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De Nardi AB, de Oliveira Massoco Salles Gomes C, Fonseca-Alves CE, de Paiva FN, Linhares LCM, Carra GJU, dos Santos Horta R, Ruiz Sueiro FA, Jark PC, Nishiya AT, de Carvalho Vasconcellos CH, Ubukata R, Batschinski K, Sobral RA, Fernandes SC, Biondi LR, De Francisco Strefezzi R, Matera JM, Rangel MMM, dos Anjos DS, Brunner CHM, Laufer-Amorim R, Cadrobbi KG, Cirillo JV, Martins MC, de Paula Reis Filho N, Silva Lessa DF, Portela R, Scarpa Carneiro C, Ricci Lucas SR, Fukumasu H, Feliciano MAR, Gomes Quitzan J, Dagli MLZ. Diagnosis, Prognosis, and Treatment of Canine Hemangiosarcoma: A Review Based on a Consensus Organized by the Brazilian Association of Veterinary Oncology, ABROVET. Cancers (Basel) 2023; 15:cancers15072025. [PMID: 37046686 PMCID: PMC10093745 DOI: 10.3390/cancers15072025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
Hemangiosarcoma is a mesenchymal neoplasm originating in the endothelial cells of blood vessels; they can be classified as non-visceral and visceral types. Non-visceral hemangiosarcomas can affect the skin, subcutaneous tissues, and muscle tissues; visceral hemangiosarcomas can affect the spleen, liver, heart, lungs, kidneys, oral cavity, bones, bladder, uterus, tongue, and retroperitoneum. Among domestic species, dogs are most affected by cutaneous HSA. Cutaneous HSA represents approximately 14% of all HSA diagnosed in this species and less than 5% of dermal tumors, according to North American studies. However, Brazilian epidemiological data demonstrate a higher prevalence, which may represent 27 to 80% of all canine HSAs and 13.9% of all skin neoplasms diagnosed in this species. Cutaneous HSA most commonly affects middle-aged to elderly dogs (between 8 and 15 years old), with no gender predisposition for either the actinic or non-actinic forms. The higher prevalence of cutaneous HSA in some canine breeds is related to lower protection from solar radiation, as low skin pigmentation and hair coverage lead to greater sun exposure. Actinic changes, such as solar dermatosis, are frequent in these patients, confirming the influence of solar radiation on the development of this neoplasm. There are multiple clinical manifestations of hemangiosarcoma in canines. The diagnostic approach and staging classification of cutaneous HSAs are similar between the different subtypes. The definitive diagnosis is obtained through histopathological analysis of incisional or excisional biopsies. Cytology can be used as a presurgical screening test; however, it has little diagnostic utility in cases of HSA because there is a high risk of blood contamination and sample hemodilution. Surgery is generally the treatment of choice for dogs with localized non-visceral HSA without evidence of metastatic disease. Recently, electrochemotherapy (ECT) has emerged as an alternative therapy for the local ablative treatment of different neoplastic types; the use of radiotherapy for the treatment of dogs with cutaneous HSA is uncommon. There is greater consensus in the literature regarding the indications for adjuvant chemotherapy in subcutaneous and muscular HSA; doxorubicin is the most frequently used antineoplastic agent for subcutaneous and muscular subtypes and can be administered alone or in combination with other drugs. Other therapies include antiangiogenic therapy, photodynamic therapy, the association of chemotherapy with the metronomic dose, targeted therapies, and natural products. The benefits of these therapies are presented and discussed. In general, the prognosis of splenic and cardiac HSA is unfavorable. As a challenging neoplasm, studies of new protocols and treatment modalities are necessary to control this aggressive disease.
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Faroni E, Sabattini S, Guerra D, Iannuzzi C, Chalfon C, Agnoli C, Stefanello D, Polton G, Ramos S, Aralla M, Ciaccini R, Foglia A, Okonji S, Marconato L. Timely adjuvant chemotherapy improves outcome in dogs with non-metastatic splenic hemangiosarcoma undergoing splenectomy. Vet Comp Oncol 2023; 21:123-130. [PMID: 36633399 DOI: 10.1111/vco.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/24/2022] [Accepted: 12/30/2022] [Indexed: 01/13/2023]
Abstract
Timely delivery of adjuvant chemotherapy has been shown to be advantageous in many human cancers and canine osteosarcoma. Adjuvant chemotherapy has been shown to improve outcome for canine splenic hemangiosarcoma. The aim of this retrospective study was to investigate whether timely adjuvant chemotherapy administration resulted in better outcome in dogs with non-metastatic splenic hemangiosarcoma undergoing splenectomy. Medical records were searched for dogs with non-metastatic, splenic hemangiosarcoma that received splenectomy and adjuvant chemotherapy. The number of days from surgery to the first chemotherapy dose (StoC) was evaluated to identify the cut-off value associated with the best survival advantage. StoC and other possible prognostic factors were tested for influence on time to metastasis (TTM) and overall survival (OS). Seventy dogs were included. Median StoC was 20 days (range: 4-70). The time interval associated with the greatest survival benefit was 21 days. Median TTM and OS of dogs with StoC ≤ 21 days were significantly longer than those with StoC >21 days (TTM: 163 vs. 118 days, p = .001; OS: 238 vs. 146 days, p < .001). On multivariable analysis, StoC >21 days was the only variable significantly associated with increased risk of tumour progression (HR 2.1, p = .010) and death (HR 2.3; p = .008). Starting adjuvant chemotherapy within 21 days of surgery may be associated with a survival benefit in dogs with non-metastatic splenic hemangiosarcoma, possibly due to the early targeting of newly recruited metastatic cells after surgery.
