title: Prolonged remission of advanced bronchoalveolar adenocarcinoma in a dog treated with autologous, tumour-derived chaperone-rich cell lysate (CRCL) vaccine.
abstract: OBJECTIVE
  This paper presents the treatment of a 12-year-old female spayed Great Dane who presented with vestibular signs (ataxia, nystagmus, hind end collapse). Thoracic radiographs revealed a discrete pulmonary nodule in the right cranial lung lobe. Ultrasound-guided fine needle aspirate detected primary bronchoalveolar adenocarcinoma, verified via computed tomography, with a second smaller nodule discovered in the right cranial lung lobe.
  
  
  METHODS
  A lateral thoracotomy with right cranial lung lobectomy was performed. Histopathological analysis of the nodules and an excised lymph node identified grade III bronchoalveolar adenocarcinoma with vascular infiltration and lymph node metastasis - a grim diagnosis with a reported median survival time of 6-27 days. A 10-g sample of the tumour was processed into a chaperone-rich cell lysate (CRCL) vaccine, which was administered weekly to the patient. Imiquimod - a Toll-like receptor 7 (TLR7) agonist - was applied topically for the first 12 treatments to stimulate local Langerhans cells. A single injection of bacillus Calmette-Guerin (BCG) was administered for additional immune stimulation at week 30 of treatment.
  
  
  RESULTS
  The dog remained stable and in otherwise good health until diffuse relapse occurred 44 weeks after the initial treatment; following gastrointestinal bleeding, the dog was euthanised 50+ weeks post diagnosis.
  
  
  CONCLUSIONS
  To the authors' knowledge, this is the first report of significantly prolonged survival following a diagnosis of grade III/stage III bronchoalveolar adenocarcinoma in a canine patient. This case report suggests that CRCL vaccine combined with topical imiquimod is a safe, effective treatment for canine tumours.
authors.affiliation: Cell and Molecular Biology Program, Cancer Biology Section, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Epple
authors.forename: Lynne T
authors.initials: LT
authors.lastname: Bemis
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Cavanaugh
authors.forename: Anne
authors.initials: A
authors.lastname: Skope
authors.forename: Tehila
authors.initials: T
authors.lastname: Mayer-Sonnenfeld
authors.forename: Chad
authors.initials: C
authors.lastname: Frank
authors.forename: Christine S
authors.initials: CS
authors.lastname: Olver
authors.forename: Alex M
authors.initials: AM
authors.lastname: Lencioni
authors.forename: Nathaniel L
authors.initials: NL
authors.lastname: Dusto
authors.forename: Alona
authors.initials: A
authors.lastname: Tal
authors.forename: Michael
authors.initials: M
authors.lastname: Har-Noy
authors.forename: Kevin O
authors.initials: KO
authors.lastname: Lillehei
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Katsanis
authors.forename: Michael W
authors.initials: MW
authors.lastname: Graner
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy* / Q000662:veterinary; D000818:Animals; D019496:Cancer Vaccines / Q000627:therapeutic use*; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D004285:Dogs; D005260:Female; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy* / Q000662:veterinary; D018832:Molecular Chaperones / Q000276:immunology*; D011859:Radiography
chemical_list: D019496:Cancer Vaccines; D018832:Molecular Chaperones