicentric lymphoma were prospectively treated with a 15-week CHOP protocol. METHODS This was a prospective cohort study. Drug doses that did not cause dose-limiting adverse effects (AEs) were increased using a standardized escalation protocol. AEs and response were assessed using VCOG criteria. Serial blood samples were collected after the first dose of each drug for pharmacokinetic analysis. RESULTS Of the 23 dogs with the opportunity to dose escalate, at least 1 drug was successfully escalated in 18 (78%). Vincristine was successfully escalated to 0.8 mg/m2 or higher in 11 dogs, cyclophosphamide to 300 mg/m2 or higher in 16 dogs, and doxorubicin to 35 mg/m2 or 1.4 mg/kg or higher in 9 dogs. Three of the 23 dogs (13%) were hospitalized at least once because of drug-induced AEs. Neutropenia was the most common dose-limiting toxicosis for all drugs. Peak doxorubicin concentrations were significantly lower in dogs where doxorubicin was successfully escalated. The objective response rate was 100%. The median progression free interval was 171 days. The median overall survival time was 254 days. CONCLUSIONS Drugs in the CHOP protocol can often be escalated safely with manageable AEs.
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Affiliation(s)
- Jacob M. Siewert
- Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
| | - Daniel L. Gustafson
- Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
- University of Colorado Comprehensive Cancer CenterAuroraColoradoUSA
| | | | | | - Douglas H. Thamm
- Flint Animal Cancer CenterColorado State UniversityFort CollinsColoradoUSA
- University of Colorado Comprehensive Cancer CenterAuroraColoradoUSA
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Griffin MA, Martin TW, Thamm DH, Worley DR. Partial ulnar ostectomy, stereotactic body radiation therapy, and palliative radiation therapy as local limb sparing treatment modalities for ulnar tumors in dogs. Front Vet Sci 2023; 10:1172139. [PMID: 37502712 PMCID: PMC10368977 DOI: 10.3389/fvets.2023.1172139] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
Background Information on dogs that undergo limb preserving local treatment for ulnar tumors is currently limited. Objective To describe the clinical characteristics and outcomes in dogs that underwent partial ulnectomy or radiation therapy (RT) for ulnar bone tumors, and to evaluate potential risk factors for outcomes as well as pre-treatment factors for association with treatment modality selected. Animals Forty client-owned dogs that underwent partial ulnectomy or RT for an ulnar tumor from July 2006 to July 2021. Methods The medical records database from a single institution were retrospectively reviewed, and data were recorded and analyzed. Results Radiation therapy was performed in 24 dogs, with 12 stereotactic body RT (SBRT) and 12 palliative RT (PRT) plans, and partial ulnectomy was performed in 16 dogs. Biomechanical complications occurred in 6/12 (50%) dogs that underwent SBRT, 6/12 (50%) dogs that underwent PRT, and 3/16 (18.8%) dogs that underwent ulnectomy. The majority of dogs had a good functional outcome following partial ulnectomy, and no dogs required surgical stabilization of the carpus even with lateral styloid process excision. Pathologic fracture occurred in 4/12 (33.3%) dogs following SBRT and 5/12 (41.7%) dogs following PRT. Local progression or recurrence was documented in 5/12 (41.7%) dogs that underwent SBRT, 2/12 (16.7%) dogs that underwent PRT, and 2/16 (12.5%) dogs that underwent ulnectomy. The overall median survival time was 198 days, and factors that were significantly associated with improved survival time included adjuvant chemotherapy administration and partial ulnectomy as local treatment method for dogs that received chemotherapy. Clinical relevance Both RT and ulnectomy were effective and well tolerated local treatment modalities for dogs with ulnar tumors.
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Affiliation(s)
- Maureen A. Griffin
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States
| | - Tiffany Wormhoudt Martin
- Department of Environmental and Radiological Health Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States
| | - Douglas H. Thamm
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States
| | - Deanna R. Worley
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States
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Brady RV, Thamm DH. Tumor-associated macrophages: Prognostic and therapeutic targets for cancer in humans and dogs. Front Immunol 2023; 14:1176807. [PMID: 37090720 PMCID: PMC10113558 DOI: 10.3389/fimmu.2023.1176807] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023] Open
Abstract
Macrophages are ancient, phagocytic immune cells thought to have their origins 500 million years ago in metazoan phylogeny. The understanding of macrophages has evolved to encompass their foundational roles in development, homeostasis, tissue repair, inflammation, and immunity. Notably, macrophages display high plasticity in response to environmental cues, capable of a strikingly wide variety of dynamic gene signatures and phenotypes. Macrophages are also involved in many pathological states including neural disease, asthma, liver disease, heart disease, cancer, and others. In cancer, most tumor-associated immune cells are macrophages, coined tumor-associated macrophages (TAMs). While some TAMs can display anti-tumor properties such as phagocytizing tumor cells and orchestrating an immune response, most macrophages in the tumor microenvironment are immunosuppressive and pro-tumorigenic. Macrophages have been implicated in all stages of cancer. Therefore, interest in manipulating macrophages as a therapeutic strategy against cancer developed as early as the 1970s. Companion dogs are a strong comparative immuno-oncology model for people due to documented similarities in the immune system and spontaneous cancers between the species. Data from clinical trials in humans and dogs can be leveraged to further scientific advancements that benefit both species. This review aims to provide a summary of the current state of knowledge on macrophages in general, and an in-depth review of macrophages as a therapeutic strategy against cancer in humans and companion dogs.
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Affiliation(s)
- Rachel V. Brady
- Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO, United States
| | - Douglas H. Thamm
- Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO, United States
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States
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Brill SA, Ammons DT, Avery AC, Thamm DH. Abstract 4465: Evaluation of tumor draining lymph nodes in dogs with spontaneously arising osteosarcoma using single-cell sequencing. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Tumor draining lymph nodes (TDLNs) function as an anatomic niche which primes immune cells to generate anti-cancer responses. While tumors are frequently staged based on the presence or absence of TDLN metastasis, mechanisms for how tumors impact the TDLN microenvironment and immunologic responses are incompletely understood. Dogs with spontaneously arising tumors provide an opportune model to study immuno-oncology, sharing many similarities to human patients with their environment, clinical care, and pathobiology. To evaluate how tumors impact TDLN responses, we conducted single cell RNA sequencing (scSeq) on cryopreserved TDLNs of dogs with osteosarcoma (n=4) and healthy controls (n=2). We obtained an average of 3,984 cells per sample (range 1,603-5,259) with a total of 4,780 cells from healthy samples and 19,121 cells from TDLN samples. All samples were integrated into one dataset, then unsupervised clustering was completed. Each unique cell cluster was assigned an identity using canonical markers and reference mapping to human datasets. Following cell classification, we observed notable changes in gene expression across all cells isolated from the LNs, with most differences arising from changes to the transcriptome of myeloid cells. Although still preliminary, the data also demonstrate differences in the abundance of T, B, and myeloid cells between healthy and tumor draining LNs. Taken together, this dataset provides indications of the changes TDLNs undergo in dogs with osteosarcoma.
Citation Format: Samuel A. Brill, Dylan T. Ammons, Anne C. Avery, Douglas H. Thamm. Evaluation of tumor draining lymph nodes in dogs with spontaneously arising osteosarcoma using single-cell sequencing. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4465.
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Affiliation(s)
- Samuel A. Brill
- 1Colorado State University, College of Veterinary Medicine & Biomedical Sciences, Fort Collins, CO
| | - Dylan T. Ammons
- 1Colorado State University, College of Veterinary Medicine & Biomedical Sciences, Fort Collins, CO
| | - Anne C. Avery
- 1Colorado State University, College of Veterinary Medicine & Biomedical Sciences, Fort Collins, CO
| | - Douglas H. Thamm
- 1Colorado State University, College of Veterinary Medicine & Biomedical Sciences, Fort Collins, CO
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Altwal J, Martin TW, Thamm DH, Séguin B. Configuration of pathologic fractures in dogs with osteosarcoma following stereotactic body radiation therapy: A retrospective analysis. Vet Comp Oncol 2023; 21:131-137. [PMID: 36633386 DOI: 10.1111/vco.12877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 01/13/2023]
Abstract
For some cases of canine appendicular osteosarcoma (OSA), limb-sparing treatment options are often desired, one of which is stereotactic body radiation therapy (SBRT). A major complication of SBRT is fracture of the irradiated bone at the site of treatment. The present study evaluated 127 appendicular OSA sites in 122 dogs treated with SBRT to identify the most common pathologic fracture locations and configurations. A total of 50 tumours experienced a pathologic fracture, and 38 had imaging sufficient to identify fracture configuration. The distal tibia was more likely to develop a fracture than other sites. Multiple types of fracture configuration (transverse, oblique, spiral and comminuted) were observed. The distal radius was significantly more likely to develop a transverse fracture than other sites. Documentation of fracture location and configuration leads to the identification of the forces contributing to fracture occurrence, since each configuration is a result of different forces acting on each affected bone. Such knowledge is imperative for the development of new approaches to diminish the occurrence of pathologic fractures.
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Affiliation(s)
- Johnny Altwal
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Tiffany Wormhoudt Martin
- Flint Animal Cancer Center and Department of Environmental and Radiological Health Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Douglas H Thamm
- Flint Animal Cancer Center and Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Bernard Séguin
- Flint Animal Cancer Center and Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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13
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Ringdahl-Mayland B, Thamm DH, Martin TW. Retrospective Evaluation of Outcome in Dogs With Appendicular Osteosarcoma Following Hypofractionated Palliative Radiation Therapy With or Without Bisphosphonates: 165 Cases (2010-2019). Front Vet Sci 2022; 9:892297. [PMID: 35619604 PMCID: PMC9128609 DOI: 10.3389/fvets.2022.892297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To report the survival times in dogs that received a standardized palliative-intent radiation therapy (RT) protocol for the treatment of canine appendicular osteosarcoma (OSA), alone or in combination with bisphosphonates (BPs), and to determine whether the addition of BPs affects survival. A secondary objective was to identify prognostic features that may influence outcome in dogs undergoing treatment. Design Retrospective case series. Materials and Methods Dogs with presumed or confirmed OSA of the appendicular limb treated with daily hypofractionated RT (8 Gy x 2) at the Flint Animal Cancer Center between 2010 and 2019 were evaluated retrospectively. Clinical data were abstracted from the medical records, and adjuvant therapies were noted. Outcome was assessed using medical records and electronic follow up. Results One hundred and sixty-five dogs were included. Sixty-eight dogs received BPs as a part of their palliative-intent treatment. The median survival time from first RT treatment to death was not significantly different between groups (119 vs. 109 days for BP and non-BP groups, respectively, p = 0.758). Only age (>9 years) was found to be prognostic in this population (p = 0.031). Factors that were not found to be associated with survival time included BP drug type, timing of BP administration, tumor location, weight, breed, sex, time to treatment, concurrent administration of chemotherapy, and salvage amputation. Conclusions This study suggests no difference in outcome for dogs treated with and without BPs in addition to hypofractionated RT. Prospective studies are needed to determine if the addition of BPs to hypofractionated RT leads to an improved quality of life in dogs undergoing palliative-intent treatment for OSA.
