Palladia Update -- It's Not Effective For Osteo

[joejoesmom]

Unfortunately research has shown that Palladia does not reduce the likelihood of developing metastases in osteosarcoma. Because of this, the Ohio State University Greyhound Health and Wellness Program no longer recommends a metronomic protocol that includes Palladia for this disease.

 

In addition, it has proven not effective at preventing the growth of existing lung metastases due to osteosarcoma.

 

Unfortunately, some early anecdotal success raised everyone's hopes. When OSU did a scientific study, the results of the fairly large study showed that Palladia did not prove helpful when dealing with osteosarcoma.

 

My sweet Joey was part of this study.

[Charlies_Dad]

That is very unfortunate news. We had Charlie on it as well however not via OSU's study group. I so wish someday a drug is found that can prevent mets.

[krissn333]

Silly as it sounds, that makes me feel better about the fact that I couldn't afford it for Pinky. That means that we truly DID do everything we could for her.

 

Hopefully someday there will be something else that can achieve the results we need!

 

And thank you, Jane, for letting Joe be a part of the study. While the results are not what we had hoped for, it is because of his involvement that studies were able to arrive at the conclusion.

[joejoesmom]

Silly as it sounds, that makes me feel better about the fact that I couldn't afford it for Pinky. That means that we truly DID do everything we could for her.

 

Without the study, I wouldn't have been able to afford it either, so I really do understand what you mean.

 

I believe so much in OSU, I would do just about anything they asked. Throughout Joe's cancer treatment, I believe that he was in 6 different studies. My new girlhoundie, Cuja, is also a blood donor for OSU -- just like the big brother she never knew. I don't think she realizes what big paws she has to fill.

 

Jane

[4My2Greys]

Very big paws indeed

[greysmom]

Thanks for posting this Jane.

[joejoesmom]

Very big paws indeed

That is so sweet of you. I loved that silly boy with all of my heart. It has been 8 months and 14 days since he went to the bridge. I still mourn him and think of him many times each day. He really was an exceptional dog.

 

Jane

[Guest diannel]

Hi Jane (Joejoesmom)

I just read your post about the ineffectiveness of Palladia against osteosarcoma mets. My Rhodesian Ridgeback mix has just gotten a bottle of Palladia from our vet with a dosage of 100 mg. MWF.

My vet says the information has not been published about the osteosarcoma Palladia trial of Dr. London's at Ohio State and that it is worth a shot to try and prevent mets. (Nemo had his left front leg amputated in October and then 6 doses of Carboplatin 3 weeks apart.)

Can you lead me to anything written about the results of the trial, or any verifiable source that I can show my vet?

I do not want to put my companion through any unnecessary chemotherapy, and quite frankly, the possible gastro side effects are frightening.

Thanking you in advance for any information you can give me.

Sincerely,

Dianne Lansden (Nemo's Mom)

[seeh2o]

Thanks for the post and heartfelt thanks to those who allowed their hounds to participate in studies.

[Guest PhillyPups]

Thank you for this information Jane and for allowing your sweet big boy to be there to help those hounds he left behind. She sure does have big big paws to fill.

 

I know what you mean about missing them everyday, in time, I found I just get used to the pain of them being gone.

[joejoesmom]

Dianne,

 

Unfortunately nothing is published yet, therefore there is nothing in writing. I feel pretty confident that they would not share the current draft of the study. It would most likely be considered confidential until it is published.

 

I heard this news from Dr. Kellogg at OSU. She is the veterinarian for the Greyhound Health and Wellness Program. They are now requiring payment for phone/email consults ($50 for one instance, $99 for a full year of consults for owners, $149 I think for vets). However, since you are not exactly asking for a consult, perhaps Dr. Kellogg would be able to respond to an email. She probably would not be able to say any more than: Our study determined that Palladia was not effective for treatment of osteosarcoma lung metastases.

 

If this would be helpful you can try to send her an email and see if she would be willing to respond. The email is

 

greyosu@osu.edu

 

Sorry I couldn't be more help.

 

Jane

Edited March 23, 2013 by joejoesmom

[greysmom]

Even negative outcomes are helpful when fighting a disease of this magnitude. Hopefully something will come along soon. Thanks for posting Jane.

[TwiggysMom]

Diane,

 

My oncologist is (along with Dr. Couto and others) one of those involved in the initial research on Palladia (but not involved in this completed but as yet un-released study).

 

Prior to hearing about this study, he truly believed that Palladia would turn out to be a turning point in osteosarcoma treatment. He contacted Dr. Couto and requested a copy of the results, and having viewed them, may be a bit less optimistic about Palladia's benefits, but does not want to dismiss it entirely yet.

