03144: Lomustine, Asparaginase, Procarbazine and Prednisone (LAPP) for Canine Multicentric Lymphoma: A Practical Multiagent Chemotherapy Protocol that Avoids Injectable Cytotoxics

Abstract

Lymphoma is one of the most common malignancies in dogs. Injectable multi-drug chemotherapy remains the standard of care, and is associated with high response rates and meaningful prolongation of life. However, a minority of dogs with lymphoma are treated with injectable chemotherapy, in part due to an inability of non-specialty practices to safely handle injectable chemotherapy drugs. Chemotherapy protocols utilizing the drugs asparaginase, lomustine and procarbazine have been utilized for treatment of relapsed lymphoma, and the LOPP protocol (which includes injectable vincristine) appears to have some activity for first-line treatment of multicentric T cell lymphoma. However, there are no established effective chemotherapy protocols for previously untreated canine lymphoma that do not involve drugs that require special handling. Investigators hypothesize that a multi-agent chemotherapy protocol consisting of lomustine, asparaginase, procarbazine and prednisolone (LAPP) will confer a significant improvement in 3-month progression free percentage in dogs with untreated multicentric lymphoma, compared with dogs treated with prednisolone as a single agent. This hypothesis will be tested through the completion of a single-arm, prospective clinical trial. Successful demonstration of safety and effectiveness of the LAPP protocol will provide a novel and effective treatment option for dogs with lymphoma that could be more widely available than current standards of care. This has the potential to impact a very large percentage of dogs with lymphoma that currently may be only treated palliatively.

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