Sensitivity of canine hematological cancers to BH3 mimetics.

BACKGROUND: Inhibition of antiapoptotic B-cell lymphoma 2 (BCL2) proteins by small molecule Bcl-2 homology 3 (BH3) mimetics causes rapid induction of apoptosis of human hematological cancers in vitro and in vivo. OBJECTIVES: Assess in vitro sensitivity of non-neoplastic lymphocytes and primary hematological cancer cells from dogs to venetoclax (VEN) or the dual BCL2/ B-cell lymphoma-extra-large (BCLxL) inhibitor, navitoclax (NAV), and evaluate the association between BCL2 protein expression and VEN sensitivity. ANIMALS: Nine client-owned dogs without cancer and 18 client-owned dogs with hematological cancer. METHODS: Prospective, nonrandomized noncontrolled study. Lymphocytes isolated from peripheral blood, lymph node, or bone marrow from dogs were incubated with BH3 mimetics for 24 hours. Viable cells were counted using flow cytometry and half maximal effective concentration (EC50 ) was calculated. BCL2 protein from whole cell lysates was assessed via immunoblots. RESULTS: Nodal B and T lymphocytes were more sensitive to VEN than circulating lymphocytes (P = .02). Neoplastic T lymphocytes were sensitive to VEN (mean EC50 ± SD = 0.023 ± 0.018 µM), whereas most non-indolent B cell cancers were resistant to killing by VEN (mean EC50 ± SD = 288 ± 700 µM). Unclassified leukemias showed variable sensitivity to VEN (mean EC50 ± SD = 0.49 ± 0.66 µM). Detection of BCL2 protein was not associated with VEN sensitivity. CONCLUSION AND CLINICAL IMPORTANCE: Neoplastic canine T lymphocytes are sensitive to VEN in vitro. Quantification of BCL2 protein alone is insufficient to predict sensitivity to VEN.

Response of canine thyroid carcinomas to radioiodine.

Radioactive iodine (131 I) has previously been reported to prolong survival in dogs with thyroid carcinoma. This study aimed to describe tumour response and progression-free interval (PFI) in dogs with thyroid carcinomas treated with 131 I. Secondary aims were to describe overall survival time (OST) and prognostic factors. A bi-institutional retrospective review of records identified 66 dogs with thyroid carcinoma treated with 131 I from January 2010 to April 2020. Response was described using RECIST or a subjective response assessment where specific tumour measurements were not available. Forty-eight dogs (72.7%) were treatment naïve and 18 dogs (27.3%) had received prior therapy at the time of 131 I treatment. Objective responses were available for 34 dogs and subjective responses for 58 dogs. The overall response rate was 35.3% (four complete and eight partial responses). Improvement of clinical signs was seen in 76.2% of dogs (32/42). Kaplan-Meier-estimated median PFI (95% confidence interval [CI]) was 301 (217-578) days and OST (95% CI) was 564 (421-865) days. Prior therapy was associated with a lower hazard for progression (hazard ratio [HR] 0.260 95% CI 0.123-0.548, p = .0004). Treatment of thyroid carcinoma using 131 I can effectively alleviate clinical signs and reduce disease burden in a proportion of dogs.

Suspected pancreatic carcinoma needle tract seeding in a cat.

CASE SUMMARY: A 15-year-old male neutered domestic longhair cat was referred for investigation of a pancreatic nodule. Fine-needle aspiration of the nodule was performed on two occasions, 2 weeks apart, and cytology revealed pyogranulomatous inflammation and moderately dysplastic exocrine pancreatic epithelium, suspicious for neoplasia. Thoracic radiographs were unremarkable and a partial pancreatectomy was performed. On histopathology, the nodule was diagnosed as a moderately differentiated pancreatic adenocarcinoma. Two weeks after surgery, a firm subcutaneous nodule was detected on the left ventrolateral abdomen. Cytology of the nodule was suggestive of pancreatic carcinoma and needle tract seeding was suspected. With palliative treatment, the cat lived a further 136 days. RELEVANCE AND NOVEL INFORMATION: To our knowledge, this represents the first report of suspected transabdominal needle tract seeding of pancreatic carcinoma following fine-needle aspiration in veterinary medicine. Veterinarians should consider this when discussing risks of pancreatic fine-needle aspiration with owners and should attempt to minimise the number of needle aspirations where possible.

