Clinical evaluation of propranolol in combination with doxorubicin for the treatment of hemangiosarcoma

Hemangiosarcoma is a type of cancer that is difficult to treat because of its aggressive behavior and rapid progression after diagnosis. We have shown that a drug commonly used to treat heart disease, propranolol, can kill hemangiosarcoma cells in the laboratory. The drug has also been effective in reducing disease progression and increasing the survival time in people with angiosarcoma, a cancer very similar to canine hemangiosarcoma. We will study the tolerability and clinical benefit of propranolol in combination with doxorubicin chemotherapy. Propranolol will be tested at three dose levels: 0.8 mg/kg, 1.0 mg/kg, and 1.3 mg/kg. Each of these doses is thought to be in the effective range for propranolol. The study will also determine if higher doses work more effectively with chemotherapy. Your dog will start at one of these doses and may be increased to the higher doses depending upon how your dog tolerates propranolol. We will also study the pharmacokinetics (PK) of propranolol in the blood to determine if there is a correlation between blood PK and effectiveness of the treatment. Results of this study will be shared with the veterinary community and pet owners. Results will provide new information so that we can continue to improve upon treatments for this disease.

Recruitment will occur through the University of Minnesota Veterinary Medical Center, Ryan Veterinary Hospital at the University of Pennsylvania, and the Purdue University Veterinary Teaching Hospital.

Participation Requirements:

Eligible dogs will have hemangiosarcoma restricted to the spleen which has been treated by surgical removal of the spleen (splenectomy) within 21 days prior to enrollment in the study. Dogs must weigh more than 15 kg (33 lbs) to be eligible for participation. Screening diagnostics required, and performed between 9-21 days following surgery, are: routine thoracic radiographs (chest x-rays), abdominal ultrasound, complete blood cell counts, serum chemistries, coagulation profile and urinalyses. These tests will help us determine eligibility. To be eligible, dogs must: 

• Have no evidence of metastases
• Have adequate supply of red blood cells (less than or equal to 22% packed red cell volume)
• Be free of concurrent kidney, liver or heart disease, or problems with blood clotting

In addition to the requirements above, to be enrolled:

• Dogs cannot have received cyclophosphamide or other chemotherapy.
• Dogs cannot have received alternative/holistic medications or supplements (See Informed Client Consent for more details).
• The use of anti-inflammatory medications (NSAIDs or prednisone) is acceptable.
  

Owner Responsibilities (samples and information to be collected):

• Days 0-96, (See Informed Client Consent for more details) Echocardiogram, study imaging, physical exam, blood for CBC, serum profile and coagulation profile, urine collected for urinalysis, thoracic x-ray and abdominal ultrasound. Chemotherapy following these procedures, echocardiogram if needed.
• 6-months, 9-months, 12-months: Physical exam, blood for CBC, serum profile and coagulation profile, urine collected for urinalysis, thoracic x-ray and abdominal ultrasound.

Read more about AKC CHF grant #02534 here!