Tolerability of Metronomic Administration of Lomustine in Dogs with Cancer

Tripp, Chelsea D.; Fidel, Janean; Anderson, Christie; Madelenat, P.; Pratt, C.; Sellon, Ranee K.; Bryan, Jeffrey N.

doi:10.1111/j.1939-1676.2011.0684.x

Cited by 38 publications

(53 citation statements)

References 27 publications

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“…Indeed, dog's owners are very reluctant to the idea that their pet undergo treatment regimens that may cause severe side effects without any marked survival advantage or improvement of the quality of life. However, it is very important to compare the obtained survival data with other metronomic [35] in advanced metastatic tumors or to historical survival curves of dogs with advanced stage disease in our clinic. As in our study, also the Tripp's veterinary clinical trial lacks of a control group and dogs, that had metastatic osteosarcoma at the time of starting metronomic lomustine, had a median survival of just 2.4 months, whereas dogs with macroscopic primary and metastatic hemangiosarcoma (an angiogenesisdependent tumor) had a median survival of 3.9 months [35].…”

Section: Discussionmentioning

confidence: 99%

“…However, it is very important to compare the obtained survival data with other metronomic [35] in advanced metastatic tumors or to historical survival curves of dogs with advanced stage disease in our clinic. As in our study, also the Tripp's veterinary clinical trial lacks of a control group and dogs, that had metastatic osteosarcoma at the time of starting metronomic lomustine, had a median survival of just 2.4 months, whereas dogs with macroscopic primary and metastatic hemangiosarcoma (an angiogenesisdependent tumor) had a median survival of 3.9 months [35]. Although the metronomic lomustine resulted markedly more toxic of metronomic cyclophosphamide and it was used in a different setting of advanced cancers (metastatic osteosarcoma and hemangiosarcomas), these data can give an interesting idea of the remarkable results obtained in our study in terms of overall survival without any appreciable toxicity and with a significant gain in quality of life.…”

Section: Discussionmentioning

confidence: 99%

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First-line metronomic chemotherapy in a metastatic model of spontaneous canine tumours: a pilot study

et al. 2011

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Metronomic chemotherapy—the low-dose, long term and\ud \ud frequently administered chemotherapy—has revealed in\ud \ud these years an important impact on the stabilization of\ud \ud cancer disease for its known antiangiogenic effects,\ud \ud prolonged clinical benefits and the improved quality of life\ud \ud of several cancer patients, without any high grade toxicity\ud \ud [1–3]. Both the low cost and the oral administration of the\ud \ud drugs are key characteristics of this schedule and may offer\ud \ud important social advantages [4]. Anecdotical case reports\ud \ud [5–7] and experiences in small subsets of patients enrolled\ud \ud in retrospective clinical studies [8–10] on metastatic cancers\ud \ud have been recently published about the use of metronomic\ud \ud therapy as a first-line treatment. These point out the\ud \ud possible importance of metronomic chemotherapy as an\ud \ud alternative approach to first-line therapy in frail patients\ud \ud requiring palliation or patients refusing the standard\ud \ud chemotherapy for its impact on the quality of life. However,\ud \ud no data of prospective clinical trials on first line metronomic\ud \ud chemotherapy are currently available in metastatic\ud \ud cancer human patients.\ud \ud The veterinary medical oncology has advanced dramatically\ud \ud over the past few decades, because of the successful\ud \ud application of a number of conventional chemotherapeutic\ud \ud drugs to the cancer conditions diagnosed in veterinary\ud \ud patients [11]. Veterinary oncology cases often present a\ud \ud unique opportunity to investigate novel drugs and treatment\ud \ud schedules providing many in vivo information to the larger\ud \ud medical community and giving new effective options for\ud \ud dogs themselves [12]. As well recently pointed out by\ud \ud Paoloni and Khanna [13], these studies may also have a\ud \ud great translational relevance, predicting new therapies and\ud \ud related surrogate markers in human beings because pet dogs\ud \ud with cancers might assist the transition between mouse\ud \ud models and human patients. Moreover, in the clinical\ud \ud practice, veterinarians and their clients are generally less\ud \ud willing to accept a high degree of side effects, which most\ud \ud often results in lower drug doses than the ones that are used\ud \ud in human oncology.\ud \ud The aim of the present pilot study was to test a first-line\ud \ud metronomic oral combination of cyclophosphamide (CTX)\ud \ud and celecoxib (CXB) in canine metastatic spontaneous\ud \ud tumours, characterizing possible biomarkers to translate in\ud \ud human clinical research

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

First-line metronomic chemotherapy in a metastatic model of spontaneous canine tumours: a pilot study

et al. 2011

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“…Metronomic chemotherapy is the administration of daily or every other day low-dose alkylating agents in combination with NSAIDs and has been evaluated in both the adjunctive and gross disease setting for various canine and feline neoplasms (Lana and others 2007, Burton and others 2011, Tripp and others 2011, Marchetti and others 2012, Leo and others 2014, London and others 2015). …”

Section: Chemotherapymentioning

confidence: 99%

Palliative care in small animal oncology

Mason¹

2016

In Practice

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Cancer is a common diagnosis in companion animals and, increasingly, clients choose to pursue treatment for their pets. Veterinary oncology is a rapidly growing field and diagnostic and treatment options for animals with cancer are constantly improving and becoming more widely available. Treatment outcomes can be good, but in many cases definitive treatment is not an option and palliative treatment is necessary. This article explores the palliative care of dogs and cats that have been diagnosed with cancer and summarises the various treatment options, with a particular focus on quality of life and the role of communication in the decision-making process.

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“…In the same year, a study on 81 dogs with inoperable tumors, or tumors that had been incompletely removed or were chemoresistant with macroscopic evidence of distant metastases, was published [ 53 ]. These dogs were treated with lomustine at 2.84 mg/m 2 daily given orally for an average of 98 days.…”

Section: Metronomic Chemotherapy In Dogsmentioning

confidence: 99%

Clinical Studies of Metronomic Chemotherapy in Dogs

Marchetti

Giorgi

2014

Metronomic Chemotherapy

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In the last decade metronomic chemotherapy has received increased interest in veterinary oncology. Indeed, low-dose metronomic chemotherapy has been shown an important stabilizing effect on cancer growth, conferring both prolonged clinical benefi ts and positive effects on the quality of life of patients. A number of studies have been performed in dogs on the effi cacy of metronomic dosing of various chemotherapeutic drugs. Metronomic chemotherapy is offered as the treatment of choice for all pets with malignant tumors where owners are reluctant to embark on an aggressive therapy protocol. It is indicated in patients with organ failure in which the toxicity of chemotherapy may be fatal as well as in patients with an aggressive nature that would require sedation for each parenteral administration. Metronomic therapy induces minimal impact on the animal; it is a low-cost alternative and it is easy to administer. Moreover, it has been recently recognized that dogs affected by natural cancer serve as unique animal model for human tumors. For this reason, the metronomic chemotherapy experience in dogs could lead to innovative and unexplored schedules for humans. It may be used as a more accurate model than rodents with induced cancers for the extrapolation of dose, effi cacy and safety profi les to humans.

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Tolerability of Metronomic Administration of Lomustine in Dogs with Cancer

Cited by 38 publications

References 27 publications

First-line metronomic chemotherapy in a metastatic model of spontaneous canine tumours: a pilot study

First-line metronomic chemotherapy in a metastatic model of spontaneous canine tumours: a pilot study

Palliative care in small animal oncology

Clinical Studies of Metronomic Chemotherapy in Dogs

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