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Affiliation(s)
- Beck Ringdahl-Mayland
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States
| | - Douglas H. Thamm
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States
| | - Tiffany W. Martin
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
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14
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Abstract
Spontaneous tumors in dogs share several environmental, epidemiologic, biologic, clinical and molecular features with a wide variety of human cancers, making this companion animal an attractive model. Nuclear factor kappa B (NF-kB) transcription factor overactivation is common in several human cancers, and there is evidence that similar signaling aberrations also occur in canine cancers including lymphoma, leukemia, hemangiosarcoma, mammary cancer, melanoma, glioma, and prostate cancer. This review provides an overview of NF-kB signaling biology, both in health and in cancer development. It also summarizes available evidence of aberrant NF-kB signaling in canine cancer, and reviews antineoplastic compounds that have been shown to inhibit NF-kB activity used in various types of canine cancers. Available data suggest that dogs may be an excellent model for human cancers that have overactivation of NF-kB.
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15
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Patterson H, Henriksen MDL, Terhaar HM, Dvornicky-Raymond Z, Olmo C, Thamm DH, Sadar MJ. Use of computed tomography and nuclear scintigraphy for diagnosis and staging of primary anterior uveal osteosarcoma in a rabbit (Oryctolagus cuniculus). J Exot Pet Med 2022. [DOI: 10.1053/j.jepm.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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16
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Weishaar KM, Wright ZM, Rosenberg MP, Post GS, McDaniel JA, Clifford CA, Phillips BS, Bergman PJ, Randall EK, Avery AC, Thamm DH, Christman Hull AA, Gust CM, Donoghue AR. Multicenter, randomized, double‐blinded, placebo‐controlled study of rabacfosadine in dogs with lymphoma. J Vet Intern Med 2021; 36:215-226. [PMID: 34952995 PMCID: PMC8783351 DOI: 10.1111/jvim.16341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background Rabacfosadine (RAB, Tanovea‐CA1) is a novel chemotherapy agent conditionally approved for the treatment of lymphoma in dogs. Hypothesis/Objectives To determine the efficacy and safety of RAB in dogs with lymphoma. Animals One hundred and fifty‐eight client‐owned dogs with naïve or relapsed multicentric lymphoma were prospectively enrolled from January to October 2019. Methods Dogs were randomized to receive RAB or placebo at a 3 : 1 ratio. Treatment was given every 21 days for up to 5 treatments. Study endpoints included progression‐free survival (PFS), overall response rate (ORR) at a given visit, best overall response rate (BORR), and percent progression free 1 month after treatment completion. Safety data were also collected. Results The median PFS was significantly longer in the RAB group compared to placebo (82 vs 21 days; P < .0001, HR 6.265 [95% CI 3.947‐9.945]). The BORR for RAB‐treated dogs was 73.2% (50.9% complete response [CR], 22.3% partial response [PR]) and 5.6% (0% CR, 5.6% PR) for placebo‐treated dogs (P < .0001). One month after the last treatment, 37 RAB‐treated dogs (33%) were progression free compared with no placebo‐treated dogs (P < .0001). The most common adverse events observed in the RAB group were diarrhea (87.5%), decreased appetite (68.3%), and vomiting (68.3%) and were generally low grade and reversible. Serious adverse events were reported in 24 RAB‐treated (20%) and 5 placebo‐treated dogs (13%). Conclusions and Clinical Importance Rabacfosadine demonstrated statistically significant antitumor efficacy in dogs with lymphoma when administered every 21 days for up to 5 treatments as compared to placebo.
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Affiliation(s)
- Kristen M. Weishaar
- Flint Animal Cancer Center Colorado State University Fort Collins Colorado USA
| | | | | | | | | | | | | | | | - Elissa K. Randall
- Department of Radiology Colorado State University Fort Collins Colorado USA
| | - Anne C. Avery
- Department of Microbiology, Immunology, and Pathology Colorado State University Fort Collins Colorado USA
| | - Douglas H. Thamm
- Flint Animal Cancer Center Colorado State University Fort Collins Colorado USA
| | | | - Cathy M. Gust
- GustPMConsulting, LLC Westlake Village California USA
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17
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Farrell KB, Zinnen S, Thamm DH, Karpeisky A. Gemcitabine-Ibandronate Conjugate Enables the Bone-Targeted Combination Therapy in Bone Cancer: Synthesis and Efficacy in Combination with Docetaxel. Bioconjug Chem 2021; 32:2530-2539. [PMID: 34779607 PMCID: PMC9773925 DOI: 10.1021/acs.bioconjchem.1c00507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Patients with cancer-induced bone disease, including primary bone cancers such as osteosarcoma (OS) and metastases from other tissues of origin, present a high unmet medical need. We present a potential therapeutic approach built upon a proven bone-targeting bisphosphonate conjugate platform with the known synergies of gemcitabine (GEM) and docetaxel (DTX). The synthesis of rationally designed GEM-IB, the conjugate of GEM-5'-phosphate with ibandronate (IB), is presented. GEM-IB as a single agent or in combination with DTX demonstrated reduced tumor burden, preservation of the bone architecture, and improved the survival in a murine model of OS. This is the first demonstration of a bone-targeting conjugate in combination with a second drug to create effective drug ratios in the bone compartment.
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Affiliation(s)
| | - Shawn Zinnen
- MBC Pharama Inc, Aurora, Colorado 80045, United States
| | - Douglas H. Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado 80523, United States
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18
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Curley TL, Thamm DH, Johnson SW, Boscan P. Effects of morphine on histamine release from two cell lines of canine mast cell tumor and on plasma histamine concentrations in dogs with cutaneous mast cell tumor. Am J Vet Res 2021; 82:1013-1018. [PMID: 34714766 DOI: 10.2460/ajvr.20.08.0137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of morphine on histamine release from 2 canine mast cell tumor (MCT) cell lines and on plasma histamine concentrations in dogs with cutaneous MCTs. ANIMALS 10 dogs with cutaneous MCT and 10 dogs with soft tissue sarcoma (STS). PROCEDURES The study consisted of 2 phases. First, 2 canine MCT cell lines were exposed to 3 pharmacologically relevant morphine concentrations, and histamine concentrations were determined by an ELISA. Second, dogs with MCT or STS received 0.5 mg of morphine/kg, IM, before surgery for tumor excision. Clinical signs, respiratory rate, heart rate, arterial blood pressure, rectal temperature, and plasma histamine concentrations were recorded before and 5, 15, 30, and 60 minutes after morphine administration but prior to surgery. Data were compared by use of a 2-way ANOVA with the Sidak multiple comparisons test. RESULTS In the first phase, canine MCT cell lines did not release histamine when exposed to pharmacologically relevant morphine concentrations. In the second phase, no differences were noted for heart rate, arterial blood pressure, and rectal temperature between MCT and STS groups. Plasma histamine concentrations did not significantly differ over time within groups and between groups. CONCLUSIONS AND CLINICAL RELEVANCE No significant changes in histamine concentrations were noted for both in vitro and in vivo study phases, and no hemodynamic changes were noted for the in vivo study phase. These preliminary results suggested that morphine may be used safely in some dogs with MCT.
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Affiliation(s)
- Taylor L Curley
- From the Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80521
| | - Douglas H Thamm
- From the Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80521
| | - Sam W Johnson
- From the Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80521
| | - Pedro Boscan
- From the Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80521
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19
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Wittenberns BM, Thamm DH, Palmer EP, Regan DP. Canine Non-Angiogenic, Non-Myogenic Splenic Stromal Sarcoma: a Retrospective Clinicopathological Analysis and Investigation of Podoplanin as a Marker of Tumour Histogenesis. J Comp Pathol 2021; 188:1-12. [PMID: 34686271 DOI: 10.1016/j.jcpa.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/30/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
Splenic stromal sarcomas are rarely reported tumours that were previously grouped as non-angiomatous, non-lymphomatous mesenchymal neoplasms of the canine spleen. Highly variable survival times have been reported probably due to their heterogeneous nature. The purpose of this study was to assess the outcome and prognostic factors in dogs with splenic stromal sarcoma after treatment by splenectomy. Clinical data were collected retrospectively and histopathology was reviewed for 47 patients. Histological classification, based on morphology in haematoxylin and eosin-stained sections, in conjunction with immunolabelling of macrophage scavenger receptor-A (CD204), desmin, factor VIII-related antigen and smooth muscle actin ,yielded diagnoses of undifferentiated stromal sarcoma (n = 22), complex nodular hyperplasia (CNH, n = 9), sarcoma arising from benign complex nodular hyperplasia (n = 3), histiocytic sarcoma (n = 3), haemangiosarcoma (n = 1) and leiomyosarcoma (n = 1). Four samples were excluded from analysis due to extensive necrosis. An anti-podoplanin (PDPN) antibody was validated on canine tissue and used to assess expression of this protein as a potential indicator of the tissue of origin of the neoplasms (28/42 tumours were positive). There was a statistically significant difference in survival time between patients with stromal sarcoma (sarcoma from benign CNH and undifferentiated stromal sarcoma) and CNH (178 d versus 637 d, respectively; P = 0.027). Dogs with stromal sarcomas and high mitotic count (≥9 per 10 high-power fields) had a significantly shorter survival time (67 d versus 439 d; P = 0.01). Clinical diagnosis of splenic tumours should include evaluation for the presence of benign nodular hyperplasia morphology and immunohistochemistry to exclude more aggressive malignancies where adjuvant therapy is recommended. As in humans, PDPN may be an effective marker for stromal sarcomas of the canine spleen and immunopositivity suggests a fibroblastic reticular or follicular dendritic cell origin.