 

My girl Twiggy was on Palladia, but had health-threatening side effects and was only able to take it for about 2 months . (She is now >19 months post-amp for osteo and hasn't had any metronomic protocol meds for about 8 months due to significant side effects - most dogs do not have the extent of side effects that Twiggy had).

 

I'm not sure my information is at all helpful to you, but thought I'd put it out there. If I were to do it over again, personally, I think I'd still be inclined to give it a try, but would stop at the first sign of intolerance. Of course, that is just me - your opinion is the only one that counts in the end.

[JJNg]

I do not want to put my companion through any unnecessary chemotherapy, and quite frankly, the possible gastro side effects are frightening.

 

Palladia obviously hasn't been proven to be effective for osteosarcoma, but without seeing the study, it's hard to say whether it's still worth trying. Twiggy's oncologist seems to feel that it may still be. Palladia is different from traditional chemo and is much less likely to cause side effects because it's action is more specifically targeted toward cancer cells. While the potential for side effects is there, most dogs take it without any problems.

 

While not for bone cancer, I have a dog who has been taking Palladia for almost 3 years now with no side effects except maybe a couple days of diarrhea (over that 3 year period). I've also had 2 patients who were on Palladia for mast cell tumors, which is the FDA-approved use for it, and neither had any problems.

[joejoesmom]

Palladia obviously hasn't been proven to be effective for osteosarcoma, but without seeing the study, it's hard to say whether it's still worth trying. Twiggy's oncologist seems to feel that it may still be. Palladia is different from traditional chemo and is much less likely to cause side effects because it's action is more specifically targeted toward cancer cells. While the potential for side effects is there, most dogs take it without any problems.

 

While not for bone cancer, I have a dog who has been taking Palladia for almost 3 years now with no side effects except maybe a couple days of diarrhea (over that 3 year period). I've also had 2 patients who were on Palladia for mast cell tumors, which is the FDA-approved use for it, and neither had any problems.

I would not let the potential side effects of doxorubicin, carboplatin or Palladia stop me from using it. Most side effects are mild. The truly bad side effects are rare. In nearly all cases, you can just stop the chemo/Palladia without permanent harm.

 

Twiggy's Mom said her vet contacted Dr. Couto and requested a copy of the results, and having viewed them, may be a bit less optimistic about Palladia's benefits, but does not want to dismiss it entirely yet. OSU has done one study on its use in osteo lung mets. A single study can be wrong. Also, apparently there were some grey areas that encouraged Twiggy's vet.

 

All that being said, if I had to pay for Palladia myself (assuming it is still about $350 a month), I probably wouldn't do it for lung metastases due to osteo. Of course, I wouldn't really know what I would do unless I were in that situation.

 

Jane

[Guest diannel]

Thank you for all the comments. I'm still a little confused.

IS THERE A PUBLISHED STUDY ON PALLADIA THAT I CAN ACCESS? IF SO, HOW?

My dog has osteosarcoma and so far no mets. (I am praying.) He had 6 chemo treatments of Carboplatin three weeks apart and now he is started on Palladia in hopes of PREVENTING lung mets.

I was trying to see if anyone knew anything about the efficacy of Palladia on preventing lung mets after amputation.

Thank you,

Dianne Lansden

Nemo's Mom

[JJNg]

As far as I know, there are currently no published studies on the use of Palladia for osteosarcoma. Palladia is only FDA approved to treat mast cell tumors in dogs But as an anti-cancer drug that has the potential for other uses, oncologists have been using it off-label to treat other cancers. Medications in the same class of drug as Palladia are used to treat a variety of other cancers in people.

 

The only study I'm aware of that looked at Palladia for osteosarcoma is the one that Jane (joejoesmom) mentioned. It hasn't been published yet, but as discussed above, the results showed that it didn't seem to be effective at reducing metastasis. However, one study doesn't necessarily prove lack of effect, and as Wendy (TwiggysMom) posted, her oncologist seems to feel it might still be helpful even after seeing a draft of that unpublished study.

 

So bottom line is that there is no clear answer yet. If you can afford it, and your dog tolerates the medication ok, Palladia is something that probably won't hurt and might help, but there is currently no proof of efficacy. If anything, the one, as yet unpublished, study shows that it isn't effective.

[joejoesmom]

As far as I know, there are currently no published studies on the use of Palladia for osteosarcoma. Palladia is only FDA approved to treat mast cell tumors in dogs But as an anti-cancer drug that has the potential for other uses, oncologists have been using it off-label to treat other cancers. Medications in the same class of drug as Palladia are used to treat a variety of other cancers in people.

