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Thalidomide antiangiogenic therapy in dogs :Prospective case series in dogs with measurable malignant cancers

21 May 2009 No Comment

Summary: This study evaluated the effects of thalidomide in 7 canine patients with a variety of tumors. No objective response was seen in these patients. No adverse effects were noted associated with Thalidomide treatment.

Publication: Jankowski M, Fulton L, Sheafor S, Prescott D, Khanna C. Ongoing evaluation of single agent thalidomide in dogs with measurable cancer. Proc Vet Cancer Soc 1999.

Background: Angiogenesis is essential for cancer progressin and metastasis. Inhibition of angiogenesis may be an effective treatment for cancers. The anticancer activity of thalidomide has been demonstrated in early human clinical trials. The objectives of this study are: 1) to determine the safety and efficacy of oral thalidomide against measurable canine cancers, 2) to define an optimal biological dose for thalidomide in dogs, and 3) to define tumor types sensitive to antiangiogenic therapy with thalidomide.

Methods: This is a single agent, phase I/II clinical study. Entry requirements include measurable and histologically confirmed diease, body weight> 10 kg, no chemotherapy within 10 days of treatment, and informed owner consent. Three escalating dose cohorts (30 cases/cohort) have been defined: 3.3-6.5, 6.6-13, 13.3-26 mg/kg QD. Physical examinations, CBC, serum biochemistry, and tumor response will be evaluated at day 0 and every 30 days thereafter. Urine and plasma samples collected before and during thalidomide therapy will be assayed for markers of antiangiogenic activity including, basic fibroblast growth factor, vascular endothelial growth factor and interleukin-8.

Results: Seven cases to date have been evaluated. All dogs had progressive disease prior to study entry. No side effects to thalidomide have been noted in the first dose cohort.

Histology

TNM Stage

Measurable Lesion

Prior Treatment

Treatment Length

Outcome

Malignant pericardial
mesothelioma

TSxM1pulmonary (possible
CNS)

Pulmonary

Surgery, Chemotherapy,
Immunotherapy

180 days

SD x 90 days

Nasal carcinoma

T3N2mandibular, Prescapular
M0

Lymph nodes, Orbital
proptosis

Radiation therapy,
Chemotherapy

80 days

SD x 77 days

Rib osteosarcoma

TSxM1pulmonary

Pulmonary, Local recurrence

Surgery, Chemotherapy

33 days

PD

Carcinomatosis, abdomen

 

Liver

None

27 days

PD

Hepatocellular
carcinoma

 

Liver

Surgery

36 days

PD

Osteosarcoma

TSxM1pulmonary

Pulmonary

Surgery, Chemotherapy

9 days

PD

Liposarcoma

T4N1M0

Cervical Lesion

Surgery, Radiation
therapy

Ongoing

SD


Conclusions: Thalidomide appears to be well tolerated in the current dose cohort. No objective tumor responses have been documented at this time. Additional entry of cases with smaller tumor burden may allow antiangiogenic activity to be exerted before disease progression. Surrogate markers of systemic antiangiogenic activity, measured in plasma and urine, may be helpful in defining optimal biologic doses.

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