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Affiliation(s)
- Brittany M Wittenberns
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA; Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Douglas H Thamm
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA; Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Eric P Palmer
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA; Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Daniel P Regan
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA; Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
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20
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Das S, Idate R, Regan DP, Fowles JS, Lana SE, Thamm DH, Gustafson DL, Duval DL. Immune pathways and TP53 missense mutations are associated with longer survival in canine osteosarcoma. Commun Biol 2021; 4:1178. [PMID: 34635775 PMCID: PMC8505454 DOI: 10.1038/s42003-021-02683-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 09/15/2021] [Indexed: 12/20/2022] Open
Abstract
Osteosarcoma affects about 2.8% of dogs with cancer, with a one-year survival rate of approximately 45%. The purpose of this study was to characterize mutation and expression profiles of osteosarcoma and its association with outcome in dogs. The number of somatic variants identified across 26 samples ranged from 145 to 2,697 with top recurrent mutations observed in TP53 and SETD2. Additionally, 47 cancer genes were identified with copy number variations. Missense TP53 mutation status and low pre-treatment blood monocyte counts were associated with a longer disease-free interval (DFI). Patients with longer DFI also showed increased transcript levels of anti-tumor immune response genes. Although, T-cell and myeloid cell quantifications were not significantly associated with outcome; immune related genes, PDL-1 and CD160, were correlated with T-cell abundance. Overall, the association of gene expression and mutation profiles to outcome provides insights into pathogenesis and therapeutic interventions in osteosarcoma patients.
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Affiliation(s)
- Sunetra Das
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA.
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523, USA.
| | - Rupa Idate
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523, USA
| | - Daniel P Regan
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523, USA
- Department of Microbiology, Immunology, & Pathology, Colorado State University, Fort Collins, CO, 80523, USA
- University of Colorado Cancer Center, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Jared S Fowles
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523, USA
- Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO, 80523, USA
| | - Susan E Lana
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523, USA
| | - Douglas H Thamm
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523, USA
- University of Colorado Cancer Center, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO, 80523, USA
| | - Daniel L Gustafson
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523, USA
- University of Colorado Cancer Center, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO, 80523, USA
| | - Dawn L Duval
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA.
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523, USA.
- University of Colorado Cancer Center, Anschutz Medical Campus, Aurora, CO, 80045, USA.
- Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO, 80523, USA.
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21
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Gustafson DL, Collins KP, Fowles JS, Ehrhart EJ, Weishaar KM, Das S, Duval DL, Thamm DH. Prospective clinical trial testing COXEN-based gene expression models of chemosensitivity in dogs with spontaneous osteosarcoma. Cancer Chemother Pharmacol 2021; 88:699-712. [PMID: 34263337 DOI: 10.1007/s00280-021-04325-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study is a prospective clinical trial in dogs with osteosarcoma testing a gene expression model (GEM) predicting the chemosensitivity of tumors to carboplatin (CARBO) or doxorubicin (DOX) developed using the COXEN method. PATIENTS AND METHODS Sixty dogs with appendicular osteosarcoma were enrolled in this trial. RNA isolation and gene expression profiling were conducted with 2 biopsies for 54/63 screened tumors, and with a single biopsy for 9 tumors. Resulting gene expression data were used for calculation of a COXEN score for CARBO and DOX based on a previous study showing the significance of this predictor on patient outcome utilizing retrospective data (BMC Bioinformatics 17:93). Dogs were assigned adjuvant CARBO, DOX or the combination based on the results of the COXEN score following surgical removal of the tumor via amputation and were monitored for disease progression by chest radiograph every 2 months. RESULTS The COXEN predictor of chemosensitivity to CARBO or DOX was not a significant predictor of progression-free interval or overall survival for the trial participants. The calculation of DOX COXEN score using gene expression data from two independent biopsies of the same tumor were highly correlated (P < 0.0001), whereas the calculated CARBO COXEN score was not (P = 0.3039). CONCLUSION The COXEN predictor of chemosensitivity to CARBO or DOX is not a significant predictor of outcome when utilized in this prospective study. This trial represents the first prospective trial of a GEM predictor of chemosensitivity and establishes pet dogs with cancer as viable surrogates for prospective trials of prognostic indicators.
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Affiliation(s)
- Daniel L Gustafson
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, USA.
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA.
- University of Colorado Cancer Center, Anschutz Medical Campus, Aurora, CO, USA.
| | - Keagan P Collins
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, USA
| | - Jared S Fowles
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, USA
| | - E J Ehrhart
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, USA
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Kristen M Weishaar
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, USA
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sunetra Das
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, USA
| | - Dawn L Duval
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, USA
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
- University of Colorado Cancer Center, Anschutz Medical Campus, Aurora, CO, USA
| | - Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, USA
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
- University of Colorado Cancer Center, Anschutz Medical Campus, Aurora, CO, USA
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22
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Regan DP, Chow L, Das S, Haines L, Palmer E, Kurihara JN, Coy JW, Mathias A, Thamm DH, Gustafson DL, Dow SW. Losartan Blocks Osteosarcoma-Elicited Monocyte Recruitment, and Combined With the Kinase Inhibitor Toceranib, Exerts Significant Clinical Benefit in Canine Metastatic Osteosarcoma. Clin Cancer Res 2021; 28:662-676. [PMID: 34580111 DOI: 10.1158/1078-0432.ccr-21-2105] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/16/2021] [Accepted: 09/21/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE There is increasing recognition that progress in immuno-oncology could be accelerated by evaluating immune-based therapies in dogs with spontaneous cancers. Osteosarcoma (OS) is one tumor for which limited clinical benefit has been observed with the use of immune checkpoint inhibitors. We previously reported the angiotensin receptor blocker losartan suppressed metastasis in preclinical mouse models through blockade of CCL2-CCR2 monocyte recruitment. Here we leverage dogs with spontaneous OS to determine losartan's safety and pharmacokinetics associated with monocyte pharmacodynamic endpoints, and assess its antitumor activity, in combination with the kinase inhibitor toceranib. PATIENTS AND METHODS CCL2 expression, monocyte infiltration, and monocyte recruitment by human and canine OS tumors and cell lines were assessed by gene expression, ELISA, and transwell migration assays. Safety and efficacy of losartan-toceranib therapy were evaluated in 28 dogs with lung metastatic OS. Losartan PK and monocyte PD responses were assessed in three dose cohorts of dogs by chemotaxis, plasma CCL2, and multiplex cytokine assays, and RNA-seq of losartan-treated human peripheral blood mononuclear cells. RESULTS Human and canine OS cells secrete CCL2 and elicit monocyte migration, which is inhibited by losartan. Losartan PK/PD studies in dogs revealed that a 10-fold-higher dose than typical antihypertensive dosing was required for blockade of monocyte migration. Treatment with high-dose losartan and toceranib was well-tolerated and induced a clinical benefit rate of 50% in dogs with lung metastases. CONCLUSIONS Losartan inhibits the CCL2-CCR2 axis, and in combination with toceranib, exerts significant biological activity in dogs with metastatic osteosarcoma, supporting evaluation of this drug combination in patients with pediatric osteosarcoma.
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Affiliation(s)
- Daniel P Regan
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado. .,Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Lyndah Chow
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Sunetra Das
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Laurel Haines
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Eric Palmer
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Jade N Kurihara
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Jonathan W Coy
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Alissa Mathias
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Daniel L Gustafson
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Steven W Dow
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado. .,Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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23
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Smith KJ, Jana JA, Kaehr A, Purcell E, Opdycke T, Paoletti C, Cooling L, Thamm DH, Hayes DF, Nagrath S. Inertial focusing of circulating tumor cells in whole blood at high flow rates using the microfluidic CTCKey™ device for CTC enrichment. Lab Chip 2021; 21:3559-3572. [PMID: 34320046 DOI: 10.1039/d1lc00546d] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Circulating tumor cells (CTCs) are extremely rare cells shed from tumors into the blood stream. These cells can provide valuable information about their tumor of origin and direct treatment decisions to improve patient outcomes. Current technologies isolate CTCs from a limited blood volume and often require pre-processing that leads to CTC loss, making it difficult to isolate enough CTCs to perform in-depth tumor analysis. Many inertial microfluidic devices have been developed to isolate CTCs at high flow rates, but they typically require either blood dilution, pre-processing to remove red blood cells, or a sheath buffer rather than being able to isolate cells directly from whole blood. To decrease the need for pre-processing while increasing CTC yield, we developed an inertial device, the CTCKey™, to focus CTCs in whole blood at high throughput yielding a concentrated product stream enriched for CTCs. The CTCKey™ consists of two sections to create CTC enriched blood that can be further processed using any CTC isolation device to selectively isolate the CTCs. A thorough analysis was performed using the MCF7 breast cancer cell line spiked into bovine serum albumin (BSA) solutions of varying concentrations, as well as whole blood to characterize the focusing patterns of the CTCKey™. At the optimal flow rate of 2.4 mL min-1, the CTCKey™ reduces the CTC containing blood volume by 78%; the CTCs from 1 mL of blood are now in 0.22 mL of blood. The CTCKey's™ ability to concentrate CTCs from a large original blood volume to a smaller, highly concentrated volume enables a much greater blood volume to be interrogated by downstream isolation and characterization methods despite their low volume input limitations.
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Affiliation(s)
- Kaylee Judith Smith
- Chemical Engineering, University of Michigan, 2800 Plymouth Rd., Ann Arbor, Michigan, USA.
| | | | - Anna Kaehr
- Chemical Engineering, University of Michigan, 2800 Plymouth Rd., Ann Arbor, Michigan, USA.
| | - Emma Purcell
- Chemical Engineering, University of Michigan, 2800 Plymouth Rd., Ann Arbor, Michigan, USA.
| | - Tyler Opdycke
- Chemical Engineering, University of Michigan, 2800 Plymouth Rd., Ann Arbor, Michigan, USA.
| | - Costanza Paoletti
- Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
| | - Laura Cooling
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas H Thamm
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniel F Hayes
- Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
| | - Sunitha Nagrath
- Chemical Engineering, University of Michigan, 2800 Plymouth Rd., Ann Arbor, Michigan, USA.
- Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
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Prebble AR, Weishaar KM, Thamm DH, Leary D, LaRue SM, Martin T, Boss MK. Increased incidence of gastrointestinal toxicity in canine cancer patients treated with concurrent abdominal radiation therapy and toceranib phosphate. Vet Comp Oncol 2021; 20:142-153. [PMID: 34310002 DOI: 10.1111/vco.12756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 07/23/2021] [Indexed: 12/29/2022]
Abstract
Receptor tyrosine kinase inhibitors (TKIs) are used to treat human and canine cancers and may be combined with radiation therapy (RT) to enhance tumor control due their anticancer and antiangiogenic effects; however, recent case reports have emerged describing incidences of gastrointestinal toxicity when antiangiogenic therapies are combined with hypofractionated radiotherapy in human cancer patients. We evaluated the incidence of gastrointestinal (GI) toxicity in dogs receiving concurrent hypofractionated abdominal RT and the TKI toceranib (TOC) compared to those receiving abdominal RT alone, TOC alone, or concurrent non-abdominal RT and TOC. Medical records of canine cancer patients were retrospectively reviewed and identified dogs were included in the following treatment categories: dogs which received RT to a portion of the abdomen and concurrent TOC (n = 19), abdominal RT alone (n-29), TOC alone (n = 20), or non-abdominal RT plus TOC (n = 9). Toxicities were graded using the Veterinary Cooperative Oncology Group - Common Terminology Criteria for Adverse Events criteria and compared to published data on TOC-associated GI toxicity. Patients receiving TOC while undergoing abdominal RT had significantly increased rates of any grade of diarrhea (p = 0.002), hyporexia (p = 0.0045), and vomiting (p = 0.003), as well as severe hyporexia (p = 0.003) when compared across the treatment groups. This retrospective study reveals significantly increased incidences of GI toxicity when abdominal RT is combined with TOC in canine patients. These findings are in-line with the clinical concerns reported for increased normal tissue toxicity in human patients when antiangiogenics are combined with RT.
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Affiliation(s)
- Amber R Prebble
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Kristen M Weishaar
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Douglas H Thamm
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Del Leary
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Susan M LaRue
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Tiffany Martin
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Mary-Keara Boss
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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25
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Brill SA, Thamm DH. There and back again: Translating adoptive cell therapy to canine cancer and improving human treatment. Vet Comp Oncol 2021; 19:420-427. [PMID: 34169631 PMCID: PMC9310446 DOI: 10.1111/vco.12744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 11/26/2022]
Abstract
Adoptive cell transfer (ACT) is a burgeoning therapeutic modality within human immuno-oncology. Novel approaches towards ACT are being developed in the pre-clinical setting faster than they can be evaluated in human clinical trials. Many of the therapeutic approaches used in human medicine have already been evaluated to some degree in canine patients. While this form of immunotherapy in veterinary medicine is still in its infancy, as these approaches develop, canine ACT will become a tool for both the veterinary oncologist and the translational researcher. This review details canine ACT trials to date, with attention given to the precedents provided by human oncology.
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Affiliation(s)
- Samuel A Brill
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado, USA
| | - Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado, USA.,Developmental Therapeutics Program, University of Colorado Comprehensive Cancer Center, Fort Collins, Colorado, USA
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26
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Faulhaber EA, Janik E, Thamm DH. Adjuvant carboplatin for treatment of splenic hemangiosarcoma in dogs: Retrospective evaluation of 18 cases (2011-2016) and comparison with doxorubicin-based chemotherapy. J Vet Intern Med 2021; 35:1929-1934. [PMID: 34227148 PMCID: PMC8295674 DOI: 10.1111/jvim.16212] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 12/12/2022] Open
Abstract
Background Doxorubicin‐based chemotherapy after splenectomy remains the standard of care for hemangiosarcoma in dogs, but prognosis is generally poor. Hypothesis/objectives To determine clinical outcome with carboplatin chemotherapy after splenectomy compared to doxorubicin‐based protocols. A secondary objective was to determine if peripheral monocyte count was associated with prognosis. Animals Medical data from 40 dogs with histopathologically confirmed stage I or II hemangiosarcoma treated with splenectomy and carboplatin (n = 18) or doxorubicin‐based protocols (n = 22) were evaluated. Methods Retrospective study. Statistical associations were assessed using the Kaplan‐Meier method for survival times and log rank analysis for differences in survival time. Demographic information and survival times were obtained via medical records. Blood monocyte counts before and after surgery were documented. Results Median survival times were 160 days (48 to >559) and 139 days (54‐975), for dogs in the carboplatin (n = 18) and doxorubicin (n = 22) groups respectively (P = .82, hazards ratio [HR] [95% CI] = 1.075 [0.56‐2.07]). The median survival time for dogs whose monocyte counts decreased between splenectomy and chemotherapy initiation was 265 days, compared to 66 days for dogs with increased monocytes (P = .002, HR [95% CI] = 4.17 [1.21‐14.39]). Conclusions and Clinical Importance Carboplatin could be considered as an alternative in cases where doxorubicin might be contraindicated. Increasing postoperative peripheral monocyte counts might be associated with a poorer prognosis.
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Affiliation(s)
- Erica A Faulhaber
- Flint Animal Cancer Center, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Emily Janik
- Flint Animal Cancer Center, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Douglas H Thamm
- Flint Animal Cancer Center, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
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27
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Udho EB, Huebner SM, Albrecht DM, Matkowskyj KA, Clipson L, Hedican CA, Koth R, Snow SM, Eberhardt EL, Miller D, Van Doorn R, Gjyzeli G, Spengler EK, Storts DR, Thamm DH, Edmondson EF, Weil MM, Halberg RB, Bacher JW. Tumor aggressiveness is independent of radiation quality in murine hepatocellular carcinoma and mammary tumor models. Int J Radiat Biol 2021; 97:1140-1151. [PMID: 33720813 DOI: 10.1080/09553002.2021.1900946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE Estimating cancer risk associated with interplanetary space travel is complicated. Human exposure data to high atomic number, high-energy (HZE) radiation is lacking, so data from low linear energy transfer (low-LET) γ-ray radiation is used in risk models, with the assumption that HZE and γ-ray radiation have comparable biological effects. This assumption has been challenged by reports indicating that HZE radiation might produce more aggressive tumors. The goal of this research is to test whether high-LET HZE radiation induced tumors are more aggressive. MATERIALS AND METHODS Murine models of mammary and liver cancer were used to compare the impact of exposure to 0.2Gy of 300MeV/n silicon ions, 3 Gy of γ-rays or no radiation. Numerous measures of tumor aggressiveness were assessed. RESULTS For the mammary cancer models, there was no significant change in the tumor latency or metastasis in silicon-irradiated mice compared to controls. For the liver cancer models, we observed an increase in tumor incidence but not tumor aggressiveness in irradiated mice. CONCLUSION Tumors in the HZE-irradiated mice were not more aggressive than those arising from exposure to low-LET γ-rays or spontaneously. Thus, enhanced aggressiveness does not appear to be a uniform characteristic of all tumors in HZE-irradiated animals.
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Affiliation(s)
| | - Shane M Huebner
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Dawn M Albrecht
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Kristina A Matkowskyj
- Carbone Cancer Center, University of Wisconsin, Madison, WI, USA.,Department of Pathology & Laboratory Medicine, University of Wisconsin, Madison, WI, USA.,William S. Middleton VA Medical Center, Madison, WI, USA
| | - Linda Clipson
- Department of Oncology, University of Wisconsin, Madison, WI, USA
| | | | | | - Santina M Snow
- Department of Oncology, University of Wisconsin, Madison, WI, USA
| | - Emily L Eberhardt
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Devon Miller
- Promega Corporation, Madison, WI, USA.,Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Rachel Van Doorn
- Promega Corporation, Madison, WI, USA.,Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Genti Gjyzeli
- Promega Corporation, Madison, WI, USA.,Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Erin K Spengler
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | | | - Douglas H Thamm
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Elijah F Edmondson
- Molecular Histopathology Lab, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Michael M Weil
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Richard B Halberg
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA.,Carbone Cancer Center, University of Wisconsin, Madison, WI, USA.,Department of Oncology, University of Wisconsin, Madison, WI, USA
| | - Jeffery W Bacher
- Promega Corporation, Madison, WI, USA.,Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, WI, USA
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28
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
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29
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Bohannan Z, Pudupakam RS, Koo J, Horwitz H, Tsang J, Polley A, Han EJ, Fernandez E, Park S, Swartzfager D, Qi NSX, Tu C, Rankin WV, Thamm DH, Lee HR, Lim S. Predicting likelihood of in vivo chemotherapy response in canine lymphoma using ex vivo drug sensitivity and immunophenotyping data in a machine learning model. Vet Comp Oncol 2020; 19:160-171. [PMID: 33025640 PMCID: PMC7894155 DOI: 10.1111/vco.12656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 02/06/2023]
Abstract
We report a precision medicine platform that evaluates the probability of chemotherapy drug efficacy for canine lymphoma by combining ex vivo chemosensitivity and immunophenotyping assays with computational modelling. We isolated live cancer cells from fresh fine needle aspirates of affected lymph nodes and collected post‐treatment clinical responses in 261 canine lymphoma patients scheduled to receive at least 1 of 5 common chemotherapy agents (doxorubicin, vincristine, cyclophosphamide, lomustine and rabacfosadine). We used flow cytometry analysis for immunophenotyping and ex vivo chemosensitivity testing. For each drug, 70% of treated patients were randomly selected to train a random forest model to predict the probability of positive Veterinary Cooperative Oncology Group (VCOG) clinical response based on input variables including antigen expression profiles and treatment sensitivity readouts for each patient's cancer cells. The remaining 30% of patients were used to test model performance. Most models showed a test set ROC‐AUC > 0.65, and all models had overall ROC‐AUC > 0.95. Predicted response scores significantly distinguished (P < .001) positive responses from negative responses in B‐cell and T‐cell disease and newly diagnosed and relapsed patients. Patient groups with predicted response scores >50% showed a statistically significant reduction (log‐rank P < .05) in time to complete response when compared to the groups with scores <50%. The computational models developed in this study enabled the conversion of ex vivo cell‐based chemosensitivity assay results into a predicted probability of in vivo therapeutic efficacy, which may help improve treatment outcomes of individual canine lymphoma patients by providing predictive estimates of positive treatment response.