 

The only study I'm aware of that looked at Palladia for osteosarcoma is the one that Jane (joejoesmom) mentioned. It hasn't been published yet, but as discussed above, the results showed that it didn't seem to be effective at reducing metastasis. However, one study doesn't necessarily prove lack of effect, and as Wendy (TwiggysMom) posted, her oncologist seems to feel it might still be helpful even after seeing a draft of that unpublished study.

 

So bottom line is that there is no clear answer yet. If you can afford it, and your dog tolerates the medication ok, Palladia is something that probably won't hurt and might help, but there is currently no proof of efficacy. If anything, the one, as yet unpublished, study shows that it isn't effective.

Great summary Jennifer.

[TwiggysMom]

Dianne, the study that is being referred to in this thread is not published yet so far as I know. I also believe that it is the first completed study on Palladia's effect on preventing lung mets. I think Twiggy's oncologist may have been given access to it because he and Dr. Couto both worked on some of the original Palladia research.

 

Twiggy went through the same protocol as Nemo so far - 6 iv carboplatin treatments, followed by a metronomic protocol consisting of Palladia, Cytoxan, Metacam, and artemisinin.

 

You don't mention that Nemo had any significant side effects from the carboplatin, so I'm assuming he didn't and that is good news. Twiggy sailed through iv chemo until her last treatment, from which she had significant side effects (I believe due to administration error; this was before I switched to her current oncologist - the one who has reviewed the OSU study). I also think that her reaction to her last iv chemo treatment is what set her up for intolerance to the metronomic protocol components (all except artemisinin, an herbal she continues to take without issues).

 

If I were to face it all over again with another dog, knowing what I know now, I would give Palladia a try so long as I could afford it and it was well-tolerated. Twiggy's experience was very unusual. Most hounds have no visible side effects to it at all, and typically only need to go on a "Palladia holiday" due to lowered blood counts on a very infrequent basis.

 

I understand how difficult it is to make a decision about this. For me, the amp/iv chemo decision was pretty easy, the decision about metronomic protocol was difficult. I so hope that one day we will have more definitive information. In the meantime, you clearly are making your decisions based in the best available information out of love for Nemo, so whatever decision you make will be the right one.

Edited March 26, 2013 by TwiggysMom

[Charlies_Dad]

Just to add, we provided Charlie with Palladia and he did handle it well overall. He enjoyed 21mths post diagnosis so whether it helped or not, we'll never know. Also Jane's Joe was on it and he enjoyed I believe 20mths post diagnosis and we were only two hounds I knew of on GT that was on it with the exception of Wendy's Twiggy for a short period. So that's just a very small informal 'study' of a couple pups here on GT which definitely is not a large enough pool to truly obtain factual data from but for Charlie, we have no regrets whatsoever in giving it to him. I will concur though it is very expensive ($350/mth).

[racindog]

That is so sweet of you. I loved that silly boy with all of my heart. It has been 8 months and 14 days since he went to the bridge. I still mourn him and think of him many times each day. He really was an exceptional dog.

 

Jane

He really was. I never even met him in person and smile when threads like this remind me of him. I can feel his energy. And I can tell you it doesn't matter whether its 8 months or 8 years-you'll still think about him all the time. Slim crossed over in 2006 and I still think of him many times each day and even talk to him. It makes me feel good because it proves he is with me still as is your boy with you.

[RaineysMom]

wish this would have come out before we put Nube on it. Not sure if it's what caused his final inappetance and downfall, but at the very least it set us back $500 big ones.

[Victor]

Does anyone know if this study has been published yet? Lana has a 5cm x 3.5cm mass in her lungs that is most likely a metastasis of her osteo, and we're trying to decide whether or not to put her on Palladia. The potential side effects are indeed frightening, and we don't want to risk having her suffer if it's not going to help...

Edited October 8, 2013 by Victor

[tbhounds]

I don't know if it's been published yet but, I think they have gotten away from it with Osteo mets. Sorry to hear Lana isn't well :-(

I don't know if it's been published yet but, I think they have gotten away from it with Osteo mets. Sorry to hear Lana isn't well :-(

Edited to add--you could e-mail Dr Cheryl London at Ohio State to get her input (she's the master brains behind palladia).

[Victor]

I don't know if it's been published yet but, I think they have gotten away from it with Osteo mets. Sorry to hear Lana isn't well :-(

 

Edited to add--you could e-mail Dr Cheryl London at Ohio State to get her input (she's the master brains behind palladia).

 

Thanks, tbhounds. I'll try to get in touch with her.