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Affiliation(s)
- Eugenio Faroni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Dina Guerra
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Chiara Iannuzzi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Carmit Chalfon
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Chiara Agnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Damiano Stefanello
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy
| | - Gerry Polton
- North Downs Specialist Referrals, Bletchingley, UK
| | - Sofia Ramos
- North Downs Specialist Referrals, Bletchingley, UK
| | | | | | - Armando Foglia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Samuel Okonji
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
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3
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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] [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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4
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Griffin MA, Culp WTN, Rebhun RB. Canine and feline haemangiosarcoma. Vet Rec 2021; 189:e585. [PMID: 34213807 DOI: 10.1002/vetr.585] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/12/2021] [Accepted: 05/04/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Haemangiosarcoma (HSA) is a malignant neoplasm of dogs and cats that is suspected to originate from a pluripotent bone marrow progenitor with a complex and multifactorial pathogenesis. APPROACH Pertinent literature was identified, reviewed, and summarized for inclusion in the manuscript. RESULTS/INTERPRETATION Dogs are more frequently diagnosed with HSA than cats, and primary sites of this disease include dermal, subcutaneous/intramuscular, and visceral (most commonly the spleen). Dogs and cats with HSA generally have a poor prognosis owing to the rapid and widespread metastasis typically associated with this disease. However, some forms such as cutaneous HSA behave in a less aggressive fashion with improved outcomes. Surgical excision and anthracycline-based chemotherapy remain the mainstays of treatment, although novel treatment modalities are currently under investigation for potential roles in treatment of this disease. CONCLUSION This review aims to describe the clinical presentation and progression of the various forms of HSA in dogs and cats as well as to provide a systematic review of the veterinary literature with a focus on the various published treatment options and associated outcomes.
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Affiliation(s)
- Maureen A Griffin
- School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - William T N Culp
- School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Robert B Rebhun
- School of Veterinary Medicine, University of California-Davis, Davis, California, USA
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Valdivia G, Alonso-Diez Á, Pérez-Alenza D, Peña L. From Conventional to Precision Therapy in Canine Mammary Cancer: A Comprehensive Review. Front Vet Sci 2021; 8:623800. [PMID: 33681329 PMCID: PMC7925635 DOI: 10.3389/fvets.2021.623800] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/11/2021] [Indexed: 12/16/2022] Open
Abstract
Canine mammary tumors (CMTs) are the most common neoplasm in intact female dogs. Canine mammary cancer (CMC) represents 50% of CMTs, and besides surgery, which is the elective treatment, additional targeted and non-targeted therapies could offer benefits in terms of survival to these patients. Also, CMC is considered a good spontaneous intermediate animal model for the research of human breast cancer (HBC), and therefore, the study of new treatments for CMC is a promising field in comparative oncology. Dogs with CMC have a comparable disease, an intact immune system, and a much shorter life span, which allows the achievement of results in a relatively short time. Besides conventional chemotherapy, innovative therapies have a large niche of opportunities. In this article, a comprehensive review of the current research in adjuvant therapies for CMC is conducted to gather available information and evaluate the perspectives. Firstly, updates are provided on the clinical-pathological approach and the use of conventional therapies, to delve later into precision therapies against therapeutic targets such as hormone receptors, tyrosine kinase receptors, p53 tumor suppressor gene, cyclooxygenases, the signaling pathways involved in epithelial-mesenchymal transition, and immunotherapy in different approaches. A comparison of the different investigations on targeted therapies in HBC is also carried out. In the last years, the increasing number of basic research studies of new promising therapeutic agents on CMC cell lines and CMC mouse xenografts is outstanding. As the main conclusion of this review, the lack of effort to bring the in vitro studies into the field of applied clinical research emerges. There is a great need for well-planned large prospective randomized clinical trials in dogs with CMC to obtain valid results for both species, humans and dogs, on the use of new therapies. Following the One Health concept, human and veterinary oncology will have to join forces to take advantage of both the economic and technological resources that are invested in HBC research, together with the innumerable advantages of dogs with CMC as a spontaneous animal model.
