Efficacy and adverse events of anthracycline and propranolol combination in five dogs with stage 3 hemangiosarcoma

Abstract

Background: Canine hemangiosarcoma (HSA), which originates from endothelial cells, is one of the most common  malignant neoplasms that frequently develop metastatic lesions. Although anthracycline-based HSA treatment  strategies have been widely investigated, reliable therapy for dogs with clinically advanced-stage HSA (stage 3 HSA) has   not been established yet. Recently, several studies have demonstrated that propranolol, a beta-adrenergic receptor   antagonist, exhibits anti-tumor effects against tumors originating from vascular endothelial cells, indicating the   possibility that propranolol is a candidate adjunctive agent for anthracycline-based therapy in dogs with stage 3 HSA.   This study aimed to evaluate the clinical efficacy and adverse events (AEs) of anthracycline and propranolol combination   in stage 3 HSA-affected dogs.

Case Description: We retrospectively investigated five dogs diagnosed with  stage 3 HSA  which were administered with both anthracycline and propranolol during the same period between January  2020 and  August 2021. Clinical benefit was observed in four of five HSA dogs (one of complete response, one of  partial response,  and two of stable disease) with gross metastatic lesions by anthracycline and propranolol  combination. Notably, some  or all of the metastatic lesions were reduced in two cases. In all five dogs administered with  anthracycline and  propranolol combination, no serious and irreversible AEs were observed.

Conclusion: Our  findings demonstrate the  efficacy and safety of anthracycline and propranolol combination in stage 3 HSA-affected  dogs. Further studies are  needed to establish treatment protocols based on anthracycline and propranolol combination  for dogs with advanced  HSA.