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Thalidomide for the treatment of hemangiosarcoma in dogs
Author(s) -
Woods J. P.,
Mathews K. A.,
Binnington A. G.
Publication year - 2004
Publication title -
veterinary and comparative oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.864
H-Index - 34
eISSN - 1476-5829
pISSN - 1476-5810
DOI - 10.1111/j.1476-5810.2004.0045p.x
Subject(s) - hemangiosarcoma , thalidomide , medicine , angiosarcoma , chemotherapy , valproic acid , surgery , pathology , multiple myeloma , psychiatry , epilepsy
Hemangiosarcoma is a malignant neoplasm of vascular endothelium occurring most frequently in older large breed dogs. Noncutaneous hemangiosarcoma is highly metastatic (>80% at diagnosis). Surgery is the primary method of treatment; however, even with adjuvant chemotherapy the prognosis for long‐term survival is low. Hence, new therapies are needed. The sedative‐hypnotic drug thalidomide (alpha‐N‐phthalimidoglutarimide) was withdrawn from general distribution in the 1960's after recognition of its teratogenicity and association with phocomelia. Recently, discredited thalidomide is making a comeback for its immunomodulatory and antiangiogenesis properties to treat inflammatory, infectious, and neoplastic diseases in people. Thalidomide can inhibit the proliferation of blood vessels associated with tumour development, thereby stopping or slowing tumour growth (similar to the devastating effect of the in utero interference with the blood supply of the developing limbs of the fetus). Therefore, the purpose of this study was to retrospectively obtain the results of thalidomide therapy for canine hemangiosarcoma. A prospective study for the use of thalidomide therapy for the treatment of canine hemangiosarcoma was also planned. Materials and Methods: Fourteen dogs with histologically diagnosed hemangiosarcoma were retrospectively entered into the study. Dogs were treated at 100–400 mg per day. Unfortunately, a legal, consistent source of thalidomide for treatment of dogs could not be obtained; therefore, the prospective study was postponed. Results: The median survival was 61 days with a range of 0 days to 2 years. Conclusions: Only limited efficacy data are available so far to define the clinical utility of thalidomide in canine hemangiosarcoma. However, in this pilot study there were prolonged responses to thalidomide in some patients which prompts a phase 2 investigation of thalidomide in canine hemangiosarcoma. The optimal dose and schedule of administration in dogs remains to be determined but the absence of myelosuppressive and other important adverse effects suggests thalidomide could be used in combination with chemotherapy. We conclude that thalidomide (or its analogues) could open the possibility for novel treatment that targets tumours and their microenvironment.