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Affiliation(s)
- Guillermo Valdivia
- Department Animal Medicine, Surgery and Pathology, Veterinary School, Complutense University of Madrid, Madrid, Spain
- Mammary Oncology Unit, Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Madrid, Spain
| | - Ángela Alonso-Diez
- Department Animal Medicine, Surgery and Pathology, Veterinary School, Complutense University of Madrid, Madrid, Spain
- Mammary Oncology Unit, Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Madrid, Spain
| | - Dolores Pérez-Alenza
- Department Animal Medicine, Surgery and Pathology, Veterinary School, Complutense University of Madrid, Madrid, Spain
- Mammary Oncology Unit, Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Madrid, Spain
| | - Laura Peña
- Department Animal Medicine, Surgery and Pathology, Veterinary School, Complutense University of Madrid, Madrid, Spain
- Mammary Oncology Unit, Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Madrid, Spain
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Pierini A, Sartini I, Giorgi M, Łebkowska-Wieruszewska B, Lisowski A, Poapolathep A, Marchetti V. Pharmacokinetics of thalidomide in dogs: can feeding affect it? A preliminary study. J Vet Sci 2020; 21:e60. [PMID: 33016014 PMCID: PMC7533387 DOI: 10.4142/jvs.2020.21.e60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/07/2020] [Accepted: 04/12/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Tumor-associated neoangiogenesis is a crucial target for antitumor therapies. Thalidomide (TAL) is a promising anti-neoangiogenetic drug that has recently been used in the treatment of several malignancies in dogs. OBJECTIVES The aim of the study was to assess the pharmacokinetics of TAL after single oral administration in dogs. Additionally, the influence of feeding on the pharmacokinetic profile of TAL in dogs has been preliminarily investigated. METHODS Six healthy adult female Labradors were enrolled according to a randomized single-dose, 2-treatment, 2-phase, paired 2 × 2 cross-over study design. The dogs were administered a single 400 mg capsule of TAL in fasted and fed conditions. Blood was collected from 15 min to 48 h after dosing, and TAL quantified in plasma by a validated high-performance liquid chromatography method. The pharmacokinetics of TAL were analyzed using a non-compartmental approach. RESULTS TAL concentration was quantifiable up to 10 h and 24 h after fasted and fed conditions, respectively. Cmax (fasted, 1.34 ± 0.12 μg/mL; fed, 2.47 ± 0.19 μg/mL) and Tmax (fasted, 3 h; fed, 10 h) differed substantially between the 2 groups. AUC and t1/2λz were significantly higher in fed (42.46 ± 6.64 mg × h/L; 17.14 ± 4.68 h) compared to fasted (12.38 ± 1.13 mg × h/L; 6.55 ± 1.25 h) dogs. The relative oral bioavailability of TAL for the fasted group was low (36.92% ± 3.28%). CONCLUSIONS Feeding affects the pharmacokinetics of oral TAL in dogs, showing a delayed, but higher absorption with different rate of elimination. These findings are of importance in clinical veterinary settings, and represent a starting point for further related studies.
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Affiliation(s)
- Alessio Pierini
- Department of Veterinary Sciences, University of Pisa, 56122 Pisa, Italy
| | - Irene Sartini
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy
| | - Mario Giorgi
- Department of Veterinary Sciences, University of Pisa, 56122 Pisa, Italy.,Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy.
| | - Beata Łebkowska-Wieruszewska
- Department of Pharmacology, Toxicology and Environmental Protection, University of Life Sciences, 20-033 Lublin, Poland
| | - Andrzej Lisowski
- Institute of Animal Breeding and Biodiversity Conservation, University of Life Sciences, 20-033 Lublin, Poland
| | - Amnart Poapolathep
- Department of Pharmacology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Veronica Marchetti
- Department of Veterinary Sciences, University of Pisa, 56122 Pisa, Italy
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7
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Bellamy EJ, Di Palma S, Verganti SP. What Is Your Diagnosis? J Am Vet Med Assoc 2020; 256:1101-1104. [PMID: 32364456 DOI: 10.2460/javma.256.10.1101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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8
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Stewart SD, Ehrhart EJ, Davies R, Khanna C. Prospective observational study of dogs with splenic mass rupture suggests potentially lower risk of malignancy and more favourable perioperative outcomes. Vet Comp Oncol 2020; 18:811-817. [PMID: 32458544 DOI: 10.1111/vco.12621] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 11/27/2022]
Abstract
Haemoperitoneum secondary to ruptured splenic tumours can be either benign or malignant in origin. The majority of previous studies of canine haemoperitoneum have been retrospective, which are associated with well-recognized biases, such as the potential to underappreciate the diversity of outcomes in a complex presentation such as haemoperitoneum. This study seeks to prospectively define perioperative morbidity and mortality of haemoperitoneum in dogs secondary to ruptured splenic masses. Forty dogs with haemoperitoneum secondary to a ruptured splenic mass met the inclusion criteria. As expected, the cohort predominately consisted of older large breed dogs. All dogs underwent preoperative staging and had a splenectomy performed. Histopathologic analysis was performed on the splenic mass, as well as any possible metastatic lesions that were noted intra-operatively. Perioperative care outside of splenectomy was delivered in specialty practices using current conventional approaches to care (eg, transfusions and anti-arrhythmic medications). Fifteen dogs (37.5%) had benign splenic tumours and were cured with surgery alone, whereas 62.5% had malignant disease (most often haemangiosarcoma [HSA]). Surgical outcomes were highly favourable in the vast majority of dogs. Indeed, 38 dogs (95%) survived and were discharged after a median hospitalization of 39.5 hours. Independent predictors of longer hospitalization times included receiving a transfusion and the development of an arrhythmia. Although small, this cohort defines distinctive and optimistic perspectives for dogs with haemoperitoneum from splenic tumour rupture. These favourable outcomes from this prospective study are sufficient to ask if larger prospective studies should be conducted to better inform owners during this challenging cancer emergency presentation.