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Affiliation(s)
| | | | - Jamin Koo
- ImpriMed, Inc., Palo Alto, California, USA.,ImpriMed Korea, Inc., Seoul, Republic of Korea.,Department of Chemical Engineering, Hongik University, Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | | - Chantal Tu
- SAGE Veterinary Centers, Dublin, California, USA
| | | | - Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
| | - Hye-Ryeon Lee
- ImpriMed, Inc., Palo Alto, California, USA.,ImpriMed Korea, Inc., Seoul, Republic of Korea
| | - Sungwon Lim
- ImpriMed, Inc., Palo Alto, California, USA.,ImpriMed Korea, Inc., Seoul, Republic of Korea
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30
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Tremolada G, Thamm DH, Milovancev M, Seguin B. Biological behaviour of primary osteosarcoma of the digits, metacarpal and metatarsal bones in dogs. Vet Comp Oncol 2020; 19:735-742. [PMID: 32893971 DOI: 10.1111/vco.12652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/21/2020] [Accepted: 09/02/2020] [Indexed: 11/27/2022]
Abstract
Osteosarcoma (OSA) arising from the digits, metatarsal and metacarpal bones is rare and may carry a better prognosis compared with other locations. The aim of this study was to retrospectively evaluate the biological behaviour, the progression free interval (PFI), the survival time (ST) and evaluate the effect of adjuvant chemotherapy for OSA affecting these bones. Medical records from two academic institutions were reviewed and 15 cases were included. Descriptive statistics were used for signalment and history. For estimation of median PFI and median ST, the Kaplan-Meier method was utilized. The prognostic effect of chemotherapy, lymphocyte and monocyte count was investigated. Log-rank analysis was used to compare PFI and ST between groups. The overall median PFI and median ST were 377 and 687 days, respectively. No significant differences were noted for any of the variables evaluated. In this study, dogs affected by OSA of digits, metacarpal and metatarsal bones appear to have a longer ST compared with dogs with OSA of other appendicular locations. A study with a larger number of patients is needed to confirm these results and investigate the potential benefit of adjuvant chemotherapy.
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Affiliation(s)
- Giovanni Tremolada
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
| | - Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
| | - Milan Milovancev
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
| | - Bernard Seguin
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
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31
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LeBlanc AK, Mazcko CN, Breen M, Thomas R, Thamm DH. Abstract 6134: A comparative oncology approach to biomarker and drug discovery for cancer diagnosis and treatment in dogs and humans. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-6134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The goals of this work are biomarker and drug discovery to advance cancer diagnostic and therapeutic strategies in humans through the study of naturally-occurring canine cancers. Many factors, including shared environment, intact host immunity, and greater cancer gene family homology between dogs and humans than mice and humans, make spontaneous canine cancers valuable complementary models of human cancer.
Transcriptomic profiling utilizing RNA sequencing (RNA SEQ) of 5 canine cancers, including osteosarcoma, melanoma, B cell lymphoma, T cell lymphoma, and pulmonary carcinoma, have revealed five distinct gene co-expression models. From these unique module expression profiles, cancer-specific gene panels were derived. A similar analysis performed on existing RNA-SEQ data from human tumor samples produced cancer-specific human gene panels.
Comparison of the canine and human gene panels found significant correlation (Spearman correlation > 0.6) which supports the translational relevance of naturally-occurring canine cancers to their human counterparts. Further, proteomic profiles derived from matched tumor tissue and peripheral blood samples mirror those of the tumor transcriptome, demonstrating these cancer-specific gene panels and their encoded proteins may represent robust canine diagnostic biomarker and/or therapeutic target candidates. Therapeutic hypotheses associated with each cancer specific gene panel were derived through matching of drugs documented to alter expression of panel genes in opposition to that exhibited by each cancer type. We identified 60 candidate drugs and screened them against a panel of canine cancer cell lines, finding 40 drugs that inhibited cell growth by 75% or more. Three or more active compounds were found for each cell line. From these 40 active compounds we then derived 30 synergistic drug combinations with the requirement that that they alter two or more panel genes in opposition to that exhibited by each cancer type. Additional studies to document drug synergism are underway and those confirmed as such will be considered good drug combination candidates for future canine clinical trials. Biomarker and drug combination candidates that perform well in canine clinical trials will then be considered for human trials.
This work exemplifies the type of approach meant to further establish the comparative relevance of canine to human cancer and provide opportunities to explore hypotheses related to detection and treatment in both species.
Citation Format: Amy Kathleen LeBlanc, Christina N. Mazcko, Matthew Breen, Rachael Thomas, Douglas H. Thamm. A comparative oncology approach to biomarker and drug discovery for cancer diagnosis and treatment in dogs and humans [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6134.
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Affiliation(s)
- Amy Kathleen LeBlanc
- 1National Institutes of Health/National Cancer Institute/Center for Cancer Research, Bethesda, MD
| | - Christina N. Mazcko
- 1National Institutes of Health/National Cancer Institute/Center for Cancer Research, Bethesda, MD
| | - Matthew Breen
- 2North Carolina State University College of Veterinary Medicine, Raleigh, NC
| | - Rachael Thomas
- 2North Carolina State University College of Veterinary Medicine, Raleigh, NC
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Thamm DH, Joseph JK, Rose BJ, Meuten TK, Weishaar KM. Phase-I trial of survivin inhibition with EZN-3042 in dogs with spontaneous lymphoma. BMC Vet Res 2020; 16:97. [PMID: 32209084 PMCID: PMC7092583 DOI: 10.1186/s12917-020-02317-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 03/16/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Lymphoma is a common cancer in dogs. While most dogs receiving chemotherapy experience remission, very few are cured, and median survival times are generally in the 12-month range. Novel approaches to treatment are unquestionably needed. The Inhibitor of Apoptosis Protein (IAP) family member survivin, which is one of the most commonly overexpressed proteins in human cancer, plays a key role in apoptosis resistance, a major cause of drug-resistant treatment failure. Survivin targeting therapies have shown promise preclinically; however, none have been evaluated in dogs to date. The goal of the current study was to determine the safety and pharmacodynamic effects of systemic administration of the anti-survivin locked nucleic acid antisense oligonucleotide EZN-3042 in dogs with lymphoma. RESULTS We performed a prospective phase-I clinical trial in dogs with biopsy-accessible peripheral nodal lymphoma. Eighteen dogs were treated with EZN-3042 as a 2-h IV infusion at 5 dose levels, from 3.25 to 8.25 mg/kg twice weekly for 3 treatments. No dose-limiting toxicities were encountered. Reduction in tumor survivin mRNA and protein were observed in 3 of 5 evaluable dogs at the 8.25 mg/kg dose cohort. CONCLUSIONS In conclusion, reduced survivin expression was demonstrated in lymphoma tissues in the majority of dogs treated with EZN-3042 at 8.25 mg/kg twice weekly, which was associated with minimal adverse effects. This dose may be used in future studies of EZN-3042/chemotherapy combinations in dogs with spontaneous lymphoma and other cancers.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523-1620, USA. .,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO, 80523, USA. .,University of Colorado Cancer Center, Anschutz Medical Campus, Aurora, CO, 80045, USA.
| | - Jenette K Joseph
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523-1620, USA.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO, 80523, USA
| | - Barbara J Rose
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523-1620, USA
| | - Travis K Meuten
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523-1620, USA.,Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
| | - Kristen M Weishaar
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, 80523-1620, USA
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33
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Cawley JR, Wright ZM, Meleo K, Post GS, Clifford CA, Vickery KR, Vail DM, Bergman PJ, Thamm DH. Concurrent use of rabacfosadine and L-asparaginase for relapsed or refractory multicentric lymphoma in dogs. J Vet Intern Med 2020; 34:882-889. [PMID: 32064697 PMCID: PMC7096650 DOI: 10.1111/jvim.15723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/24/2020] [Indexed: 01/14/2023] Open
Abstract
Background Rabacfosadine (RAB), a novel antineoplastic agent conditionally licensed for the treatment of lymphoma in dogs, is efficacious in both naïve and previously treated dogs. Its use in combination with L‐asparaginase (L‐ASP) has not been studied. Hypothesis/Objectives To evaluate the safety and efficacy of L‐ASP given concurrently with RAB in dogs with relapsed multicentric lymphoma. Animals Fifty‐two dogs with relapse of lymphoma after treatment with at least 1 doxorubicin‐based chemotherapy protocol. Methods Open‐label, multicenter, prospective single‐arm clinical trial. Dogs were treated with RAB at 1.0 mg/kg IV every 21 days for up to a total of 5 doses. L‐asparaginase was administered at 400 IU/kg SQ concurrently with the first 2 treatments of RAB. Results The overall response rate (ORR) for all dogs was 67%, with 19 dogs (41%) achieving a complete response (CR). The median progression‐free survival time (MPFS) was 63 days (range 5‐428 days). Dogs experiencing a CR as their best response had an MPFS of 144 days (range 44‐428 days). Adverse events were similar to previous studies evaluating single agent RAB. Failure to achieve a CR and having previously received L‐ASP were negative prognostic factors on multivariate analysis. Conclusions and Clinical Importance Concurrent RAB/L‐ASP appears to be both efficacious and safe for treating relapsed multicentric lymphoma in dogs. Adverse events were most often mild and no unexpected toxicoses were observed.
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Affiliation(s)
- Jacob R Cawley
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | | | | | | | | | | | - David M Vail
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Douglas H Thamm
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado.,Developmental Therapeutics Program, Comprehensive Cancer Center, University of Colorado, Aurora, Colorado
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34
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Wolf-Ringwall A, Lopez L, Elmslie R, Fowler B, Lori J, Sfiligoi G, Skope A, Arnold E, Hughes KL, Thamm DH, Ehrhart EJ, Avery AC, Lana SE. Prospective evaluation of flow cytometric characteristics, histopathologic diagnosis and clinical outcome in dogs with naïve B-cell lymphoma treated with a 19-week CHOP protocol. Vet Comp Oncol 2019; 18:342-352. [PMID: 31682319 DOI: 10.1111/vco.12553] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 12/27/2022]
Abstract
Canine B-cell lymphoma is a clinically heterogenous disease; however, it is generally treated as a single disease entity. The purpose of this clinical trial was to prospectively evaluate naïve canine B-cell lymphoma patients using histopathology, flow cytometry (FC) and a standardized chemotherapy protocol to better define subsets of this disease that may respond differently to treatment. Sixty-four dogs with naïve multicentric B-cell lymphoma were treated with a standardized 19-week CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy protocol. Most of the dogs (84.3%) were diagnosed with diffuse large B-cell lymphoma (DLBCL), followed by nodal marginal zone (7.8%), small B-cell (4.7%), Burkitt-like (1.6%) and follicular lymphoma (1.6%). FC confirmed the diagnosis of B-cell lymphoma in all cases. There were no clear phenotyping differences between the subtypes of B-cell lymphoma detectable by our FC panel. The histologic subtypes in this study exhibited a range of forward scatter values on flow cytometry, but all of the DLBCL cases were higher than a value of 469, while the only cases with a lower forward scatter value were follicular lymphoma and diffuse small B-cell lymphoma. Dogs with DLBCL had a significantly better objective response rate to the CHOP protocol (96.3%) than the non-DLBCL subtypes (70%, P = .024). The median progression-free survival time for patients with DLBCL (233 days) was significantly longer than that of all other histopathologic subgroups combined (163 days, P = .0005).
