Abstract
In the last decade metronomic chemotherapy has received increased interest in veterinary oncology. Indeed, low-dose metronomic chemotherapy has been shown an important stabilizing effect on cancer growth, conferring both prolonged clinical benefits and positive effects on the quality of life of patients. A number of studies have been performed in dogs on the efficacy of metronomic dosing of various chemotherapeutic drugs. Metronomic chemotherapy is offered as the treatment of choice for all pets with malignant tumors where owners are reluctant to embark on an aggressive therapy protocol. It is indicated in patients with organ failure in which the toxicity of chemotherapy may be fatal as well as in patients with an aggressive nature that would require sedation for each parenteral administration. Metronomic therapy induces minimal impact on the animal; it is a low-cost alternative and it is easy to administer. Moreover, it has been recently recognized that dogs affected by natural cancer serve as unique animal model for human tumors. For this reason, the metronomic chemotherapy experience in dogs could lead to innovative and unexplored schedules for humans. It may be used as a more accurate model than rodents with induced cancers for the extrapolation of dose, efficacy and safety profiles to humans.
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References
Gonzalez-Billalabeitia E et al (2009) Long-term follow-up of an anthracycline-containing metronomic chemotherapy schedule in advanced breast cancer. Breast J 15:551–553
Laquente B, Vinals F, Germa JR (2007) Metronomic chemotherapy: an antiangiogenic scheduling. Clin Transl Oncol 9:93–98
Miller KD, Sweeney CJ, Sledge GW Jr (2001) Redefining the target: chemotherapeutics as antiangiogenics. J Clin Oncol 19:1195–1206
Pasquier E, Andre N, Braguer D (2007) Targeting microtubules to inhibit angiogenesis and disrupt tumour vasculature: implications for cancer treatment. Curr Cancer Drug Targets 7:566–581
Blansfield JA, Caragacianu D, Alexander HA III et al (2008) Combining agents that target the tumor microenvironment improves the efficacy of anticancer therapy. Clin Cancer Res 14(1):270–280
Bocci G, Nicolaou KC, Kerbel RS (2002) Protracted low-dose effects on human endothelial cell proliferation and survival in vitro reveal a selective antiangiogenic window for various chemotherapeutic drugs. Cancer Res 62(23):6938–6943
Pasquier E, Kavallaris M, André N (2010) Metronomic chemotherapy: new rationale for new directions. Nat Rev Clin Oncol 7(8):455–465
Bocci G, Francia G, Man S et al (2003) Thrombospondin 1, a mediator of the antiangiogenic effects of low-dose metronomic chemotherapy. Proc Natl Acad Sci U S A 100(22):12917–12922
Damber JE, Vallbo C, Albertsson P et al (2006) The anti-tumour effect of low-dose continuous chemotherapy may partly be mediated by thrombospondin. Cancer Chemother Pharmacol 58:354–360
Park ST, Jang JW, Kim GD et al (2010) Beneficial effect of metronomic chemotherapy on tumor suppression and survival in a rat model of hepatocellular carcinoma with liver cirrhosis. Cancer Chemother Pharmacol 65:1029–1037
Kerbel RS, Kamen BA (2004) Antiangiogenic basis of low-dose metronomic chemotherapy. Nat Rev Cancer 4:423–436
Mutsaers AJ (2007) Chemotherapy: new uses for old drugs. Vet Clin North Am Small Anim Pract 37:1079–1090
Bocci G, Fioravanti A, Orlandi P et al (2012) Metronomic ceramide analogs inhibit angiogenesis in pancreatic cancer through up-regulation of caveolin-1 and thrombospondin-1 and down-regulation of cyclin D1. Neoplasia 14(9):833–845
