Dataset Information

Adjuvant carboplatin for treatment of splenic hemangiosarcoma in dogs: Retrospective evaluation of 18 cases (2011-2016) and comparison with doxorubicin-based chemotherapy.

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.

SUBMITTER: Faulhaber EA

PROVIDER: S-EPMC8295674 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Canine splenic hemangiosarcoma (HSA) is an aggressive tumor with a short overall survival time (OST) despite treatment with splenectomy and adjuvant doxorubicin. Modulation of the immune system has been shown to be effective for a variety of human tumors, and may be effective for canine tumors, including HSA. Immunocidin® is a non-specific immunotherapy based on a mycobacterial cell wall fraction. Preliminary work suggests Immunocidin® is safe to give intravenously (IV) in tumor-bearing dogs. This work aimed to evaluate the safety of doxorubicin and Immunocidin® combination in dogs with naturally occurring splenic HSA. A secondary aim of this study was to collect preliminary efficacy data to support a subsequent comprehensive, prospective clinical trial in canine patients with HSA, if the combination of doxorubicin and Immunocidin® was found to be safe. Eighteen dogs with stage II-III splenic HSA were recruited to receive 5 doses of sequential IV doxorubicin and Immunocidin® at two-week intervals following splenectomy. Adverse events (AEs) were graded according to the Veterinary Cooperative Oncology Group v1.1 (VCOG) scheme. Overall survival time was calculated from the date of splenectomy to date of death or loss to follow-up. AEs during administration were infrequent, the most common being hypertension. One patient developed limb and facial twitching and was removed from the study. After infusion, common AEs included lethargy, hyporexia, and diarrhea. One patient developed VCOG grade 5 diarrhea, thrombocytopenia, and anemia. Modifications in the treatment regimen were made to prevent these signs in subsequent patients. The median OST in dogs treated with the combination therapy was estimated at 147 days (range: 39-668 days). Although generally safe, the combination of doxorubicin and Immunocidin® appeared to cause more gastrointestinal effects than doxorubicin alone, and no apparent improvement in OST was noted in this population of dogs.