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Affiliation(s)
- Samuel D Stewart
- Emergency and Critical Care, Ethos Veterinary Health, Woburn, Massachusetts, USA
| | - E J Ehrhart
- Emergency and Critical Care, Ethos Veterinary Health, Woburn, Massachusetts, USA
| | - Rebecca Davies
- Emergency and Critical Care, Ethos Veterinary Health, Woburn, Massachusetts, USA
| | - Chand Khanna
- Emergency and Critical Care, Ethos Veterinary Health, Woburn, Massachusetts, USA
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9
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Marconato L, Sabattini S, Marisi G, Rossi F, Leone VF, Casadei-Gardini A. Sorafenib for the Treatment of Unresectable Hepatocellular Carcinoma: Preliminary Toxicity and Activity Data in Dogs. Cancers (Basel) 2020; 12:cancers12051272. [PMID: 32443457 PMCID: PMC7281367 DOI: 10.3390/cancers12051272] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 12/20/2022] Open
Abstract
Unresectable nodular and diffuse hepatocellular carcinoma (HCC) have a poor prognosis with limited treatment options. Systemic traditional chemotherapy has been only rarely reported, with unsatisfactory results. The aim of this prospective, non-randomized, non-blinded, single center clinical trial was to investigate safety profile, objective response rate, time to progression and overall survival of sorafenib in comparison with metronomic chemotherapy (MC) consisting of thalidomide, piroxicam and cyclophosphamide in dogs with advanced, unresectable HCC. Between December 2011 and June 2017, 13 dogs were enrolled: seven received sorafenib, and six were treated with MC. Median time to progression was 363 days (95% CI, 191–535) in dogs treated with sorafenib versus 27 days (95% CI, 0–68) in dogs treated with MC (p = 0.044). Median overall survival was 361 days (95% CI, 0–909) in dogs receiving sorafenib, while 32 days (95% CI, 0–235) in those receiving MC (p = 0.079). Sorafenib seems to be a good candidate for the treatment of dogs with advanced HCC, due to a benefit in disease control and an acceptable safety profile, offering a good basis on which new randomized prospective clinical trials should be undertaken to compare the efficacy and drawback of sorafenib versus MC or traditional chemotherapy.
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Affiliation(s)
- Laura Marconato
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, Ozzano dell’Emilia, 40064 Bologna, Italy;
- Correspondence:
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, Ozzano dell’Emilia, 40064 Bologna, Italy;
| | - Giorgia Marisi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per Lo Studio e La Cura Dei Tumori (IRST) IRCCS, Via Piero Maroncelli 40, Meldola, 47014 Forlì-Cesena, Italy;
| | - Federica Rossi
- Centro Oncologico Veterinario, via San Lorenzo 1-4, Sasso Marconi, 40037 Bologna, Italy; (F.R.); (V.F.L.)
| | - Vito Ferdinando Leone
- Centro Oncologico Veterinario, via San Lorenzo 1-4, Sasso Marconi, 40037 Bologna, Italy; (F.R.); (V.F.L.)
| | - Andrea Casadei-Gardini
- Division of Oncology, Department of Oncology and Hematology, University Hospital Modena, 41124 Modena, Italy;
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10
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Treggiari E, Borrego JF, Gramer I, Valenti P, Harper A, Finotello R, Toni C, Laomedonte P, Romanelli G. Retrospective comparison of first-line adjuvant anthracycline vs metronomic-based chemotherapy protocols in the treatment of stage I and II canine splenic haemangiosarcoma. Vet Comp Oncol 2019; 18:43-51. [PMID: 31648405 DOI: 10.1111/vco.12548] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/15/2019] [Accepted: 10/02/2019] [Indexed: 12/14/2022]
Abstract
Splenectomy followed by adjuvant chemotherapy is commonly used to treat canine splenic haemangiosarcoma (HSA), although it is unclear if different treatment protocols may have a similar efficacy. The objective of this retrospective study was to assess outcome in dogs with stage I and II splenic HSA treated with either first-line adjuvant anthracycline (AC) or metronomic (MC)-based chemotherapy protocols, by comparing median time to progression (TTP) and median survival time (MST). Medical records of nine institutions were searched for dogs diagnosed with stage I and II splenic HSA that underwent adjuvant treatment with AC- or MC-based protocols following splenectomy. Patients treated with MC following AC were included in an additional group (AMC). Ninety-three dogs were included: 50 in the AC group, 23 in the AMC group and 20 in the MC group. The overall MST was 200 days (range 47-3352) and the overall median TTP was 185 days (range 37-1236). The median TTP of stage I dogs was significantly longer compared to stage II dogs (338 vs 151 days, respectively, P = .028). When adjusting for treatment type, the MST was 154 days for the AC group (range 47-3352 days), 338 days for the AMC group (range 79-1623 days) and 225 days for the MC group (range 57-911 days). The difference in MST and median TTP was not found to be statistically significant between treatment groups. This study suggests that adjuvant MC in canine splenic HSA may result in a similar outcome when compared to other treatment protocols. Further studies are warranted to confirm these findings.