The Proteasome Inhibitor Ixazomib Inhibits the Formation and Growth of Pulmonary and Abdominal Osteosarcoma Metastases in Mice.

Osteosarcoma is the most common form of primary bone cancer. Over 20% of osteosarcoma patients present with pulmonary metastases at diagnosis, and nearly 70% of these patients fail to respond to treatment. Previous work revealed that human and canine osteosarcoma cell lines are extremely sensitive to the therapeutic proteasome inhibitor bortezomib in vitro. However, bortezomib has proven disappointingly ineffective against solid tumors including sarcomas in animal experiments and clinical trials. Poor tumor penetration has been speculated to account for the inconsistency between in vitro and in vivo responses of solid tumors to bortezomib. Here we show that the second-generation proteasome inhibitor ixazomib, which reportedly has enhanced solid tumor penetration compared to bortezomib, is toxic to human and canine osteosarcoma cells in vitro. We used experimental osteosarcoma metastasis models to compare the efficacies of ixazomib and bortezomib against primary tumors and metastases derived from luciferase-expressing KRIB or 143B human osteosarcoma cell lines in athymic mice. Neither proteasome inhibitor reduced the growth of primary intramuscular KRIB tumors, however both drugs inhibited the growth of established pulmonary metastases created via intravenous inoculation with KRIB cells, which were significantly better vascularized than the primary tumors. Only ixazomib slowed metastases from KRIB primary tumors and inhibited the growth of 143B pulmonary and abdominal metastases, significantly enhancing the survival of mice intravenously injected with 143B cells. Taken together, these results suggest ixazomib exerts better single agent activity against osteosarcoma metastases than bortezomib. These data provide hope that incorporation of ixazomib, or other proteasome inhibitors that penetrate efficiently into solid tumors, into current regimens may improve outcomes for patients diagnosed with metastatic osteosarcoma.

Substitution of mitoxantrone for doxorubicin in a multidrug chemotherapeutic protocol for first-line treatment of dogs with multicentric intermediate- to large-cell lymphoma.

OBJECTIVE To evaluate effects of substituting mitoxantrone for doxorubicin in a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapeutic protocol for first-line treatment of dogs with multicentric intermediate- to large-cell lymphoma. DESIGN Retrospective cohort study. ANIMALS 44 dogs treated with cyclophosphamide, mitoxantrone, vincristine, and prednisone (CMOP) and 51 dogs treated with CHOP at 12 referral institutions. PROCEDURES Medical records were reviewed to determine response to treatment, progression-free survival time, and overall survival time. For dogs treated with CMOP, adverse events were also recorded. RESULTS All 44 (100%) dogs treated with CMOP and 37 of 38 (97.4%) dogs treated with CHOP had a complete or partial response. Median progression-free survival time for dogs treated with CMOP was 165 days (95% confidence interval [CI], 143 to 187 days), and median overall survival time was 234 days (95% CI, 165 to 303 days). For dogs treated with CHOP, median progression-free survival time was 208 days (95% CI, 122 to 294 days), and median overall survival time was 348 days (95% CI, 287 to 409 days). Progression-free and overall survival times were not significantly different between groups. Overall, 9 of the 44 (20%) dogs treated with CMOP had adverse events likely or probably related to mitoxantrone, but all of these adverse events were mild. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that mitoxantrone may be a reasonable substitution in a CHOP protocol for treatment of dogs with multicentric intermediate- to large-cell lymphoma when doxorubicin is contraindicated.

