Auranofin improves overall survival when combined with standard of care in a pilot study involving dogs with osteosarcoma

Endo-Munoz, Liliana, Bennett, Tristram C., Topkas, Eleni, Wu, Sherry Y., Thamm, Douglas H., Brockley, Laura, Cooper, Maureen, Sommerville, Scott, Thomson, Maurine, O'Connell, Kathleen, Lane, Amy, Bird, Guy, Peaston, Anne, Matigian, Nicholas, Straw, Rodney C., and Saunders, Nicholas A. (2020) Auranofin improves overall survival when combined with standard of care in a pilot study involving dogs with osteosarcoma. Veterinary and Comparative Oncology, 18 (2). pp. 206-213.

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Osteosarcoma is the most common paediatric primary bone malignancy. The major cause of death in osteosarcoma is drug-resistant pulmonary metastasis. Previous studies have shown that thioredoxin reductase 2 is a driver of metastasis in osteosarcoma and can be inhibited by auranofin (AF). Moreover, studies have shown that AF significantly reduces pulmonary metastases in xenotransplant models. Here, we describe a phase I/II study of AF in canine osteosarcoma, a well-recognized spontaneous model of human osteosarcoma. We performed a single-arm multicentre pilot study of AF in combination with standard of care (SOC) (amputation + carboplatin). We recruited 40 dogs to the trial and used a historical SOC-only control group (n = 26). Dogs >15 kg received 9 mg AF q3d PO and dogs <15 kg received 6 mg q3d. Follow-up occurred over at least a 3-year period. Auranofin plus SOC improved overall survival (OS) (P = .036) in all dogs treated. The improved outcome was attributable entirely to improved OS in male dogs (P = .009). At the time of writing, 10 dogs (25%) survive without measurable disease in the treatment group with survival times ranging between 806 and 1525 days. Our study shows that AF improves OS in male dogs when combined with SOC. Our findings have translational relevance for the management of canine and human osteosarcoma. Our data justify a larger multicentre phase 2 trial in dogs and a phase I/II trial in human patients with refractory disease at the time of initial surgery.

Item ID: 60926
Item Type: Article (Research - C1)
ISSN: 1476-5829
Keywords: auranofin, clinical trial, metastasis, osteosarcoma, thioredoxin reductase 2
Copyright Information: © 2019 John Wiley & Sons Ltd.
Funders: Cancer Council Queensland (CCQ), University of Queensland (UQ), Medical Research Council (MRC)
Projects and Grants: CCQ Grant Number: APP1025479, MRC Grant Number GID24, MRC Grant Number APP1049182
Date Deposited: 13 Nov 2019 07:33
FoR Codes: 30 AGRICULTURAL, VETERINARY AND FOOD SCIENCES > 3009 Veterinary sciences > 300907 Veterinary medicine (excl. urology) @ 100%
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