Burton JH, Mitchell L, Thamm DH et al (2011) Low-dose cyclophosphamide selectively decreases regulatory T cells and inhibits angiogenesis in dogs with soft tissue sarcoma. J Vet Intern Med 25(4):920–926
Tanaka H, Matsushima H, Mizumoto N et al (2009) Classification of chemotherapeutic agents based on their differential in vitro effects on dendritic cells. Cancer Res 69:6978–6986
Tanaka H, Matsushima H, Nishibu A et al (2009) Dual therapeutic efficacy of vinblastine as a unique chemotherapeutic agent capable of inducing dendritic cell maturation. Cancer Res 69:6987–6994
Al-Dissi AN, Haines DM, Singh B et al (2010) Immunohistochemical expression of vascular endothelial growth factor and vascular endothelial growth factor receptor-2 in canine simple mammary gland adenocarcinomas. Can Vet J 51(10):1109–1114
Qiu C, Lin DD, Wang HH et al (2008) Quantification of VEGF-C expression in canine mammary tumours. Aust Vet J 86(7):279–282
Qiu CW, Lin DG, Wang JQ et al (2008) Expression and significance of PTEN and VEGF in canine mammary gland tumours. Vet Res Commun 32(6):463–472
Queiroga FL, Pires I, Parente M et al (2011) COX-2 over-expression correlates with VEGF and tumour angiogenesis in canine mammary cancer. Vet J 189(1):77–82
Restucci B, Papparella S, Maiolino P et al (2002) Expression of vascular endothelial growth factor in canine mammary tumors. Vet Pathol 39(4):488–493
Giantin M, Aresu L, Benali S et al (2012) Expression of matrix metalloproteinases, tissue inhibitors of metalloproteinases and vascular endothelial growth factor in canine mast cell tumours. J Comp Pathol. doi:10.1016/j.jcpa.2012.01.011
Patruno R, Arpaia N, Gadaleta CD et al (2009) VEGF concentration from plasma-activated platelets rich correlates with microvascular density and grading in canine mast cell tumour spontaneous model. J Cell Mol Med 13(3):555–561
Rebuzzi L, Willmann M, Sonneck K et al (2007) Detection of vascular endothelial growth factor (VEGF) and VEGF receptors Flt-1 and KDR in canine mastocytoma cells. Vet Immunol Immunopathol 115(3–4):320–333
Yonemaru K, Sakai H, Murakami M et al (2006) Expression of vascular endothelial growth factor, basic fibroblast growth factor, and their receptors (flt-1, flk-1, and flg-1) in canine vascular tumors. Vet Pathol 43(6):971–980
Dickinson PJ, Sturges BK, Higgins RJ et al (2008) Vascular endothelial growth factor mRNA expression and peritumoral edema in canine primary central nervous system tumors. Vet Pathol 45(2):131–139
Platt SR, Scase TJ, Adams V et al (2006) Vascular endothelial growth factor expression in canine intracranial meningiomas and association with patient survival. J Vet Intern Med 20(3):663–668
Rossmeisl JH, Duncan RB, Huckle WR et al (2007) Expression of vascular endothelial growth factor in tumors and plasma from dogs with primary intracranial neoplasms. Am J Vet Res 68(11):1239–1245
Shiomitsu K, Johnson CL, Malarkey DE et al (2009) Expression of epidermal growth factor receptor and vascular endothelial growth factor in malignant canine epithelial nasal tumours. Vet Comp Oncol 7(2):106–114
Wolfesberger B, Guija de Arespacohaga A, Willmann M et al (2007) Expression of vascular endothelial growth factor and its receptors in canine lymphoma. J Comp Pathol 137(1):30–40
Wolfesberger B, Tonar Z, Fuchs-Baumgartinger A et al (2012) Angiogenic markers in canine lymphoma tissues do not predict survival times in chemotherapy treated dogs. Res Vet Sci 92(3):444–450
Wolfesberger B, Tonar Z, Witter K et al (2008) Microvessel density in normal lymph nodes and lymphomas of dogs and their correlation with vascular endothelial growth factor expression. Res Vet Sci 85(1):56–61