Phase I/II evaluation of RV1001, a novel PI3Kδ inhibitor, in spontaneous canine lymphoma.

BACKGROUND: RV1001 is a novel, potent, and selective PI3Kδ inhibitor. The purpose of this study was to evaluate the safety and efficacy of RV1001 in canine Non-Hodgkin lymphoma (NHL). METHODS AND RESULTS: Inhibition of endogenous pAKT by RV1001 in primary canine NHL cells was determined by Western blotting. A phase I study of RV1001 was performed in 21 dogs with naïve and drug resistant T and B-cell NHL to assess safety, pharmacokinetic profile, and response to therapy. The objective response rate was 62% (complete response (CR) n = 3; partial response (PR) n = 10), and responses were observed in both naïve and chemotherapy-resistant B and T cell NHL. This study provided the recommended starting dose for a phase II, non-pivotal, exploratory, open label multi-centered clinical trial in 35 dogs with naïve and drug resistant T and B-cell NHL, to further define the efficacy and safety profile of RV1001. The objective response rate in the phase II study was 77% (CR n = 1; PR n = 26). Clinical toxicities were primarily hepatobiliary and gastrointestinal, and were responsive to dose modifications and/or temporary drug discontinuation. Hepatotoxicity was the primary dose limiting toxicity. CONCLUSIONS: RV1001 exhibits good oral bioavailability, an acceptable safety profile, and biologic activity with associated inhibition of pAKT in dogs with B and T cell NHL. Data from these studies can be leveraged to help inform the design of future studies involving isoform-selective PI3K inhibitors in humans.

Evaluation of protein kinase CK2 as a therapeutic target for squamous cell carcinoma of cats.

OBJECTIVE To investigate protein kinase CK2 (CK2) expression in squamous cell carcinoma (SCC) of cats and to examine effects of CK2 downregulation on in vitro apoptosis and viability in SCC. SAMPLE Biopsy specimens of oral mucosa and testis and blood samples from clinically normal cats, biopsy specimens of oral SCC from cats, and feline SCC (SCCF1) and mammary gland carcinoma (K12) cell lines. PROCEDURES Immunohistochemical labeling for CK2α was performed on biopsy specimens. Sequences of the CK2α subunit gene and CK2α' subunit gene in feline blood and feline cancer cell lines were determined by use of PCR and reverse-transcription PCR assays followed by direct Sanger sequencing. Specific small interfering RNAs (siRNAs) were developed for feline CK2α and CK2α'. The SCCF1 cells were treated with siRNA and assessed 72 hours later for CK2α and CK2α' expression and markers of apoptosis (via western blot analysis) and for viability (via 3-[4,5-dimethylthiazol-2-yl]-5-[3-carboxymethoxyphenyl]-2-[4-sulfophenyl]-2H-tetrazolium assays). RESULTS CK2α was expressed in all feline oral mucosa samples and 7 of 8 oral SCC samples. Expression of CK2α and CK2α' was successfully downregulated in SCCF1 cells by use of siRNAs, which resulted in decreased viability and induction of apoptosis. CONCLUSIONS AND CLINICAL RELEVANCE In this study, CK2 appeared to be a promising therapeutic target for SCCs of cats. A possible treatment strategy for SCCs of cats would be RNA interference that targets CK2.

Therapeutic Targeting of Protein Kinase CK2 Gene Expression in Feline Oral Squamous Cell Carcinoma: A Naturally Occurring Large-Animal Model of Head and Neck Cancer.

