Epirubicin in the treatment of canine histiocytic sarcoma: sequential, alternating and rescue chemotherapy

Abstract

The aims of this study were to report treatment outcomes for dogs with histiocytic sarcoma (HS) treated with both lomustine and epirubicin, and to report response rates to epirubicin as a rescue therapy in dogs previously treated with lomustine. Medical records of dogs with a diagnosis of HS that were treated with both lomustine and epirubicin were retrospectively evaluated. Of 29 dogs receiving epirubicin alternating with, or subsequent to lomustine treatment, including in a rescue setting, response to epirubicin could be assessed in 20 with an overall response rate (ORR) of 29% and biological response rate (BRR) of 71%. Median time to progression (TTP) in 12 of these 20 dogs in which it was assessable was 69 days (range: 40-125 days). For dogs treated in the rescue setting epirubicin specific ORR was 19% and BRR 63%. Median TTP in the 9 of these 16 dogs in which it was assessable was 62 days (range: 40-125 days). Median survival time for all dogs treated with both epirubicin and lomustine was 185 days (range: 27-500 days). Some dogs with HS respond to epirubicin and dogs treated with combinations of epirubicin and lomustine have modestly improved survival times compared with single agent studies, and similar to dogs with HS treated with alternating lomustine and doxorubicin. Single agent epirubicin is also a valid short term rescue therapy for canine HS.

Primary tonsillar histiocytic sarcoma in two dogs

“…There is less information regarding alternative chemotherapy agents or rescue therapy for dogs that respond less favourably to CCNU. Alternating protocols combining CCNU and an anthracycline may be a new interesting approach and may improve outcomes compared with single agent protocols 20. Anthracyclines such as epirubicin can be effective with an overall response rate of 29 per cent (19 per cent in the rescue setting).…”

“…Anthracyclines such as epirubicin can be effective with an overall response rate of 29 per cent (19 per cent in the rescue setting). The overall MST in a study combining CCNU with epirubicin was 185 days 20. Doxorubicin can also be safely alternated with CCNU every two weeks with an overall response rate of 58 per cent and a MST of 185 days 39.…”

“…Doxorubicin can also be safely alternated with CCNU every two weeks with an overall response rate of 58 per cent and a MST of 185 days 39. In the above‐mentioned studies,20 39 most of the patients were affected by disseminated disease. Dacarbazine is well tolerated and may be beneficial for rescue therapy in HS.…”

Utilização de antibióticos quimioterápicos na oncológica de pequenos animais: Revisão

“…A EPI se apresenta como um estereoisômero semissintético da DOX, com mecanismo de ação e atividade antineoplásica semelhante, no entanto, com efeitos adversos menos recorrentes (Mason et al, 2018), principalmente no que se refere a cardiotoxicidade (Elliott et al, 2013). A dose recomendada varia de 25-30 mg/m² por via intravenosa a cada 21 dias (Bray & Polton, 2016;Elliott et al, 2013;Mason et al, 2018) e demonstra-se como uma opção nos casos de sarcoma histiocítico canino refratário ao tratamento com DOX ou com má aceitação ao tratamento convencional (Mason et al, 2018), sarcomas de aplicação em felinos (Bray & Polton, 2016) e linfoma (Elliott et al, 2013).…”

“…As principais classes observadas e adaptadas da utilização em medicina humana são agentes alquilantes, antimetabólitos, antibióticos antineoplásicosinibidores de topoisomerase II, inibidores de topoisomerase I, corticosteroides, inibidores de tirosina quinase e agentes miscelâneos (Klopfleisch et al, 2016). A utilização de antibióticos com ação quimioterápica é bem definida e difundida, e é tida como uma das classes mais versáteis para utilização na terapia antineoplásica (Mason et al, 2018), tendo como principal agente a doxorrubicina (Lima & Costa, 2015).…”