Taylor KH, Smith AN, Higginbotham M et al (2007) Expression of vascular endothelial growth factor in canine oral malignant melanoma. Vet Comp Oncol 5(4):208–218
Matiasek LA, Platt SR, Adams V et al (2009) Ki-67 and vascular endothelial growth factor expression in intracranial meningiomas in dogs. J Vet Intern Med 23(1):146–151
Al-Dissi AN, Haines DM, Singh B et al (2007) Immunohistochemical expression of vascular endothelial growth factor and vascular endothelial growth factor receptor associated with tumor cell proliferation in canine cutaneous squamous cell carcinomas and trichoepitheliomas. Vet Pathol 44(6):823–830
Maiolino P, De Vico G, Restucci B (2000) Expression of vascular endothelial growth factor in basal cell tumours and in squamous cell carcinomas of canine skin. J Comp Pathol 123(2–3):141–145
de Queiroz GF, Dagli ML, Fukumasu H et al (2010) Vascular endothelial growth factor expression and microvascular density in soft tissue sarcomas in dogs. J Vet Diagn Invest 22(1):105–108
Marchetti V, Giorgi M, Fioravanti A et al (2012) First-line metronomic chemotherapy in a metastatic model of spontaneous canine tumours: a pilot study. Invest New Drugs 30(4):1725–1730
Troy GC, Huckle WR, Rossmeisl JH et al (2006) Endostatin and vascular endothelial growth factor concentrations in healthy dogs, dogs with selected neoplasia, and dogs with nonneoplastic diseases. J Vet Intern Med 20(1):144–150
Wergin MC, Kaser-Hotz B (2004) Plasma vascular endothelial growth factor (VEGF) measured in seventy dogs with spontaneously occurring tumours. In Vivo 18(1):15–19
Aresu L, Aricò A, Comazzi S et al (2014) VEGF and MMP-9: biomarkers for canine lymphoma. Vet Comp Oncol 12(1):29–36. doi:10.1111/j.1476-5829.2012.00328
Gentilini F, Calzolari C, Turba ME et al (2005) Prognostic value of serum vascular endothelial growth factor (VEGF) and plasma activity of matrix metalloproteinase (MMP) 2 and 9 in lymphoma-affected dogs. Leuk Res 29(11):1263–1269
Zizzo N, Patruno R, Zito FA et al (2010) Vascular endothelial growth factor concentrations from platelets correlate with tumor angiogenesis and grading in a spontaneous canine non-Hodgkin lymphoma model. Leuk Lymphoma 51(2):291–296
Clifford CA, Hughes D, Beal MW et al (2001) Plasma vascular endothelial growth factor concentrations in healthy dogs and dogs with hemangiosarcoma. J Vet Intern Med 15(2):131–135
Kato Y, Asano K, Mogi T et al (2007) Clinical significance of circulating vascular endothelial growth factor in dogs with mammary gland tumors. J Vet Med Sci 69(1):77–80
Thamm DH, O’Brien MG, Vail DM (2008) Serum vascular endothelial growth factor concentrations and postsurgical outcome in dogs with osteosarcoma. Vet Comp Oncol 6(2):126–132
de Queiroz GF, Dagli ML, Meira SA et al (2013) Serum vascular endothelial growth factor in dogs with soft tissue sarcomas. Vet Comp Oncol 11(3):230–235
Nelius T, Rinard K, Filleur S (2011) Oral/metronomic cyclophosphamide-based chemotherapy as option for patients with castration-refractory prostate cancer: review of the literature. Cancer Treat Rev 37(6):444–455
Mutsaers AJ (2009) Metronomic chemotherapy. Top Companion Anim Med 24(3):137–143
Lana S, U’Ren L, Plaza S et al (2007) Continuous low-dose oral chemotherapy for adjuvant therapy of splenic hemangiosarcoma in dogs. J Vet Intern Med 21:764–769
VCOG (2004) Veterinary co-operative oncology group – common terminology criteria for adverse events (VCOG-CTCAE) following chemotherapy or biological antineoplastic therapy in dogs and cats v1.0. Vet Comp Oncol 2(4):194–213