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Affiliation(s)
- Amber Wolf-Ringwall
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Lynelle Lopez
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Robyn Elmslie
- VRCC Veterinary Specialty and Emergency Hospital, Englewood, Colorado
| | - Brooke Fowler
- Aspen Meadow Veterinary Specialists, Longmont, Colorado
| | - Janet Lori
- Animal Emergency and Specialty Center, Parker, Colorado
| | - Gabriella Sfiligoi
- Wheat Ridge Animal Hospital and Veterinary Specialists, Wheat Ridge, Colorado
| | - Anne Skope
- VCA Alameda East Veterinary Hospital, Denver, Colorado
| | - Erin Arnold
- VRCC Veterinary Specialty and Emergency Hospital, Englewood, Colorado
| | - Kelly L Hughes
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - E J Ehrhart
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Anne C Avery
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Susan E Lana
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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Abstract
Cancer is the most common cause of death in adult dogs. Many features of spontaneously developing tumors in pet dogs contribute to their potential utility as a human disease model. These include similar environmental exposures, similar clonal evolution as it applies to important factors such as immune avoidance, a favorable body size for imaging and serial biopsy, and a relatively contracted time course of disease progression, which makes evaluation of temporal endpoints such as progression free or overall survival feasible in a comparatively short time frame. These criteria have been leveraged to evaluate novel local therapies, demonstrate proof of tumor target inhibition or tumor localization, evaluate potential antimetastatic approaches, and assess the efficacy, safety and immune effects of a variety of immune-based therapeutics. Some of these canine proof of concept studies have been instrumental in informing subsequent human clinical trials. This review will cover key aspects of clinical trials in dogs with spontaneous neoplasia, with examples of how these studies have contributed to human cancer therapeutic development.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, CO, United States.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, CO, United States.,University of Colorado Cancer Center, Anschutz Medical Campus, Aurora, CO, United States
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Endo-Munoz L, Bennett TC, Topkas E, Wu SY, Thamm DH, Brockley L, Cooper M, Sommerville S, Thomson M, O'Connell K, Lane A, Bird G, Peaston A, Matigian N, Straw RC, Saunders NA. Auranofin improves overall survival when combined with standard of care in a pilot study involving dogs with osteosarcoma. Vet Comp Oncol 2019; 18:206-213. [PMID: 31441983 DOI: 10.1111/vco.12533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 08/11/2019] [Accepted: 08/16/2019] [Indexed: 12/29/2022]
Abstract
Osteosarcoma is the most common paediatric primary bone malignancy. The major cause of death in osteosarcoma is drug-resistant pulmonary metastasis. Previous studies have shown that thioredoxin reductase 2 is a driver of metastasis in osteosarcoma and can be inhibited by auranofin (AF). Moreover, studies have shown that AF significantly reduces pulmonary metastases in xenotransplant models. Here, we describe a phase I/II study of AF in canine osteosarcoma, a well-recognized spontaneous model of human osteosarcoma. We performed a single-arm multicentre pilot study of AF in combination with standard of care (SOC) (amputation + carboplatin). We recruited 40 dogs to the trial and used a historical SOC-only control group (n = 26). Dogs >15 kg received 9 mg AF q3d PO and dogs <15 kg received 6 mg q3d. Follow-up occurred over at least a 3-year period. Auranofin plus SOC improved overall survival (OS) (P = .036) in all dogs treated. The improved outcome was attributable entirely to improved OS in male dogs (P = .009). At the time of writing, 10 dogs (25%) survive without measurable disease in the treatment group with survival times ranging between 806 and 1525 days. Our study shows that AF improves OS in male dogs when combined with SOC. Our findings have translational relevance for the management of canine and human osteosarcoma. Our data justify a larger multicentre phase 2 trial in dogs and a phase I/II trial in human patients with refractory disease at the time of initial surgery.
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Affiliation(s)
- Liliana Endo-Munoz
- Translational Research Institute, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Queensland, Australia.,Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
| | | | - Eleni Topkas
- Translational Research Institute, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Sherry Y Wu
- School of Biomedical Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | - Laura Brockley
- Victorian Animal Cancer Care, Melbourne, Victoria, Australia
| | - Maureen Cooper
- Victorian Animal Cancer Care, Melbourne, Victoria, Australia
| | - Scott Sommerville
- Department of Orthopedic Oncology, Princess Alexandra Hospital and The Wesley Hospital, Brisbane, Queensland, Australia
| | - Maurine Thomson
- Veterinary Specialist Services, Brisbane, Queensland, Australia
| | | | - Amy Lane
- Small Animal Oncology, Newcastle, New South Wales, Australia
| | - Guy Bird
- Veterinary Emergency Centre and Hospital, James Cook University School of Veterinary and Biomedical Science, Townsville, Queensland, Australia
| | - Anne Peaston
- School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nicholas Matigian
- QFAB Bioinformatics, BIODATA Institute of Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Rodney C Straw
- Brisbane Veterinary Specialist Centre, Brisbane, Queensland, Australia.,Australian Consortium of Comparative Oncology of the Australian Animal Cancer Foundation, Brisbane, Queensland, Australia
| | - Nicholas A Saunders
- Translational Research Institute, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Queensland, Australia
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Thamm DH, Weishaar KM, Charles JB, Ehrhart EJ. Phosphorylated KIT as a predictor of outcome in canine mast cell tumours treated with toceranib phosphate or vinblastine. Vet Comp Oncol 2019; 18:169-175. [PMID: 31365175 DOI: 10.1111/vco.12525] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 11/29/2022]
Abstract
Canine cutaneous mast cell tumour (MCT) is the most common malignant skin tumour in dogs and can exhibit variable biologic behaviour. Dysregulated signalling through the receptor tyrosine kinase (RTK) KIT can promote cell proliferation and survival, and assessment of its dysregulation via detection of activating c-kit gene mutations or assessment of KIT protein localization is associated with multiple features of malignancy. The aim of the current study was to use a previously validated immunohistochemical (IHC) assay to directly measure phosphorylated KIT (pKIT) in order to investigate its association with other established prognostic markers, response to therapy, progression free interval (PFI) and overall survival time (OST) in dogs treated medically for measurable MCT. Tumour tissue from 74 dogs enrolled in a prospective study comparing toceranib and vinblastine for MCT treatment were evaluated for pKIT immunoreactivity. pKIT was variably expressed, with some degree of positivity observed in 49/74 cases (66%). pKIT immunoreactivity was significantly associated with aberrant KIT localization, high mitotic index and high histologic grade. On univariate analysis, pKIT immunoreactivity predicted shorter PFI and OST in the entire patient population as well as shorter PFI in the toceranib treated group, and was the sole predictive factor for OST upon multivariate analysis, while mitotic index was the sole independent predictive factor for PFI. These results demonstrate that IHC detection of pKIT correlates with several features of aggressive behaviour, and may confer information that is complementary to other prognostic factors. However, the role of pKIT in predicting outcome needs to be studied further before recommendations can be made for its routine use.
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Affiliation(s)
- Douglas H Thamm
- Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado.,Flint Animal Cancer Center, College of Veterinary Medicine and Biosciences, Colorado State University, Fort Collins, Colorado
| | - Kristen M Weishaar
- Flint Animal Cancer Center, College of Veterinary Medicine and Biosciences, Colorado State University, Fort Collins, Colorado
| | - Joseph B Charles
- Flint Animal Cancer Center, College of Veterinary Medicine and Biosciences, Colorado State University, Fort Collins, Colorado
| | - E J Ehrhart
- Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado.,Flint Animal Cancer Center, College of Veterinary Medicine and Biosciences, Colorado State University, Fort Collins, Colorado.,Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biosciences, Colorado State University, Fort Collins, Colorado
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Hlavaty SI, Chang YM, Orth RP, Goulian M, Planet PJ, Thamm DH, Punt JA, Garden OA. Bacterial Killing Activity of Polymorphonuclear Myeloid-Derived Suppressor Cells Isolated From Tumor-Bearing Dogs. Front Immunol 2019; 10:2371. [PMID: 31649676 PMCID: PMC6795752 DOI: 10.3389/fimmu.2019.02371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/20/2019] [Indexed: 12/11/2022] Open
Abstract
Polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs) are implicated in the progression and outcome of a variety of pathological states, from cancer to infection. Our previous work has identified three antimicrobial peptides differentially expressed by PMN-MDSCs compared to conventional neutrophils isolated from dogs, mice, and human patients with cancer. We therefore hypothesized that PMN-MDSCs in dogs with cancer possess antimicrobial activity. In the current work, we observed that exposure of PMN-MDSCs to Gram-negative bacteria (Escherichia coli) increased the expression of reactive oxygen species by the PMN-MDSCs, indicating that they are capable of initiating an anti-microbial response. Electron microscopy revealed that the PMN-MDSCs phagocytosed Gram-negative and Gram-positive (Staphylococcus aureus) bacterial species. Lysis of bacteria within some of the PMN-MDSCs suggested bactericidal activity, which was confirmed by the recovery of significantly lower numbers of bacteria of both species following exposure to PMN-MDSCs isolated from tumor-bearing dogs. Our data therefore indicate that PMN-MDSCs isolated from dogs with cancer, in common with PMNs, have phagocytic and bactericidal activity. This nexus of immunosuppressive and antimicrobial activity reveals a hitherto unrecognized function of MDSCs.