Protein kinase CK2 (CK2) is a highly promising target for cancer therapy, and anti-CK2 gene expression therapy has shown effectiveness in rodent models of human head and neck cancer (HNC). To date, there has been no large-animal model of cancer in which to further explore anti-CK2 therapies. Feline oral squamous cell carcinoma (FOSCC) has been proposed as a large-animal model for human HNC, and we have previously shown that CK2 is a rational target in FOSCC. Here we have tested the hypothesis that a novel tenfibgen-coated tumor-specific nanocapsule carrying RNA interference (RNAi) oligonucleotides targeting feline CK2α and CK2α' (TBG-RNAi-fCK2αα') would be safe in cats with FOSCC; assessment of target inhibition and tumor response were secondary aims. Nine cats were enrolled and treated at two dose levels in a 3+3 escalation. Cats received a total of six treatments with TBG-RNAi-fCK2αα'. Pre- and posttreatment, tumor and normal oral mucosa biopsies were collected to assess CK2 expression, using immunohistochemistry (IHC) preparations evaluated by light microscopy. Toxicity and tumor response were assessed on the basis of standard criteria. The most common adverse events were grade 1 or 2 weight loss and anorexia. Grade 3 tissue necrosis was seen in association with tumor response in one cat, asymptomatic grade 4 elevations in aspartate transaminase and creatine phosphokinase in one cat, and asymptomatic grade 3 hypokalemia in one cat. Of six cats with evaluable biopsies, two had a reduction in CK2 IHC score in tumors after treatment. Four cats had progressive disease during the study period, three had stable disease, one had partial response, and response could not be evaluated in one cat. We conclude that the drug appeared safe and that there is some evidence of efficacy in FOSCC. Further investigation regarding dosing, schedule, target modulation, toxicity, and efficacy in a larger group of cats is warranted and may inform future clinical studies in human head and neck cancer.

CK2 Molecular Targeting-Tumor Cell-Specific Delivery of RNAi in Various Models of Cancer.

Protein kinase CK2 demonstrates increased protein expression relative to non-transformed cells in the majority of cancers that have been examined. The elevated levels of CK2 are involved in promoting not only continued proliferation of cancer cells but also their resistance to cell death; thus, CK2 has emerged as a plausible target for cancer therapy. Our focus has been to target CK2 catalytic subunits at the molecular level using RNA interference (RNAi) strategies to achieve their downregulation. The delivery of oligonucleotide therapeutic agents warrants that they are protected and are delivered specifically to cancer cells. The latter is particularly important since CK2 is a ubiquitous signal that is essential for survival. To achieve these goals, we have developed a nanocapsule that has the properties of delivering an anti-CK2 RNAi therapeutic cargo, in a protected manner, specifically to cancer cells. Tenfibgen (TBG) is used as the ligand to target tenascin-C receptors, which are elevated in cancer cells. This strategy is effective for inhibiting growth and inducing death in several types of xenograft tumors, and the nanocapsule elicits no safety concerns in animals. Further investigation of this therapeutic approach for its translation is warranted.

GADOXETATE DISODIUM (GD-EOB-DTPA) CONTRAST ENHANCED MAGNETIC RESONANCE IMAGING CHARACTERISTICS OF HEPATOCELLULAR CARCINOMA IN DOGS.

Hepatocellular carcinoma is the most common primary hepatic tumor in dogs and is amenable to surgical resection in many cases. Unfortunately, overlap of sonographic findings between benign and malignant hepatic lesions typically requires more invasive diagnostic tests to be performed (e.g., biopsy for histopathology). The availability of a noninvasive diagnostic test to identify hepatocellular carcinoma would be beneficial. The use of a liver-specific magnetic resonance imaging (MRI) contrast agent such as gadoxetate disodium (Gd-EOB-DTPA; Eovist® or Primovist®) has improved lesion detection in human patients. In this descriptive study, gadoxetate disodium contrast-enhanced MRI characteristics in dogs were evaluated in seven dogs (total of eight lesions). The imaging characteristics were variable with the exception of all lesions being hypointense to surrounding normal hepatic parenchyma on 3D T1-weighted gradient recalled echo images at all postcontrast time points. All lesions displayed signal intensity ratios less than 1, consistent with retained but impaired hepatocyte function. Hepatic lesions not identified on previous imaging were found in 3/7 patients which may affect surgical planning. In two patients, several hepatic nodules were identified during surgery which had not been visualized on MRI and were found to be benign on histopathology. This descriptive study reports the MRI characteristics of hepatocellular carcinoma in dogs using the liver-specific contrast agent gadoxetate disodium.