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Affiliation(s)
- Elisabetta Treggiari
- Centro Specialistico Veterinario, Milan, Italy.,Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - Juan F Borrego
- Hospital Auna Especialidades Veterinarias, Paterna, Valencia, Spain
| | - Irina Gramer
- Davies Veterinary Specialists, Higham Gobion, Herts, UK
| | - Paola Valenti
- Clinica Veterinaria Malpensa, Samarate, Varese, Italy
| | - Aaron Harper
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Riccardo Finotello
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Cristina Toni
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
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11
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Metastatic Cardiac Hemangiosarcoma in a 6 Year Old Wheaten Terrier Mix. Vet Sci 2019; 6:vetsci6030065. [PMID: 31340545 PMCID: PMC6789882 DOI: 10.3390/vetsci6030065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/18/2019] [Accepted: 07/17/2019] [Indexed: 11/19/2022] Open
Abstract
A 6 year old Wheaten Terrier mix with a history of collapse and lethargy was referred for evaluation of pericardial effusion. The echocardiogram identified pericardial effusion and a right auricular mass. No sign of metastasis was noted at this time in thoracic radiographs and abdominal ultrasounds. The patient underwent the right auriculectomy via right lateral thoracotomy. Several metastatic masses were located in the visceral aspect of the pericardium at the time of surgery and were all excised. The right auricular mass and pericardial masses were diagnosed as hemangiosarcoma with a sign of metastasis. The patient recovered from surgery uneventfully and was discharged the sixth day after surgery. The patient received doxorubicin followed by cyclophosphamide, piroxicam and Coriolus versicolor extract postoperatively. Pulmonary metastases were noted 229 days and the dog was euthanized 318 days after surgery. No clinical signs were noted until 309 days postoperatively.
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12
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Marconato L, Chalfon C, Finotello R, Polton G, Vasconi ME, Annoni M, Stefanello D, Mesto P, Capitani O, Agnoli C, Amati M, Sabattini S. Adjuvant anthracycline-based vs metronomic chemotherapy vs no medical treatment for dogs with metastatic splenic hemangiosarcoma: A multi-institutional retrospective study of the Italian Society of Veterinary Oncology. Vet Comp Oncol 2019; 17:537-544. [PMID: 31251441 DOI: 10.1111/vco.12519] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/23/2019] [Accepted: 06/24/2019] [Indexed: 12/24/2022]
Abstract
Treatment options for dogs with metastatic (stage III) splenic hemangiosarcoma are limited. A doxorubicin-based chemotherapy regimen is commonly administered; however, there are no published data to support this practice. The aim of this study was to investigate the impact of maximum-tolerated-dose chemotherapy (MTD), metronomic chemotherapy (MC) and no adjuvant treatment on outcome in dogs with stage III splenic hemangiosarcoma undergoing splenectomy. Medical records of dogs with stage III splenic hemangiosarcoma that underwent splenectomy followed by MTD chemotherapy, MC or no adjuvant treatment were retrieved. Time to progression (TTP), survival time (ST) and toxicity were evaluated. One hundred three dogs were identified: 23 received adjuvant MTD, 38 MC and 42 were not medically treated. Overall median TTP and ST were 50 (95% confidence interval [CI], 39-61) and 55 days (95% CI, 43-66), respectively. Dogs treated with adjuvant MTD had a significantly longer TTP and ST compared with dogs receiving MC (median TTP, 134 vs 52 days, P = .025; median ST, 140 vs 58 days, P = .023, respectively). Dogs treated by splenectomy only had the shortest median TTP (28 days) and ST (40 days). However, treatment-related adverse events (AEs) were significantly more frequent in the MTD group (P = .017). The outcome for dogs with metastatic splenic hemangiosarcoma is poor. While MTD showed greater efficacy compared to MC, toxicity was higher in this group. Treatment-related AEs need to be carefully balanced against this modest survival prolongation when offering adjuvant MTD to dogs with advanced stage hemangiosarcoma.
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Affiliation(s)
| | - Carmit Chalfon
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Riccardo Finotello
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Gerry Polton
- North Downs Specialist Referrals, Bletchingley, UK
| | | | | | | | - Paola Mesto
- Centro Medico Veterinario BMVet, Bari, Italy
| | - Ombretta Capitani
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Chiara Agnoli
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Maria Amati
- Ospedale Veterinario Città di Pavia, Pavia, Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
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13
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Abstract
Histiocytic sarcoma (HS) and hemangiosarcoma (HSA) are uncommon and aggressive neoplasms that develop much more frequently in dogs than in cats. Breed-specific predispositions have been identified for both cancers. The development of novel diagnostics is underway and may aid in earlier diagnosis. Therapeutic approaches to HS and HSA depend on the stage of disease and may include surgery, radiation therapy, and chemotherapy. Such interventions improve outcome; however, aside from a small number of clinical circumstances, both diseases are considered largely incurable. Continued efforts toward the identification of driver mutations and subsequent druggable targets may lead to improvements in long-term prognosis.