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Affiliation(s)
- Sabina I Hlavaty
- Garden Immune Regulation Laboratory, Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Yu-Mei Chang
- Research Support Office, Royal Veterinary College, London, United Kingdom
| | - Rachel P Orth
- School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, United States
| | - Mark Goulian
- Department of Biology, School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, United States
| | - Paul J Planet
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Pediatric Infectious Disease Division, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Douglas H Thamm
- Flint Animal Cancer Center, Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Jennifer A Punt
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Oliver A Garden
- Garden Immune Regulation Laboratory, Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Thamm DH, Gustafson DL. Drug dose and drug choice: Optimizing medical therapy for veterinary cancer. Vet Comp Oncol 2019; 18:143-151. [PMID: 31487110 DOI: 10.1111/vco.12537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/29/2019] [Accepted: 09/02/2019] [Indexed: 12/18/2022]
Abstract
Although novel agents hold great promise for the treatment of animal neoplasia, there may be room for significant improvement in the use of currently available agents. These improvements include altered dosing schemes, novel combinations, and patient-specific dosing or selection of agents. Previous studies have identified surrogates for "individualized dose intensity,", for example, patient size, development of adverse effects, and pharmacokinetic parameters, as potential indicators of treatment efficacy in canine lymphoma, and strategies for patient-specific dose escalation are discussed. Strategies for treatment selection in individual patients include conventional histopathology, protein-based target assessment (eg, flow cytometry, immunohistochemistry, and mass spectrometry), and gene-based target assessment (gene expression profiling and targeted or global sequencing strategies). Currently available data in animal cancer evaluating these strategies are reviewed, as well as ongoing studies and suggestions for future directions.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado.,Developmental Therapeutics Program, University of Colorado Comprehensive Cancer Center, Fort Collins, Colorado
| | - Daniel L Gustafson
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado.,Cell and Molecular Biology Graduate Program, Colorado State University, Fort Collins, Colorado.,Developmental Therapeutics Program, University of Colorado Comprehensive Cancer Center, Fort Collins, Colorado
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Diao H, Cheng N, Zhao Y, Xu H, Dong H, Thamm DH, Zhang D, Lin D. Ivermectin inhibits canine mammary tumor growth by regulating cell cycle progression and WNT signaling. BMC Vet Res 2019; 15:276. [PMID: 31375107 PMCID: PMC6679554 DOI: 10.1186/s12917-019-2026-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 07/29/2019] [Indexed: 01/04/2023] Open
Abstract
Background Mammary gland tumor is the most common spontaneous tumor in intact female dogs, and its poor prognosis remains a clinical challenge. Ivermectin, a well-known anti-parasitic agent, has been implicated as a potential anticancer agent in various types of human cancer. However, there are no reports evaluating the antitumor effects of ivermectin in canine mammary tumor. Here, we investigated whether ivermectin was able to inhibit canine mammary tumor development and explored the related mechanisms. Results Ivermectin inhibited the growth of canine mammary tumor cell lines in a dose- and time-dependent manner. The antitumor effects induced by ivermectin were associated with cell cycle arrest at G1 phase via down-regulation of CDK4 and cyclin D1 expression, with no significant induction of apoptosis. Furthermore, significantly reduced β-catenin nuclear translocation was observed after treatment with ivermectin, resulting in the inactivation of WNT signaling. Consistent with the results in vitro, a significant suppression of tumor growth by ivermectin was observed in canine mammary tumor xenografts. Conclusion Ivermectin, as a promising anti-cancer agent, inhibits the growth of canine mammary tumor by regulating cell cycle progression and WNT signaling. Electronic supplementary material The online version of this article (10.1186/s12917-019-2026-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hongxiu Diao
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Nan Cheng
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Ying Zhao
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Huihao Xu
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Haodi Dong
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Douglas H Thamm
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Di Zhang
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China.
| | - Degui Lin
- Department of Veterinary Clinical Science, College of Veterinary Medicine, China Agricultural University, Beijing, China.
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Thamm DH, Avery AC, Berlato D, Bulman-Fleming J, Clifford CA, Hershey AE, Intile JL, Jones PD, Kamstock DA, Liptak JM, Pavuk A, Peauroi J, Powell R, Rissetto K, Valli VEO, Webster JD. Prognostic and predictive significance of KIT protein expression and c-kit gene mutation in canine cutaneous mast cell tumours: A consensus of the Oncology-Pathology Working Group. Vet Comp Oncol 2019; 17:451-455. [PMID: 31264352 DOI: 10.1111/vco.12518] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 02/06/2023]
Abstract
One of the primary objectives of the Oncology-Pathology Working Group (OPWG), a joint initiative of the Veterinary Cancer Society and the American College of Veterinary Pathologists, is for oncologists and pathologists to collaboratively generate consensus documents to standardize aspects of and provide guidelines for oncologic pathology. Consensus is established through critical review of peer-reviewed literature relevant to a subgroup's particular focus. Subsequent acceptance and approval of the document by the OPWG membership at large establishes consensus. The intent of this publication is to help educate practitioners and pathologists on the value of diagnostics related to the KIT receptor tyrosine kinase for canine cutaneous mast cell tumours and to provide a guide for the use of these tests in veterinary medicine. This document represents the opinions of the OPWG and the authors and does not constitute a formal endorsement by the American College of Veterinary Pathologists or the Veterinary Cancer Society.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | - Anne C Avery
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | | | | | | | | | - Joanne L Intile
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina
| | | | | | | | - Alana Pavuk
- Antech Diagnostics, Hillsborough, North Carolina
| | | | - Roger Powell
- Powell Torrance Diagnostic Services, Hertfordshire, UK
| | - Kerry Rissetto
- Charleston Veterinary Referral Center, Charleston, South Carolina
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Janc JW, Hill CM, Ng PP, Hoston AN, Madriaga A, Dao-Pick TP, Yeung KS, Hudson R, Beausoleil AM, Bradley E, Verner E, Thamm DH, Miller RA, Buggy JJ. Abstract 1313: CPI-818: A selective inhibitor of interleukin-2-inducible T-cell kinase (ITK) that inhibits T-cell receptor signaling, promotes Th1 skewing, and achieves objective tumor responses when administered to dogs with T cell lymphomas. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: ITK is a non-receptor tyrosine kinase that modifies T cell receptor (TCR) signaling. Mice deficient in ITK, but not resting lymphocyte kinase (RLK), exhibit defects in Th2 differentiation while retaining the ability to differentiate into Th1 cells and secrete IFNγ. Combined disruption of ITK and RLK in mice leads to more severe T cell functional defects compared to disrupting ITK alone, and paradoxically allows for normal Th2 responses. Thus, selective pharmacologic inhibition of ITK versus RLK is necessary to inhibit Th2 responses without affecting Th1-dependent immunity. ITK is widely expressed in T cell malignancies, and activation of ITK upregulates GATA-3, a transcription factor that drives Th2 differentiation and is associated with poor survival. Here we report the discovery and characterization of CPI-818, an irreversible inhibitor of ITK. CPI-818 is highly selective for ITK over RLK allowing for an assessment of pure ITK inhibition on normal and malignant T cells.
Results: CPI-818 irreversibly inhibited ITK (IC502.3 nM) with >100-fold selectivity over RLK (430 nM) and BTK (850 nM). The mechanism of ITK inhibition involves covalent binding to CYS-442 confirmed by mass spectrometry. Irreversible inhibition of ITK in vitroand in vivowas demonstrated using an active site competitive probe. CPI-818 inhibited anti-CD3/28 induced phosphorylation of ERK (T202/Y204) and PLCγ (Y783) in PMBCs, and inhibited IL2 secretion in Jurkat T cells (IC5075 nM). CPI-818 demonstrated dose dependently inhibition of TCR-induced proliferation of malignant T cells from Sezary Syndrome patients. In mice orally treatedwith CPI-818 an increase in the ratio of IFNγ/IL-4 (p<0.05) upon antigen-specific re-stimulation in an OVA transgenic adoptive transfer model was observed, consistent with Th1-skewing. Additionally, toassess the impact of CPI-818 on Th-biasing, activated human PBMCs were cultured for 6 days with CPI-818 and inhibition of IL-4 production (average 64% inhibition, n=12) was significantly greater than IFNγ production (average 19% inhibition), supportive of Th1 skewing. To assess the potential of CPI-818 to treat human T cell lymphoproliferative disorders, the safety and efficacy of CPI-818 in companion dogs with spontaneously-occurring T cell lymphomas were evaluated. CPI-818 was dosed orally at 20 mg/kg BID for 2 weeks to 5 months. Three animals were treated: 1 with peripheral T cell lymphoma and 2 with cutaneous T cell lymphoma. Full ITK occupancy in peripheral blood was confirmed using a probe assay. Evidence of anti-tumor activity was seen in all dogs including complete and partial responses. CPI-818 was well tolerated with no change in normal lymphocyte counts. These data support evaluation of CPI-818 in clinical trials in patients with T cell malignancies.
Citation Format: James W. Janc, Craig M. Hill, Patrick P. Ng, Andrew N. Hoston, Antonett Madriaga, Trang P. Dao-Pick, Kitman S. Yeung, Ryan Hudson, Anne-Marie Beausoleil, Erin Bradley, Erik Verner, Douglas H. Thamm, Richard A. Miller, Joseph J. Buggy. CPI-818: A selective inhibitor of interleukin-2-inducible T-cell kinase (ITK) that inhibits T-cell receptor signaling, promotes Th1 skewing, and achieves objective tumor responses when administered to dogs with T cell lymphomas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1313.
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Smith K, Kim TH, Paoletti C, Thamm DH, Hayes DF, Nagrath S. Abstract 444: Continuous, high throughput microfluidic device to monitor circulating tumor cells in cancer patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Analysis of circulating tumor biomarkers, designated “liquid biopsies” are less invasive and lower risk to the patient and might replace or complement standard tissue biopsies to determine prognosis, predict benefit from specific therapies, or monitor patients with cancer. Circulating tumor cells (CTCs) are extremely rare, with only 1-10 CTCs per mL of blood. Current technologies typically process 1-10 mL of blood ex vivo. We report an in vivo, indwelling CTC-capture device that is analogous to a Holter monitor used to interrogate cardiac rhythm abnormalities over long periods of time. The system incorporates a dual lumen intravenous catheter that directs blood from the vein into a small (~ the size of a wristwatch) capture carriage by virtue of a peristaltic pump. The carriage contains a CTC capture chip which separates CTCs from whole blood based on flow differences and solid phase anti-EpCAM capture, while the remaining whole blood is returned to the venous system via the dual lumen catheter. The chip is then removed from the carriage for further enumeration and characterization of the CTCs. In a proof of principle set of experiments, the system was placed into investigational canines into which fluorescently labeled human breast cancer cells were injected intravenously. Although the vast majority of these xeno-cancer cells were rapidly removed from circulation, the system captured “CTCs” over a 2 hour time period more successfully than was seen in simultaneous blood draws for ex vivo enumeration over the same time. No adverse effects were observed in the subjects at the time of the experiments or over the succeeding 48 hours after removal of the IV system.Our system permits interrogation of a much larger volume of blood than can be processed with standard blood draws. The larger processed volume will drastically increase the number of cells isolated which in turn increases the number of downstream assays that can be performed. This study is focused on developing a high throughput microfluidic device that can detect CTCs and implementing it in a canine model.
Citation Format: Kaylee Smith, Tae Hyun Kim, Costanza Paoletti, Douglas H. Thamm, Daniel F. Hayes, Sunitha Nagrath. Continuous, high throughput microfluidic device to monitor circulating tumor cells in cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 444.