Elmslie RE, Glawe P, Dow SW (2008) Metronomic therapy with cyclophosphamide and piroxicam effectively delays tumor recurrence in dogs with incompletely resected soft tissue sarcomas. J Vet Intern Med 22(6):1373–1379
Tripp CD, Fidel J, Anderson CL et al (2011) Tolerability of administration of lomustine in dogs with cancer. J Vet Intern Med 25:278–284
Leach TN, Childress MO, Greene SN et al (2012) Prospective trial of metronomic chlorambucil chemotherapy in dogs with naturally occurring cancer. Vet Comp Oncol 10(2):102–112
Choisunirachon N, Jaroensong T, Yoshida K et al (2013) Effects of low-dose cyclophosphamide with piroxicam on tumour neovascularization in a canine oral malignant melanoma-xenografted mouse model. Vet Comp Oncol. doi:10.1111/vco.12059
Mitchell L, Thamm DH, Biller BJ (2012) Clinical and immunomodulatory effects of toceranib combined with low-dose cyclophosphamide in dogs with cancer. J Vet Intern Med 26:355–362
London CA, Hannah AL, Zadovoskaya R et al (2003) Phase I dose-escalating study of SU11654, a small molecule receptor tyrosine kinase inhibitor, in dogs with spontaneous malignancies. Clin Cancer Res 9:2755–2768
London CA, Malpas PB, Wood-Follis SL et al (2009) Multi-center, placebo-controlled, double-blind, randomized study of oral toceranib phosphate (SU11654), a receptor tyrosine kinase inhibitor, for the treatment of dogs with recurrent (either local or distant) mast cell tumor following surgical excision. Clin Cancer Res 15:3856–3865
Giorgi M, Saccomanni G, Del Carlo S, Manera C, Lavy E (2012) Pharmacokinetics of intravenous and intramuscular parecoxib in healthy Beagles. Vet J 193:246–250
Kerbel RS (2012) Strategies for improving the clinical benefit of antiangiogenic drug based therapies for breast cancer. J Mammary Gland Biol Neoplasia 7(3–4):229–239
Herschman HR (2004) Noninvasive imaging of reporter gene expression in living subjects. Adv Cancer Res 92:29–80
Greenhough A, Smartt HJM, Moore AE et al (2009) The COX-2/PGE2 pathway: key roles in the hallmarks of cancer and adaptation to the tumour microenvironment. Carcinogenesis 30:377–386
Gupta GP, Nguyen DX, Chiang AC et al (2007) Mediators of vascular remodelling co-opted for sequential steps in lung metastasis. Nature 446:765–770
Harris SG, Padilla J, Koumas L et al (2002) Prostaglandins as modulators of immunity. Trends Immunol 23:144–150
Tsuji M, Kawano S, Tsujii S et al (1998) Cyclooxygenase regulates angiogenesis induced by colon cancer cells. Cell 93:705–716
Dore’ M, Lanthier I, Sirois J (2003) Cyclooxygenase-2 expression in canine mammary tumors. Vet Pathol 40:207–212
Heller DA, Clifford CA, Goldschmidt MH et al (2005) Cyclooxygenase-2 expression is associated with histologic tumor type in canine mammary carcinoma. Vet Pathol 42:776–780
Queiroga FL, Alves A, Pires I et al (2007) Expression of Cox-1 and Cox-2 in canine mammary tumors. J Comp Pathol 136:177–185
Queiroga FL, Perez-Alenza MD, Silvan G, Pena L, Lopes C, Illera JC (2005) Cox-2 levels in canine mammary tumors, including inflammatory mammary carcinoma: clinicopathological features and prognostic significance. Anticancer Res 25:4269–4275
L’eplattenier HF, Lai CL, van den Ham R et al (2007) Regulation of COX-2 expression in canine prostate carcinoma: increased COX-2 expression is not related to inflammation. J Vet Intern Med 21:776–782
Mohammed SI, Khan KNM, Sellers RS et al (2004) Expression of cyclooxygenase-1 and 2 in naturally-occurring canine cancer. Prostaglandins Leukot Essent Fatty Acids 70:479–483