Clinical Signs, Treatment, and Outcome in Cats with Myeloma-Related Disorder Receiving Systemic Therapy.

Myeloma-related disorder (MRD) is an uncommon disease in cats, for which there is no established standard of care. In this retrospective study, we evaluated presentation, response to treatment, and toxicity in cats with MRD receiving systemic treatment. Previously reported prognostic factors were evaluated for their impact on survival in cats receiving chemotherapy. Of fifteen cases identified, thirteen received melphalan or cyclophosphamide +/- corticosteroids as first-line therapy. Chlorambucil was commonly used as rescue therapy in cats with progressive disease, or in cases of chemotherapy-related toxicity with first line agents. Overall response rates were 71% and 83% for melphalan- and cyclophosphamide-treated cats, respectively. Discontinuation of melphalan due to toxicity was common. Survival times for cats initially treated with melphalan or cyclophosphamide were not significantly different (median 252 and 394 days, respectively), and no statistically significant prognostic factors were identified. This study suggests that the combination of cyclophosphamide and corticosteroids is well tolerated and may be considered as first-line therapy for cats with systemic MRD.

Lower urinary tract cancer.

Lower urinary tract neoplasia is uncommon in dogs and cats, though transitional cell carcinoma (TCC) is the most common tumor of the lower urinary tract in both species. Clinical signs are not specific for neoplasia, but neoplasia should be considered in patients that are older, have specific risk factors, or have persistent, severe, or relapsing signs. Local disease is often the cause of death or euthanasia; local control is challenging owing to tumor size and location. Systemic therapy is the mainstay of treatment. Prognosis is generally guarded, but therapy can result in improvement in clinical signs and quality of life.

Cats, Cancer and Comparative Oncology.

Naturally occurring tumors in dogs are well-established models for several human cancers. Domestic cats share many of the benefits of dogs as a model (spontaneous cancers developing in an immunocompetent animal sharing the same environment as humans, shorter lifespan allowing more rapid trial completion and data collection, lack of standard of care for many cancers allowing evaluation of therapies in treatment-naïve populations), but have not been utilized to the same degree in the One Medicine approach to cancer. There are both challenges and opportunities in feline compared to canine models. This review will discuss three specific tumor types where cats may offer insights into human cancers. Feline oral squamous cell carcinoma is common, shares both clinical and molecular features with human head and neck cancer and is an attractive model for evaluating new therapies. Feline mammary tumors are usually malignant and aggressive, with the 'triple-negative' phenotype being more common than in humans, offering an enriched population in which to examine potential targets and treatments. Finally, although there is not an exact corollary in humans, feline injection site sarcoma may be a model for inflammation-driven tumorigenesis, offering opportunities for studying variations in individual susceptibility as well as preventative and therapeutic strategies.

Mice lacking dopamine D1 receptors express normal lithium chloride-induced conditioned taste aversion for salt but not sucrose.

Conditioned taste aversion (CTA), is a form of Pavlovian learning wherein a novel flavour is powerfully associated with subsequent feelings of illness, and is afterwards avoided. In rats, pharmacological blockade of dopamine D1 receptors has been reported to prevent the expression of a CTA to the sweet taste of sucrose or saccharine. We used genetically modified mice to determine whether dopamine D1 receptors are necessary for the expression of a CTA. Food-deprived mice lacking the dopamine D1 receptor (D1r-/-) did not express a LiCl-induced (125 or 254 mg/kg) CTA to the sweet taste of 0.5 m sucrose, in agreement with previous pharmacological studies. However, water-deprived D1r-/- mice did express normal LiCl-induced (40, 150 and 254 mg/kg) CTA to a salty taste (0.2 m NaCl). Our results suggest that activation of D1 receptors might contribute to the strength of an aversive gustatory association, but might not be required for the formation of a CTA in general.