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Abstract
Lymphoma is a common disease in companion animals. Although conventional chemotherapy has the potential to induce remission and prolong life, relapse is common, and novel treatments are needed to improve outcome. This review discusses recent modifications/adjustments to conventional standard of care therapy for canine and feline lymphoma, as well as cutting-edge immunotherapy and small-molecule-based approaches that are in varying stages of regulatory approval.
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Affiliation(s)
- Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523-1620, USA.
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45
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Kim TH, Wang Y, Oliver CR, Thamm DH, Cooling L, Paoletti C, Smith KJ, Nagrath S, Hayes DF. A temporary indwelling intravascular aphaeretic system for in vivo enrichment of circulating tumor cells. Nat Commun 2019; 10:1478. [PMID: 30932020 PMCID: PMC6443676 DOI: 10.1038/s41467-019-09439-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 03/11/2019] [Indexed: 12/18/2022] Open
Abstract
Circulating tumor cells (CTCs) have become an established biomarker for prognosis in patients with various carcinomas. However, current ex vivo CTC isolation technologies rely on small blood volumes from a single venipuncture limiting the number of captured CTCs. This produces statistical variability and inaccurate reflection of tumor cell heterogeneity. Here, we describe an in vivo indwelling intravascular aphaeretic CTC isolation system to continuously collect CTCs directly from a peripheral vein. The system returns the remaining blood products after CTC enrichment, permitting interrogation of larger blood volumes than classic phlebotomy specimens over a prolonged period of time. The system is validated in canine models showing capability to screen 1-2% of the entire blood over 2 h. Our result shows substantial increase in CTC capture, compared with serial blood draws. This technology could potentially be used to analyze large number of CTCs to facilitate translation of analytical information into future clinical decisions.
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Affiliation(s)
- Tae Hyun Kim
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, 48109, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, 48109, USA
- Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Yang Wang
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, 48109, USA
| | - C Ryan Oliver
- Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Douglas H Thamm
- Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
| | - Laura Cooling
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Costanza Paoletti
- Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, MI, 48109, USA
| | - Kaylee J Smith
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Sunitha Nagrath
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA.
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Daniel F Hayes
- Department of Internal Medicine, University of Michigan Rogel Cancer Center, Ann Arbor, MI, 48109, USA.
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Griffin LR, Thamm DH, Brody A, Selmic LE. Prognostic value of fluorine 18 flourodeoxyglucose positron emission tomography/computed tomography in dogs with appendicular osteosarcoma. J Vet Intern Med 2019; 33:820-826. [PMID: 30768736 PMCID: PMC6430893 DOI: 10.1111/jvim.15453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/30/2019] [Indexed: 12/22/2022] Open
Abstract
Background Factors indicative of a negative prognosis for appendicular osteosarcoma (OSA) in dogs are visible metastatic disease, location, and size of lesion. In human medicine maximum standard uptake value (SUVmax), as measured on a fluorine18 flourodeoxyglucose positron emission tomography/computed tomography (18F‐FDG PET/CT), is prognostic for survival for several tumor types. Objective Determine if SUVmax is associated with progression‐free interval (PFI) and determination of survival in dogs with appendicular OSA. Animals Sixty‐two dogs with untreated appendicular OSA that had been staged with 18F‐FDG PET/CT. Methods Retrospective analysis of the 18F‐FDG PET/CT was performed. Dogs were excluded from the study if they did not receive definitive intent treatment for their primary OSA and adjuvant chemotherapy with carboplatin, or had visible metastatic disease on initial imaging. A region of interest (ROI) was created around the primary tumor to measure SUVmax. Univariable and multivariable Cox proportional hazards analysis was performed to evaluate for associations between variables including SUVmax and outcome of PFI and overall survival (OS). Results Maximum standard uptake value of the primary tumor was significantly associated with the OS (P = .04) with adjustment for treatment type and monocyte count. The overall median survival time (OST) was 284 days (range, 39‐1293 days) with the OST of dogs having an SUVmax of ≥7.4 of 254 days (range, 98‐428 days) and dogs with an SUVmax of <7.4 of 680 days (range, 108‐811 days, P = .01). Conclusions and Clinical Importance Maximum standard uptake value as measured via 18F‐FDG PET/CT is significantly associated with survival in dogs with appendicular OSA with a high SUVmax being an indicator of a negative prognosis.
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Affiliation(s)
- Lynn R Griffin
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Douglas H Thamm
- Department of Clinical Sciences and Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | - Ariel Brody
- North Carolina State University Veterinary Hospital, Raleigh, North Carolina
| | - Laura E Selmic
- Ohio State University Veterinary Medical Center, Columbus, Ohio
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Heishima K, Meuten T, Yoshida K, Mori T, Thamm DH. Prognostic significance of circulating microRNA-214 and -126 in dogs with appendicular osteosarcoma receiving amputation and chemotherapy. BMC Vet Res 2019; 15:39. [PMID: 30683101 PMCID: PMC6347759 DOI: 10.1186/s12917-019-1776-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 01/11/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dogs with appendicular osteosarcoma (OSA) receiving standard amputation and adjuvant chemotherapy demonstrate variable outcome with treatment; however, additional biomarkers would be helpful for predicting their outcome. In the present study, we assessed the potential of circulating microRNA-214 (miR-214) and - 126 (miR-126) to predict time to metastasis and death in dogs with OSA treated with amputation and chemotherapy. RESULTS Seventy-six dogs that fully met inclusion criteria were included in the analysis. The criteria included (1) a diagnosis of appendicular OSA without metastases at diagnosis, (2) treatment by amputation and chemotherapy using carboplatin, doxorubicin, cisplatin, or a combination of these agents. Circulating miR-214 and -126 levels at the time before treatment were measured by using RT-qPCR. High circulating miR-214 and serum alkaline phosphatase (ALP) significantly predicted short disease-free survival (DFS) and overall survival (OS). Conversely, high circulating miR-126 significantly predicted prolonged DFS and OS. An integrated approach using circulating miR-214, - 126, and serum ALP showed better accuracy in the prediction of DFS and OS and identification of long-term survivors than prediction using only ALP. Other variables (age, weight, sex, monocyte counts, and primary tumor site) were associated with neither DFS nor OS. miRNA levels did not strongly correlate with histopathological indices. CONCLUSIONS Circulating miR-214, - 126, and an integrated prognostic score have strong potential to predict the outcome of canine appendicular OSA patients receiving amputation and chemotherapy.
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Affiliation(s)
- Kazuki Heishima
- Laboratory of Veterinary Clinical Oncology, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu, Japan
| | - Travis Meuten
- Flint Animal Cancer Center, Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523 USA
| | - Kyoko Yoshida
- Laboratory of Veterinary Clinical Oncology, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu, Japan
| | - Takashi Mori
- Laboratory of Veterinary Clinical Oncology, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu, Japan
- Center for Highly Advanced Integration of Nano and Life Sciences (G-CHAIN), Gifu University, 1-1 Yanagido, Gifu, Japan
| | - Douglas H. Thamm
- Flint Animal Cancer Center, Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523 USA
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Marquardt TM, Lindley SES, Smith AN, Cannon CM, Rodriguez CO, Thamm DH, Childress MO, Northrup NC. Substitution of mitoxantrone for doxorubicin in a multidrug chemotherapeutic protocol for first-line treatment of dogs with multicentric intermediate- to large-cell lymphoma. J Am Vet Med Assoc 2019; 254:236-242. [DOI: 10.2460/javma.254.2.236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Laver T, Feldhaeusser BR, Robat CS, Baez JL, Cronin KL, Buracco P, Annoni M, Regan RC, McMillan SK, Curran KM, Selmic LE, Shiu KB, Clark K, Fagan E, Thamm DH. Post-surgical outcome and prognostic factors in canine malignant melanomas of the haired skin: 87 cases (2003-2015). Can Vet J 2018; 59:981-987. [PMID: 30197441 PMCID: PMC6091115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The medical records of 87 dogs treated with surgery for cutaneous malignant melanoma (CMM) of the haired skin were retrospectively reviewed for overall survival time (OST), progression-free survival time (PFS), and prognostic factors. The post-surgery median PFS and median OST were 1282 days and 1363 days, respectively. The post-surgery metastatic rate was 21.8% with a local recurrence rate of 8%. Increasing mitotic index (MI) was predictive of a significantly decreased OST and PFS on multivariable analysis [hazard ratio (HR): 1.05, 95% confidence interval (CI): 1.02 to 1.07 and HR: 1.04, 95% CI: 1.02 to 1.06, respectively]. Increasing age was likewise predictive of a significantly decreased OST and PFS on multivariable analysis (HR: 1.39, 95% CI: 1.17 to 1.65 and HR: 1.33, 95% CI: 1.14 to 1.54, respectively). These results confirm clinical impressions that long survival times are likely in dogs diagnosed with malignant melanoma of the haired skin when treated with surgery alone.
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Affiliation(s)
- Travis Laver
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Brittany R Feldhaeusser
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Cecilia S Robat
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Jennifer L Baez
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Kim L Cronin
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Paolo Buracco
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Maurizio Annoni
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Rebecca C Regan
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Sarah K McMillan
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Kaitlin M Curran
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Laura E Selmic
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Kai-Biu Shiu
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Kyle Clark
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Erin Fagan
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
| | - Douglas H Thamm
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30605, USA (Laver, Feldhaeusser); Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin 53706, USA (Robat); Center for Animal Referral and Emergency Services, 2010 Cabot Blvd. West, Suite D, Langhorne, Pennsylvania 19047, USA (Baez); New England Veterinary Oncology Group, Ste C, 180 Bear Hill Road, Waltham, Massachusetts 02454, USA (Cronin); Department of Veterinary Science, School of Veterinary Medicine, Universita' degli Studi di Torino, 10095 Turin, Italy (Buracco); Clinica Veterinaria Tibaldi, Viale Tibaldi, 66, 20136, Milan, Italy (Annoni); Bluepearl Georgia Veterinary Specialists, 455 Abernathy Road NE, Sandy Springs, Georgia 30328, USA (Regan); Veterinary Emergency and Referral Center of Hawaii, 1347 Kapiolani Blvd #103, Honolulu, Hawaii 96814, USA (McMillan); College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA (Curran); Department of Veterinary Medicine, Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois 61802, USA (Selmic); Veterinary Specialty Center, 1612 High Point Road, Middleton, Wisconsin 53562, USA (Shiu); Massey University, Palmerston North 4442, New Zealand (Clark); Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia 24060, USA (Fagan); Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA (Thamm)
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