Margaret L Musser, Craig A Clifford, Philip J Bergman, Laura S Treml, Lydia C Cook McAnulty, Elizabeth A McNiel, Chad M Johannes
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引用次数: 0
Abstract
Background: Canine peripheral nodal T-cell lymphoma is considered chemotherapy resistant and carries a relatively poor prognosis. Prospective evaluations reporting the impact of chemotherapy on progression-free survival (PFS) and overall survival time for dogs with T-cell lymphoma are lacking. This study examined the impact of L-CHOP (L-asparaginase, doxorubicin, cyclophosphamide, vincristine, prednisone) chemotherapy or L-CHOP in combination with AT-005, a US Department of Agriculture-licensed caninised monoclonal antibody, on PFS and response rates in dogs with clinical intermediate- and high-grade peripheral nodal T-cell lymphoma.
Methods: A prospective, randomised, placebo-controlled, investigator- and owner-blinded, multicentre study was completed. All dogs received a 19-week L-CHOP chemotherapy protocol with randomisation (1:1) into placebo or AT-005 groups. Response was evaluated via the Veterinary Cooperative Oncology Group criteria for canine lymphoma.
Results: Forty-nine dogs were enrolled (25 received placebo and 24 received AT-005). Most demographic factors were similar between the two groups, with the exception that more dogs with stage IV and V disease were treated with AT-005 (34% vs. 8%; p = 0.03). Median PFS was 103 days (95% confidence interval [CI], 56-118) in the placebo group versus 64 days (95% CI, 36-118) in the AT-005 group. The overall response rate (ORR) for all dogs was 98% (48 of 49); complete response rate in the placebo group (64%) was not different from the AT-005 group (67%).
Conclusions: To the best of the authors' knowledge, this is the first prospective study to document that treatment with L-CHOP chemotherapy, with or without AT-005, may result in a high ORR, but relatively brief PFS in dogs with clinical intermediate- and high-grade T-cell lymphoma.
背景:犬外周结节性 T 细胞淋巴瘤被认为具有化疗耐药性,预后相对较差。目前还缺乏化疗对T细胞淋巴瘤患犬无进展生存期(PFS)和总生存期影响的前瞻性评估报告。本研究考察了L-CHOP(L-天冬酰胺酶、多柔比星、环磷酰胺、长春新碱、泼尼松)化疗或L-CHOP联合AT-005(一种美国农业部许可的犬化单克隆抗体)对临床中高级外周结节性T细胞淋巴瘤犬的无进展生存期和应答率的影响:完成了一项前瞻性、随机、安慰剂对照、研究者和狗主盲的多中心研究。所有犬只均接受了为期19周的L-CHOP化疗方案,并随机(1:1)分为安慰剂组或AT-005组。根据兽医合作肿瘤组织犬淋巴瘤标准对反应进行评估:49只狗参加了治疗(25只狗接受安慰剂治疗,24只狗接受AT-005治疗)。两组的大多数人口统计学因素相似,但接受AT-005治疗的IV期和V期病犬较多(34%对8%;P = 0.03)。安慰剂组的中位PFS为103天(95%置信区间[CI],56-118),而AT-005组为64天(95%置信区间[CI],36-118)。所有狗的总反应率(ORR)为98%(49只中有48只);安慰剂组的完全反应率(64%)与AT-005组(67%)没有差异:据作者所知,这是第一项前瞻性研究,该研究记录了临床中高分化T细胞淋巴瘤患者接受L-CHOP化疗(无论是否使用AT-005)可能会获得较高的ORR,但PFS相对较短。
期刊介绍:
Veterinary Record Open is a journal dedicated to publishing specialist veterinary research across a range of topic areas including those of a more niche and specialist nature to that considered in the weekly Vet Record. Research from all disciplines of veterinary interest will be considered. It is an Open Access journal of the British Veterinary Association.