Dose escalation study to evaluate safety, tolerability and efficacy of intravenous etoposide phosphate administration in 27 dogs with multicentric lymphoma

PLoS One. 2017 May 15;12(5):e0177486. doi: 10.1371/journal.pone.0177486. eCollection 2017.

Abstract

Comparative oncology has shown that naturally occurring canine cancers are of valuable and translatable interest for the understanding of human cancer biology and the characterization of new therapies. This work was part of a comparative oncology project assessing a new, clinical-stage topoisomerase II inhibitor and comparing it with etoposide in dogs with spontaneous lymphoma with the objective to translate findings from dogs to humans. Etoposide is a topoisomerase II inhibitor widely used in various humans' solid and hematopoietic cancer, but little data is available concerning its potential antitumor efficacy in dogs. Etoposide phosphate is a water-soluble prodrug of etoposide which is expected to be better tolerated in dogs. The objectives of this study were to assess the safety, the tolerability and the efficacy of intravenous etoposide phosphate in dogs with multicentric lymphoma. Seven dose levels were evaluated in a traditional 3+3 phase I design. Twenty-seven owned-dogs with high-grade multicentric lymphoma were enrolled and treated with three cycles of etoposide phosphate IV injections every 2 weeks. Adverse effects were graded according to the Veterinary Cooperative Oncology Group criteria. A complete end-staging was realized 45 days after inclusion. The maximal tolerated dose was 300 mg/m2. At this dose level, the overall response rate was 83.3% (n = 6, 3 PR and 2 CR). Only a moderate reversible gastrointestinal toxicity, no severe myelotoxicity and no hypersensitivity reaction were reported at this dose level. Beyond the characterization of etoposide clinical efficacy in dogs, this study underlined the clinical and therapeutic homologies between dog and human lymphomas.

MeSH terms

  • Administration, Intravenous
  • Animals
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects
  • Dog Diseases / drug therapy*
  • Dog Diseases / epidemiology
  • Dog Diseases / pathology*
  • Dogs
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Etoposide / analogs & derivatives*
  • Lymphoma / veterinary*
  • Neoplasm Grading
  • Neoplasm Staging
  • Organophosphorus Compounds / administration & dosage*
  • Organophosphorus Compounds / adverse effects
  • Treatment Outcome
  • Tumor Burden

Substances

  • Antineoplastic Agents
  • Organophosphorus Compounds
  • etoposide phosphate
  • Etoposide

Grants and funding

This study was conducted by Oncovet Clinical Research (OCR) as part of a collaborative research project between OCR and Pierre Fabre Medicament. OCR provided support in the form of salaries for authors FS, JH, EB, and DT. OCR did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Pierre Fabre Medicament provided support in the form of salaries for BG. Pierre Fabre Medicament did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.