Sorenmo KU, Goldschmidt MH, Shofer FS et al (2004) Evaluation of cyclooxygenase-1 and cyclooxygenase-2 expression and the effect of cyclooxygenase inhibitors in canine prostatic carcinoma. Vet Comp Oncol 2:13–23
Tremblay C, Dore’ M, Boschler PN et al (1999) Induction of prostaglandin G/H synthase-2 in a canine model of spontaneous prostatic adenocarcinomas. J Natl Cancer Inst 91:1398–1403
Khan KN, Knapp DW, Denicola DB et al (2000) Expression of cyclooxygeanse-2 in transitional cell carcinoma of the urinary bladder in dogs. Am J Vet Res 61:478–481
Knottenbelt C, Mellor D, Nixon C et al (2006) Cohort study of COX-1 and COX-2 expression in canine rectal and bladder tumours. J Small Anim Pract 47:196–200
Lee JY, Tanabe S, Shimohira H et al (2007) Expression of cyclooxygenase-2, P-glycoprotein and multi-drug resistance-associated protein in canine transitional cell carcinoma. Res Vet Sci 83:210–216
Boria PA, Murry DJ, Bennett PF et al (2004) Evaluation of cisplatin combined with piroxicam for the treatment of oral malignant melanoma and oral squamous cell carcinoma in dogs. J Am Vet Med Assoc 224:388–394
Borzacchiello G, Paciello O, Papparella S (2004) Expression of cyclooxygenase-1 and −2 in canine nasal carcinomas. J Comp Pathol 131:70–76
Borzacchiello G, Russo V, Russo M (2007) Immunohistochemical expression of cyclooxygenase-2 in canine ovarian carcinomas. J Vet Med Sci 54:247–249
Impellizeri JA, Esplin DG (2008) Expression of cyclooxygenase-2 in canine nasal carcinomas. Vet J 176:408–410
Khan KNM, Stanfield KM, Trakovic D et al (2001) Expression of cyclooxygenase-2 in canine renal cell carcinoma. Vet Pathol 38:116–119
Kleiter M, Malarkey DE, Ruslander DE et al (2004) Expression of cyclooxygenase-2 in canine epithelial nasal tumors. Vet Radiol Ultrasound 45:255–260
Mullins MN, Lana SE, Dernell WS et al (2004) Cyclooxygenase-2 expression in canine appendicular osteosarcomas. J Vet Intern Med 18:859–865
Rossmeisl JH Jr, Robertson JL, Zimmerman KL et al (2009) Cyclooxygenase-2 (COX-2) expression in canine intracranial meningiomas. Vet Comp Oncol 7:173–180
Brunelle M, Sartin EA, Wolfe LG et al (2006) Cyclooxygenase-2 expression in normal and neoplastic canine mammary cell lines. Vet Pathol 43:656–666
Pronovost N, Suter MM, Mueller E et al (2004) Expression and regulation of cyclooxygenase-2 in normal and neoplastic canine keratinocytes. Vet Comp Oncol 2:222–233
Wolfesberger B, Walter I, Hoelzl C et al (2006) Antineoplastic effect of the cyclooxygenase inhibitor meloxicamon canine osteosarcoma cells. Res Vet Sci 80:308–316
Knapp DW, Richardson RC, Chan TCK et al (1994) Piroxicam therapy in 34 dogs with transitional cell carcinoma of the urinary bladder. J Vet Intern Med 8:273–278
Mohammed SI, Bennett PF, Craig BA et al (2002) Effects of the cyclooxygenase inhibitor, piroxicam, on tumor response, apoptosis and angiogenesis in a canine model of human invasive urinary bladder cancer. Cancer Res 62:356–358
Mutsaers AJ, Mohanmed SI, DeNicola DB et al (2005) Pretreatment tumor prostaglandin E2 concentration and cyclooxygenase-2 expression are not associated with the response of canine naturally occurring invasive urinary bladder cancer to cyclooxygenase inhibitor therapy. Prostaglandins Leukot Essent Fatty Acids 72:181–186
Schmidt BR, Glickman NW, De Nicola DB et al (2001) Evaluation of piroxicam for the treatment of oral squamous cell carcinoma in dogs. J Am Vet Med Assoc 218:1783–1786
London CA, Hannah AL, Zadovoskaya R et al (2003) Phase I dose-escalating study of SU11654, a small molecule receptor tyrosine kinase inhibitor, in dogs with spontaneous malignancies. Clin Cancer Res 9(7):2755–2768
