Individualized chemotherapy drug dose escalation in dogs with multicentric lymphoma.

Abstract

BACKGROUND:

This study was performed to determine the ability to escalate drug doses in a 15-week CHOP protocol in dogs with multicentric lymphoma.

HYPOTHESIS:

We hypothesized that at least 50% of dogs could successfully be escalated in at least 1 drug. Secondary aims were to establish objective response rate (ORR), progression-free interval (PFI), and overall survival time (OST).

ANIMALS:

Thirty dogs with newly diagnosed multicentric lymphoma were prospectively treated with a 15-week CHOP protocol.

METHODS:

This was a prospective cohort study. Drug doses that did not cause dose-limiting adverse effects (AEs) were increased using a standardized escalation protocol. AEs and response were assessed using VCOG criteria. Serial blood samples were collected after the first dose of each drug for pharmacokinetic analysis.

RESULTS:

Of the 23 dogs with the opportunity to dose escalate, at least 1 drug was successfully escalated in 18 (78%). Vincristine was successfully escalated to 0.8 mg/m2 or higher in 11 dogs, cyclophosphamide to 300 mg/m2 or higher in 16 dogs, and doxorubicin to 35 mg/m2 or 1.4 mg/kg or higher in 9 dogs. Three of the 23 dogs (13%) were hospitalized at least once because of drug-induced AEs. Neutropenia was the most common dose-limiting toxicosis for all drugs. Peak doxorubicin concentrations were significantly lower in dogs where doxorubicin was successfully escalated. The objective response rate was 100%. The median progression free interval was 171 days. The median overall survival time was 254 days.

CONCLUSIONS:

Drugs in the CHOP protocol can often be escalated safely with manageable AEs.

• Authors: Jacob M Siewert, Daniel L Gustafson, Kristen M Weishaar, Annie M Galloway, Douglas H Thamm
• Journal: Journal of veterinary internal medicine (J Vet Intern Med) 2023 Nov-Dec Vol. 37 Issue 6 Pg. 2402-2409 ISSN: 1939-1676 [Electronic] United States
• PMID: 37787577 (Publication Type: Journal Article)
• Copyright: © 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.

Chemical References

• Doxorubicin

Topics

• Humans
• Dogs
• Animals
• Prospective Studies
• Lymphoma (drug therapy, veterinary)
• Neutropenia (veterinary)
• Doxorubicin (adverse effects)
• Dog Diseases (drug therapy)