Cancer Therapeutics for Dogs and Cats

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1 Cancer Therapeutics for Dogs and Cats Alexandria Gochenauer BSPS, BA The University of Mississippi School of Pharmacy

Disclosures I declare no conflicts of interest, real or apparent, and no financial interests in any company, product, or service mentioned in this program, including grants, employment,

2 Disclosures I declare no conflicts of interest, real or apparent, and no financial interests in any company, product, or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria. The American College of Apothecaries is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

3 Learning Objectives At the conclusion of this program, the participating pharmacist or technician will be able to: List current veterinary cancer therapeutics Describe how current veterinary cancer therapeutics work Discuss how current veterinary cancer therapeutics are used in practice

4 Introduction There are three things that are typically associated with cancer in dogs and cats Environmental exposure Neuter status Administration of injections

5 Facts About Cancer The number one cause of death in geriatric dogs and cats is cancer The most common type of tumor in cats and dogs is a mammary tumor Mainly in female dogs Skin tumors are most commonly diagnosed Biopsy is the main tool for diagnosis

6 Options for Treatment Surgery Most common option Stereotactic radiosurgery (SRS) Radiation therapy Chemotherapy Pharmacotherapy Immunotherapy

7 Immunotherapy Adjunct Oncept (Canine Melanoma Vaccine, DNA) The first USDA-licensed therapeutic vaccine proven to extend the lives of dogs treated for oral melanoma Has been used in dogs with stage II or stage III canine oral melanoma Support surgery and/or radiation therapy and prolong survival time

8 Immunotherapy Adjunct Oncept IL-2 (Feline Interleukin-2 Recombinant Canarypox Virus) Adjunct immunotherapy for feline fibrosarcoma Treatment of feline fibrosarcomas is a challenge due to high risk of veterinary recurrence, even after surgical excision Shown to significantly reduce the risk of relapse

9 Cancer Protocol (Pharmacotherapy) Currently the main protocol in place is CHOP Madison Wisconsin Chemotherapy Protocol Considered the gold standard of current conventional canine lymphoma care Most commonly recommended treatment

10 CHOP Protocol Combining 3 chemotherapy drugs traditionally used for canine lymphoma care Plus prednisone for a portion of the treatment cycle 25 week protocol that combines Vincristine, Doxorubicin, and Cytoxan (or cyclophosphamide)

11 CHOP Protocol CHOP-based chemotherapy protocol provides the basis for most lymphoma chemotherapy protocols in cats, although there is currently no consensus treatment protocol recommended for this species

12 Palladia (Toceranib) Tyrosine kinase inhibitor Used to treat mast cell tumors Common form of cancer that affects dogs Statistically significant difference in tumor shrinking when compared with placebo

13 CA1 Drugs CA1 stands for conditionally approved When used according to the label, the drug is safe and has a reasonable expectation for effectiveness Conditional approval allows the drug to legally be sold before proving that it meets the substantial evidence standard for effectiveness for full approval

14 Tanovea-CA1 (Rabacfosadine) Novel acyclic nucleotide analogue Intended to treat canine lymphoma Lymphosarcoma cancer in dogs Received conditional approval on January 3, 2017

15 Paccal Vet-CA1 (Paclitaxel) Member of the taxane family Was granted CA for the treatment of: Non-resectable stage III, IV, or V mammary carcinoma in dogs that have not received previous chemotherapy radiotherapy Resectable and non-resectable squamous cell carcinoma in dogs that have not received previous chemotherapy or radiotherapy As of February 8, 2017, FDA removed conditional approval

16 Vet vs. Human Paclitaxel Differs from human generic paclitaxel as it eliminates the need for Cremophor through the use of a patented combination of water-soluble retinoid derivative called XR-17

17 Kinavet-CA1 (Masitinab mesylate) Tyrosine kinase inhibitor Indicated for the treatment of recurrent (post-surgery) or non-resectable Grade II or III cutaneous mast cell tumors in dogs that have not previously received radiotherapy and/or chemotherapy except corticosteroids As of December 15, 2015, FDA removed conditional approval of drug in United States

18 Extra-Label The Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA) made extra-label drug use an FDA-regulated veterinary medical activity Deviations include use in another species, use for a different indication, use at a different dose or frequency, and use via a different route of administration

19 Antineoplastic Chemotherapy Antineoplastic chemotherapy is an important component of small animal practice Effective use depends on an understanding of basic principles of cancer biology, drug actions, toxicities, and drug handling safety

20 Classification of Antineoplastic Chemotherapeutic Agents Conventional agents can be grouped by biochemical mechanism of action into the following categories: Alkylating agents Antimetabolites Mitotic inhibitors Antineoplastic antibiotics Hormonal agents Miscellaneous

21 Antineoplastic Agents Alkylating Agents Carboplatin Cisplatin Cyclophosphamide Dacarbazine Antimetabolites Cytarabine Fluorouracil

22 Antineoplastic Agents Mitotic Inhibitors Vinblastine Vincristine Antibiotics Doxorubicin Miscellaneous Hydroxyurea

23 Clinical Trials Benzarubicin Cytoplasmic PKC Activation Indicated as a cardio-protective antitumor agent for veterinary tumors Treatment of metastatic canine and feline tumors for which anthracycline-based therapy is not currently indicated or has failed to achieve durable remission Credit to Paradox Pharmaceuticals Inc.

24 Citations American Veterinary Medical Association. " Extralabel Drug Use and AMDUCA: FAQ." AVMA. American Veterinary Medical Association, Web. 28 Feb Barber, Lisa G., and Kristen E. Burgess. "Overview of Antineoplastic Agents." Merck Veterinary Manual. Merck Sharp & Dohme Corp., Web. 28 Feb Center for Veterinary Medicine. "Conditional Approval Explained: A Resource for Veterinarians." US Food and Drug Administration. Center for Veterinary Medicine, 16 Feb Web. 28 Feb Center for Veterinary Medicine. "FDA Conditionally Approves Tanovea-CA1, the First New Animal Drug for Treating Lymphoma in Dogs." US Food and Drug Administration Home Page. Center for Veterinary Medicine, 3 Jan Web. 28 Feb Masitinib Mesylate." Plumb's Veterinary Drugs. Educational Concepts, L.L.C. Dba Brief Media, Feb Web. 28 Feb Merial. "Pioneering Advances." Merial. Boehringer Ingelheim, Web. 09 Mar Paclitaxel." Plumb's Veterinary Drugs. Educational Concepts, L.L.C. Dba Brief Media, 8 Feb Web. 28 Feb Paradox Pharmaceuticals. "Benzarubicin." Paradox Pharmaceuticals. Paradox Pharmaceuticals Inc., Web. 28 Feb "Toceranib Phosphate." Plumb's Veterinary Drugs. Educational Concepts, L.L.C. Dba Brief Media, Web. 28 Feb

25 Resources Plumb s Veterinary Drugs: Merck Manual Veterinary Manual: Veterinary Cancer Society: Paradox Pharmaceuticals: Merial:

26 Acknowledgements Dr. Mary Milewski Mississippi State University Dr. Erin Holmes The University of Mississippi Dr. John Rimoldi Paradox Pharmaceuticals, Inc.

27 Need More Information? Alexandria Gochenauer Student Pharmacist University of Mississippi School of Pharmacy

New treatments for cancer

Vet Times The website for the veterinary profession https://www.vettimes.co.uk New treatments for cancer Author : James Elliott Categories : Canine, Companion animal, Feline, Vets Date : November 9, 2015