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Affiliation(s)
- Christine Mullin
- Hope Veterinary Specialists, 40 Three Tun Road, Malvern, PA 19355, USA.
| | - Craig A Clifford
- Hope Veterinary Specialists, 40 Three Tun Road, Malvern, PA 19355, USA
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14
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Goto M, Owaki K, Hirata A, Yanai T, Sakai H. Tumour necrosis factor‐related apoptosis‐inducing ligand induces apoptosis in canine hemangiosarcoma cells in vitro. Vet Comp Oncol 2019; 17:285-297. [DOI: 10.1111/vco.12471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/06/2019] [Accepted: 02/11/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Minami Goto
- Laboratory of Veterinary PathologyGifu University Gifu Japan
| | - Keishi Owaki
- Laboratory of Veterinary PathologyGifu University Gifu Japan
| | - Akihiro Hirata
- Laboratory of Veterinary PathologyGifu University Gifu Japan
- Division of Animal Experiment, Life Science Research CenterGifu University Gifu Japan
| | - Tokuma Yanai
- Laboratory of Veterinary PathologyGifu University Gifu Japan
| | - Hiroki Sakai
- Laboratory of Veterinary PathologyGifu University Gifu Japan
- Center for Highly Advanced Integration of Nano and Life SciencesGifu University Gifu Japan
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15
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DE Campos CB, Lavalle GE, Monteiro LN, Pêgas GRA, Fialho SL, Balabram D, Cassali GD. Adjuvant Thalidomide and Metronomic Chemotherapy for the Treatment of Canine Malignant Mammary Gland Neoplasms. In Vivo 2019; 32:1659-1666. [PMID: 30348731 DOI: 10.21873/invivo.11429] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIM The aim of the present study was to evaluate a multimodal approach for the treatment of canine malignant mammary gland neoplasms, including surgery, chemotherapy, thalidomide, and metronomic chemotherapy (MC). MATERIALS AND METHODS Fifty-eight female dogs were submitted to four different treatments: surgery; surgery with chemotherapy; surgery with chemotherapy and thalidomide; and surgery with chemotherapy and metronomic chemotherapy and overall survival was evaluated. RESULTS No statistical difference was found in the proliferative index and microvessel density of primary neoplasms and distant metastases following thalidomide treatment. Diffuse intense inflammatory infiltrate was predominant in primary tumors and diffuse moderate inflammatory infiltrate in metastatic lesions. No statistically significant difference was observed in median survival time (MST) between treatment groups when including all clinical stages (p=0.3177). However, animals diagnosed with distant metastasis treated with surgery and chemotherapy associated with thalidomide or MC presented longer MST when compared to animals treated only with surgery or surgery and chemotherapy (p<0.0001). CONCLUSION The proposed multimodal therapy protocols including antiangiogenic and immunomodulatory therapies demonstrated a clinical benefit for patients in advanced clinical stages.
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Affiliation(s)
- Cecilia Bonolo DE Campos
- Laboratory of Comparative Pathology, Department of General Pathology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.,Department of Veterinary Clinic and Surgery, School of Agricultural and Veterinary Sciences of the Sao Paulo State University (FCAV/UNESP), Jaboticabal, Brazil
| | - Gleidice Eunice Lavalle
- Department of Veterinary Clinic and Surgery, Veterinary School, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Gabriela Rafaela Arantes Pêgas
- Laboratory of Comparative Pathology, Department of General Pathology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Silvia Ligório Fialho
- Department of Pharmaceutical and Biotechnological Development, Fundação Ezequiel Dias, Belo Horizonte, Brazil
| | - Débora Balabram
- Education and Research Institute Santa Casa BH, Belo Horizonte, Brazil
| | - Geovanni Dantas Cassali
- Laboratory of Comparative Pathology, Department of General Pathology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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16
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Reckelhoff CR, Lejeune A, Thompson PM, Shiomitsu K. In vitro effects of the chemotherapy agent water-soluble micellar paclitaxel (Paccal Vet) on canine hemangiosarcoma cell lines. Vet Comp Oncol 2018; 17:32-41. [PMID: 30267450 DOI: 10.1111/vco.12442] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 12/11/2022]
Abstract
Paccal Vet (Osamia Pharmaceuticals) is a water-soluble nanoparticle micellar formulation of the drug paclitaxel that is well tolerated in dogs. This study evaluated the in vitro effect of Paccal Vet on two canine hemangiosarcoma (HSA) cell lines and their expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). Paccal Vet caused HSA cell death in a dose- and time-dependent manner. The 50% inhibitory concentration (IC50 ) for the two HSA cell lines were 7 to 610 ng/mL, which are clinically achievable. Cell cycle analysis through flow cytometry showed cell cycle arrest at G2/M phase. Annexin-V and caspase 3/7 activity assays showed significant increases in apoptosis in correlation with the IC50 in each cell line. Reverse transcriptase-PCR was performed on the cell lines to validate the gene expression of VEGF and bFGF. Results obtained from this study support future studies involving the use of paclitaxel (micellar) for treatment of canine HSA.
