Multicentric Lymphoma

Biodynamic Imaging (BDI) as a Promising Strategy for Personalized Therapy of Canine Diffuse Large B-cell Lymphoma

Primary Investigator:

Dr. Michael Childress

Background:

Diffuse large B-cell lymphoma (DLBCL), the most common type of lymphoma in dogs, is associated with varying degrees of clinical aggressiveness.  The standard treatment for DLBCL, combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (i.e. “CHOP”) affords cancer remission to 80-90% of affected dogs and significantly extends survival in most cases.  However, some dogs with DLBCL derive little benefit from CHOP, a therapy that is expensive and may produce serious side effects in some dogs.  Methods to accurately predict which dogs are and are not likely to benefit from CHOP are therefore desirable.  We have recently shown that a novel tumor tissue imaging technology called biodynamic imaging (BDI) predicts the responsiveness of canine DLBCL to CHOP with approximately 84% accuracy.  The purpose of this study will be to expand the use of BDI in a larger population of dogs with DLBCL to more fully define its predictive capability.  Tissue biopsy samples will be collected from all dogs in this study prior to administering chemotherapy and at the time that their cancer first relapses after receiving chemotherapy.  These biopsy samples will be analyzed using BDI in order to develop a more complete understanding of the ability of this technology to predict the response of DLBCL in dogs to CHOP chemotherapy.     

Eligibility for Dogs to Participate in the Study:

  • Cytologically-confirmed lymphoma primarily affecting peripheral lymph nodes
  • At least one peripheral lymph node ≥2 cm in longest diameter
  • Expected survival time of ≥ 4 weeks with treatment
  • No prior therapy for the lymphoma, including corticosteroids such as prednisone and dexamethasone 

Exclusion Criteria:

  • Confirmed or suspected T-cell lymphoma or lymphoma other than DLBCL
    • Dogs with hypercalcemia
    • Dogs with cranial mediastinal masses
    • Dogs at high risk for T-cell lymphoma – Boxer, Asian/Arctic breeds (unless confirmed to have DLBCL by histopathology)
    • Lymphoma originating at extranodal sites (e.g. mediastinum, skin, gastrointestinal tract)
    • Dogs at risk for the ABCB1-1D mutation (p-glycoprotein mutation)
      • Collie, Border collie, Shetland sheepdog, Australian shepherd, Old English sheepdog
      • These dogs are at increased risk for adverse reactions to cancer chemotherapy drug treatment, and may not tolerate standard drug doses used in CHOP
      • Dogs weighing <15 kg
      • Dogs displaying significant lymphoma-associated illness (i.e. “substage B”) or with serious comorbid diseases
      • Dogs that have received prior chemotherapy (including prednisone or other corticosteroids) or radiation therapy to treat their lymphoma

Financial Support:

  • The cost of initial tumor biopsy is discounted by $250.
  • The cost of tumor biopsy at the time of cancer relapse is fully covered by the study.
  • CHOP chemotherapy is provided at a discounted rate to dogs enrolled in this study.

Trial Start Date:

Currently ongoing

For Questions, Please Call:

Ms. Sarah Lahrman, RVT, or Dr. Michael Childress at (765) 494-1107

paw in hand

Biodynamic Testing of Chemotherapy Sensitivity in Dogs Receiving Gemcitabine for Cutaneous T-cell Lymphoma

Primary Investigator:

Dr. Michael Childress

Background:

Epitheliotropic cutaneous T-cell lymphoma (ETCL) in dogs is a skin cancer for which few effective therapies exist.  The chemotherapy drug gemcitabine is commonly used to treat humans with this cancer.  Although gemcitabine has been shown to be well-tolerated in dogs, its use as a treatment for dogs with ETCL has not been described.  In this clinical trial, we will enroll 10 dogs with ETCL to test the efficacy of gemcitabine against this cancer.  In addition, we will test the ability of a novel tissue imaging technology, biodynamic imaging (BDI), to predict the responsiveness of ETCL to gemcitabine.  We have shown in previous studies BDI predicts the response of primary nodal lymphomas in dogs to chemotherapy with approximately 80-90% accuracy.  This will be the first time that BDI is used to predict the response of canine ETCL to a chemotherapy drug.  All dogs enrolled in this study will undergo biopsy of one or more skin tumors at the time of trial entry to provide tissue for BDI.  All dogs will then receive 6 gemcitabine infusions over a period of 8 weeks while participating in this study.

Eligibility for Dogs to Participate in the Study:

  • Histopathologically-confirmed ETCL (tumors diagnosed outside of Purdue must undergo pathology review at the Purdue Animal Disease Diagnostic Laboratory (ADDL) before dogs can be enrolled)
  • Dogs with any stage of disease are eligible.  However, dogs must have at least 2 grossly apparent ETCL lesions, one of which must be suitable for biopsy to provide tissue for BDI.
  • No chemotherapy or radiotherapy in the past 2 weeks.  Dogs must not have received any corticosteroids for at least 7 days prior to study enrollment.
  • Expected survival of at least 2 months with treatment
  • Absence of serious comorbid disease

Exclusion Criteria:

  • Non-epitheliotropic cutaneous T-cell lymphoma or other cutaneous lymphomas
  • Disease lesions too limited for biopsy
  • Organ dysfunction considered likely to affect tolerability of sedation/biopsy or gemcitabine:
    • Hematocrit <25%
    • Neutrophils <2,500/ml
    • Platelets <50,000/ml
    • Creatinine ≥2.1 mg/dl
    • Increased bilirubin
    • Serum ALT >4X normal without concurrent increase in ALP
    • Evidence of hepatic synthetic failure
    • Clinically evident coagulopathy
    • Serious cardiorespiratory disease
    • Prior chemotherapy or radiotherapy within past 14 days
    • Prior prednisone or other glucocorticoids within past 7 days
    • Body weight <15 kg

Financial Support:

  • Pet owners will be responsible for $100 towards the cost of initial office visit and clinical evaluation to determine their dog’s eligibility for participation in the study (normal cost approximately $450).
  • Pet owners will be responsible for $25 for each gemcitabine treatment given to their dog while it is enrolled in the study, up to a maximum of 6 treatments (normal cost approximately $200 per treatment).

Trial Start Date:

Currently Ongoing

For Questions, Please Call:

Ms. Sarah Lahrman, RVT, or Dr. Michael Childress at (765) 494-1107 

paw in hand

 

 

 

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