Shchemelinin I, Sefc L, Necas E (2006) Protein kinases, their function and implication in cancer and other diseases. Folia Biologica (Praha) 52:81–100
Pryer NK, Lee LB, Zadovaskaya R et al (2003) Proof of target for SU11654: inhibition of KIT phosphorylation in canine mast cell tumors. Clin Cancer Res 9:5729–5734
Frost D, Lasota J, Miettinen M (2003) Gastrointestinal stromal tumors and leiomyomas in the dog: a histopathologic, immunohistochemical, and molecular genetic study of 50 cases. Vet Pathol 40:42–54
Wakeling AE (2005) Inhibitors of growth factor signalling. Endocr Relat Cancer 12(Suppl 1):183–187
Wanebo HJ, Argiris A, Bergsland E et al (2006) Targeting growth factors and angiogenesis; using small molecules in malignancy. Cancer Metastasis Rev 25:279–292
Isotani M, Ishida N, Tominaga M et al (2008) Effect of tyrosine kinase inhibition by imatinib mesylate on mast cell tumors in dogs. J Vet Intern Med 22(4):985–988
Marconato L, Bettini G, Giacoboni C et al (2008) Clinicopathological features and outcome for dogs with mast cell tumors and bone marrow involvement. J Vet Intern Med 22(4):1001–1007
Hahn KA, Ogilvie G, Rusk T et al (2008) Masitinib is safe and effective for the treatment of canine mast cell tumors. J Vet Intern Med 22:1301–1309
Finke JH, Rini B, Ireland J et al (2008) Sunitinib reverses type-1 immune suppression and decreases T-regulatory cells in renal cell carcinoma patients. Clin Cancer Res 14:6674–6682
Kenyon BM, Browne F, D’Amato RJ (1997) Effects of thalidomide and related metabolites in a mouse corneal model of neovascularization. Exp Eye Res 64(6):971–978
Farese JP, Fox LE, Detrisac CJ et al (2004) Effect of thalidomide on growth and metastasis of canine osteosarcoma cells after xenotransplantation in athymic mice. Am J Vet Res 65(5):659–664
Marconato L, Buchholz J, Keller M, Bettini G, Valenti P, Kaser-Hotz B (2013) Multimodal therapeutic approach and interdisciplinary challenge for the treatment of unresectable head and neck squamous cell carcinoma in six cats: a pilot study. Vet Comp Oncol 11(2):101–112
Paoloni MC, Khanna C (2007) Comparative oncology today. Vet Clin North Am Small Anim Pract 37(6):1023–1032
Bettini G, Morini M, Marconato L et al (2010) Association between environmental dust exposure and lung cancer in dogs. Vet J 186(3):364–369
Bukowski JA, Wartenberg D, Goldschmidt M (1998) Environmental causes for sinonasal cancers in pet dogs, and their usefulness as sentinels of indoor cancer risk. J Toxicol Environ Health 54(7):579–591
Marconato L, Leo C, Girelli R et al (2009) Association between waste management and cancer in companion animals. J Vet Intern Med 23(3):564–569
Lindblad-Toh K, Wade CM, Mikkelsen TS et al (2005) Genome sequence, comparative analysis and haplotype structure of the domestic dog. Nature 438(7069):803–819
Ostrander EA, Giger U, Lindblad-Toh K (2006) The dog and its genome, Cold Spring Harbor Monograph Series. Cold Spring Harbor Laboratory Press, New York
Gordon I, Paoloni M, Mazcko C et al (2009) The comparative oncology trials consortium: using spontaneously occurring cancers in dogs to inform the cancer drug development pathway. PLoS Med 6(10):e1000161
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Marchetti, V., Giorgi, M. (2014). Clinical Studies of Metronomic Chemotherapy in Dogs. In: Bocci, G., Francia, G. (eds) Metronomic Chemotherapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43604-2_19
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