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Affiliation(s)
- Caroline R Reckelhoff
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Amandine Lejeune
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Patrick M Thompson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Keijiro Shiomitsu
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
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17
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Alexander CK, Cronin KL, Silver M, Gardner HL, London C. The addition of metronomic chemotherapy does not improve outcome for canine splenic haemangiosarcoma. J Small Anim Pract 2018; 60:32-37. [PMID: 30209807 DOI: 10.1111/jsap.12926] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/24/2018] [Accepted: 06/26/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To determine whether the addition of metronomic chemotherapy improved outcome for dogs with splenic haemangiosarcoma treated with splenectomy and adjuvant maximum tolerated dose chemotherapy. MATERIALS AND METHODS Medical records were examined retrospectively for dogs with splenic haemangiosarcoma that had undergone splenectomy followed by anthracycline-based chemotherapy. Thirty-nine dogs underwent splenectomy followed by maximum tolerated dose chemotherapy with an anthracycline, cyclophosphamide, or both (Group 1). Twenty-two dogs underwent splenectomy followed by adjuvant maximum tolerated dose chemotherapy with an anthracycline, cyclophosphamide, or both, plus metronomic chemotherapy (Group 2). Dogs in both groups were further separated into those treated with either maximum tolerated dose anthracycline or maximum tolerated dose anthracycline and cyclophosphamide. RESULTS Median progression-free survival was 165 days and median overall survival time was 180 days in Group 1. Median progression-free survival was 185 days and median overall survival time was 212 days in Group 2. In both groups, the overall survival was shorter in dogs that had received maximum tolerated dose cyclophosphamide. CLINICAL SIGNIFICANCE The addition of metronomic to maximum tolerated dose chemotherapy protocols does not appear to improve outcome in dogs with splenic haemangiosarcoma treated with splenectomy and maximum tolerated dose chemotherapy.
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Affiliation(s)
- C K Alexander
- New England Veterinary Oncology Group, Waltham, Massachusetts 02451, USA
| | - K L Cronin
- New England Veterinary Oncology Group, Waltham, Massachusetts 02451, USA
| | - M Silver
- Atlantic Veterinary Internal Medicine and Oncology, Columbia, Maryland 21046, USA
| | - H L Gardner
- Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, Massachusetts 02111, USA
| | - C London
- Cummings School of Veterinary Medicine, Tufts University, Grafton, Massachusetts 01536, USA
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18
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Yee-Ka Cheng K, Krockenberger M, Bennett P. Use of metronomic chemotherapy in the management of a cat with abdominal haemangiosarcoma. JFMS Open Rep 2018; 4:2055116918793455. [PMID: 30135739 PMCID: PMC6090494 DOI: 10.1177/2055116918793455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CASE SUMMARY A 12-year-old entire domestic shorthair was evaluated for a 5 week history of intermittent vomiting, loss of appetite and weight loss. Abdominal ultrasound revealed a multi-lobulated heterogeneous mass adjacent to the mesenteric vessels. Cytology from fine-needle aspirates was non-diagnostic. Histopathology from a Tru-cut biopsy was consistent with haemangiosarcoma. The cat was treated with metronomic chemotherapy using oral cyclophosphamide. The cat remained clinically well and was euthanased 10 months after diagnosis owing to development of a haemoabdomen. RELEVANCE AND NOVEL INFORMATION Prognosis of feline abdominal haemangiosarcoma is generally poor and limited information on treatment is available in the veterinary literature. The use of metronomic chemotherapy with oral cyclophosphamide in this cat provided a 10 month period of good-quality life.
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Affiliation(s)
- Katrina Yee-Ka Cheng
- University Teaching Veterinary Hospital
Sydney, Sydney School of Veterinary Science, Faculty of Science, University of
Sydney, NSW, Australia
| | - Mark Krockenberger
- Veterinary Pathology Diagnostic
Services, Sydney School of Veterinary Science, Faculty of Science, University of
Sydney, NSW, Australia
| | - Peter Bennett
- University Teaching Veterinary Hospital
Sydney, Sydney School of Veterinary Science, Faculty of Science, University of
Sydney, NSW, Australia
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19
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Rossi F, Sabattini S, Vascellari M, Marconato L. The impact of toceranib, piroxicam and thalidomide with or without hypofractionated radiation therapy on clinical outcome in dogs with inflammatory mammary carcinoma. Vet Comp Oncol 2018; 16:497-504. [PMID: 29806156 DOI: 10.1111/vco.12407] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 04/06/2018] [Accepted: 04/09/2018] [Indexed: 12/19/2022]
Abstract
In dogs, inflammatory mammary carcinoma is a clinicopathological entity characterized by rapid progression and aggressive behavior from onset of disease. Reported median survival time is short, with no effective treatment options. The aims of this prospective, noncontrolled clinical trial were to investigate outcome variables and safety profile of toceranib, thalidomide and piroxicam with or without hypofractionated radiation therapy in dogs with measurable histologically confirmed inflammatory mammary carcinoma that underwent a complete staging. Eighteen dogs were enrolled: 14 received medical treatment, and 4 were treated with hypofractionated radiation therapy and medical therapy. Overall, median time to progression was 34 days and median survival time was 109 days. In dogs treated with medical therapy, overall response rate was 21%, and clinical benefit rate (CBR) was 64%; median time to progression was 28 days and median survival time was 59 days. In dogs receiving medical therapy and undergoing radiation therapy, overall response rate and clinical benefit rate were 100%, with significantly longer time to progression (156 days) and survival time (180 days). Overall, treatment was well tolerated, with mild gastrointestinal and dermatological adverse events. Although the optimal treatment to this disease remains uncertain, the current approach consisting of systemic anti-angiogenic drugs with or without hypofractionated radiation therapy, provided clinical benefit in a significant proportion of dogs and should, therefore, be further explored.