Dysregulation of striatal dopamine signaling by amphetamine inhibits feeding by hungry mice.

Amphetamine (AMPH) releases monoamines, transiently stimulates locomotion, and inhibits feeding. Using a genetic approach, we show that mice lacking dopamine (DA-deficient, or DD, mice) are resistant to the hypophagic effects of a moderate dose of AMPH (2 microg/g) but manifest normal AMPH-induced hypophagia after restoration of DA signaling in the caudate putamen by viral gene therapy. By contrast, AMPH-induced hypophagia in response to the same dose of AMPH is not blunted in mice lacking the ability to make norepinephrine and epinephrine (Dbh(-/-)), dopamine D(2) receptors (D2r(-/-)), dopamine D(1) receptors (D1r(-/-)), serotonin 2C receptors (Htr2c(-/Y)), neuropeptide Y (Npy(-/-)), and in mice with compromised melanocortin signaling (A(y)). We suggest that, at this moderate dose of AMPH, dysregulation of striatal DA is the primary cause of AMPH-induced hypophagia and that regulated striatal dopaminergic signaling may be necessary for normal feeding behaviors.

Is dopamine required for natural reward?

Reward is fundamental to the organization of behavior, and the neurotransmitter dopamine (DA) is widely recognized to be critical to the neurobiology of reward, learning and addiction. Virtually all drugs of abuse, including heroin and other opiates, alcohol, cocaine, amphetamine and nicotine activate dopaminergic systems. So called "natural" rewards such as food, positive social interactions and even humor, likewise activate DA neurons and are powerful aids to attention and learning. Sweet solutions are a well-characterized natural reward. When a source of sugar is encountered, animals will consume substantial amounts, return to it preferentially, and will work to obtain access. Dopamine systems are activated in animals drinking sugar solutions, and lesions of dopaminergic neurons or pharmacological blockade of DA receptors seem to reduce the reward value of both sweet tastes and drugs of abuse. However, we have recently demonstrated that genetically modified mice that cannot make DA (DD mice) manifest normal sucrose preference. During preference tests, mutant mice initiated licking less frequently than did normal mice, but the rate of licking by DD mice for sweets was actually higher than that of normal mice, indicating that their motor ability to lick is intact. We conclude that DA is not required for the hedonic response to sweets nor for their discrimination. This brief and slightly humorous review discusses these findings in the context of current and historical answers to the question, "What is the role of DA in reward?"

Reward without dopamine.

Dopamine (DA) is believed to play a fundamental role in reward processes. Virtually all drugs of abuse activate dopaminergic systems, as do "natural" rewards such as sexual interaction and food. Sweet-tasting solutions, for example, are a well characterized natural reward. In the present experiments, we used mice that cannot make DA (DD mice) to test the hypothesis that DA is necessary for reward. Sucrose preference, assessed with a computerized "lickometer," was used to determine whether DD mice respond preferentially for rewarding stimuli. DD mice preferentially chose sucrose over water, and also preferred the noncaloric sweetener saccharin. Furthermore, the rate of licking, bout size, and length were greater in DD mice drinking sweets than in controls. These data refute the necessity of DA for the reward processes manifested by sucrose preference. However, DD mice initiated licking less frequently than control mice and had fewer total licks. We suggest that DD mice have a deficit of goal-directed behavior that is not specific to reward processes. Lastly, juvenile DD mice demonstrate robust sucrose preference before experience with food in the presence of DA. Thus, DA is not required for mice to learn to consume sweet solutions preferentially. We conclude that DA is not required to find the sweet tastes of sucrose or saccharin rewarding.