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Affiliation(s)
- F Rossi
- Centro Oncologico Veterinario, Bologna, Italy.,Clinica Veterinaria dell'Orologio, Bologna, Italy
| | - S Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - M Vascellari
- Istituto Zooprofilattico Sperimentale delle Venezie, Padova, Italy
| | - L Marconato
- Centro Oncologico Veterinario, Bologna, Italy
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20
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Polton G, Finotello R, Sabattini S, Rossi F, Laganga P, Vasconi ME, Barbanera A, Stiborova K, Rohrer Bley C, Marconato L. Survival analysis of dogs with advanced primary lung carcinoma treated by metronomic cyclophosphamide, piroxicam and thalidomide. Vet Comp Oncol 2018; 16:399-408. [PMID: 29508493 DOI: 10.1111/vco.12393] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 02/02/2018] [Accepted: 02/02/2018] [Indexed: 12/26/2022]
Abstract
Unresectable or metastatic (advanced) primary pulmonary carcinoma (PPC) represents a therapeutic challenge where surgery may be contraindicated and the therapeutic role of maximum-tolerated dose (MTD) chemotherapy remains uncertain. This study was undertaken to explore the impact of metronomic chemotherapy (MC) in dogs with advanced PPC. Previously untreated dogs with advanced (T3 or N1 or M1) PPC, with complete staging work-up and follow-up data, receiving MC (comprising low-dose cyclophosphamide, piroxicam and thalidomide), surgery, MTD chemotherapy or no oncologic treatment were eligible for inclusion. For all patients, time to progression (TTP) and survival time (ST) were evaluated. Quality-of-life (QoL) was only evaluated in patients receiving MC. To assess QoL, owners of dogs receiving MC were asked to complete a questionnaire before and during treatment. Ninety-one dogs were included: 25 received MC, 36 were treated with surgery, 11 with MTD chemotherapy and 19 received no treatment. QoL was improved in dogs receiving MC. Median TTP was significantly longer in patients receiving MC (172 days) than patients undergoing surgery (87 days), receiving MTD chemotherapy (22 days), or no oncologic treatment (20 days). Median ST was similarly longer in patients receiving MC (139 days) than those undergoing surgery (92 days), MTD chemotherapy (61 days) and no oncologic treatment (60 days). In dogs with advanced PPC, MC achieved a measurable clinical benefit without significant risk or toxicity. This makes MC a potential alternative to other recognized management approaches.
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Affiliation(s)
- G Polton
- North Downs Specialist Referrals, Brewerstreet Dairy Business Park, Surrey, UK
| | - R Finotello
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Faculty of Health and Life Science, University of Liverpool, Neston, UK
| | - S Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - F Rossi
- Centro Oncologico Veterinario, Sasso Marconi, Italy
| | - P Laganga
- Centro Oncologico Veterinario, Sasso Marconi, Italy
| | | | - A Barbanera
- Centro Oncologico Veterinario, Sasso Marconi, Italy
| | - K Stiborova
- Department of Small Animal Clinical Science, Institute of Veterinary Science, Faculty of Health and Life Science, University of Liverpool, Neston, UK
| | - C Rohrer Bley
- Division of Radiation Oncology, Vetsuisse-Faculty, University of Zurich, Zürich, Switzerland
| | - L Marconato
- Centro Oncologico Veterinario, Sasso Marconi, Italy
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21
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Gaspar TB, Henriques J, Marconato L, Queiroga FL. The use of low-dose metronomic chemotherapy in dogs-insight into a modern cancer field. Vet Comp Oncol 2017; 16:2-11. [PMID: 28317239 DOI: 10.1111/vco.12309] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 02/03/2017] [Accepted: 02/11/2017] [Indexed: 12/22/2022]
Abstract
The era of chemotherapy, which started in the middle of the last century, has been ruled by the routine use of dose-intense protocols, based on the "maximum-tolerated dose" concept. By promoting a balance between patient's quality of life and the goal of rapidly killing as many tumour cells as possible, these protocols still play a prominent role in veterinary oncology. However, with the opening of a new millennium, metronomic chemotherapy (MC) started to be considered a possible alternative to traditional dose-intense chemotherapy. Characterized by a long-term daily administration of lower doses of cytotoxic drugs, this new modality stands out for its unique combination of effects, namely on neovascularization, immune response and tumour dormancy. This article reviews the rationale for treatment with MC, its mechanism of action and the main studies conducted in veterinary medicine, and discusses the key challenges yet to be solved.
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Affiliation(s)
- T B Gaspar
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Hospital Veterinário Berna, Lisboa, Portugal
| | - J Henriques
- Hospital Veterinário Berna, Lisboa, Portugal
| | - L Marconato
- Centro Oncologico Veterinario, Bologna, Italy
| | - F L Queiroga
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Center for the Study of Animal Sciences, CECA-ICETA, University of Porto, Porto, Portugal.,Center for Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
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