Case Report: Microfragmented Adipose Tissue Drug Delivery in Canine Mesothelioma: A Case Report on Safety, Feasibility, and Clinical Findings

Our plain-English summary of Case Report: Microfragmented Adipose Tissue Drug Delivery in Canine Mesothelioma: A Case Report on Safety, Feasibility, and Clinical Findings, by O. Zeira, E. Ghezzi, L. Pettinari, et al (Frontiers in Veterinary Science, 2020).

The study

• Authors: O. Zeira, E. Ghezzi, L. Pettinari, V. Re, D.M. Lupi, S.L. Benali, S. Borgonovo, G. Alessandri, F. Petrella, R. Paroni, M. Dei Cas, C. Tremolada, V. Coccè, A. Pessina
• Journal: Frontiers in Veterinary Science
• Published: 2020;7:585427
• Type of article: Case report
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Mesothelioma is a rare lethal tumor of dogs and humans involving cavities of the body. Dogs are considered a model for new drugs and therapeutic methods since they present spontaneous diseases similar to humans. Microfragmented adipose tissue (MFAT) uploaded by paclitaxel (PTX) is a drug delivery medium providing slow release of chemotherapic drugs. A dog affected by pleural, pericardial, and peritoneal mesothelioma was treated by 17 intracavitary ultrasound-guided injections of MFAT-PTX over 22 months. A long-lasting improvement of general conditions was observed, treatment was well-tolerated, and no toxicity or hypersensitivity was reported. Pharmacokinetic (PK) data indicated low drug localization in the circulatory system and a tendency to enter or remain in the extravascular compartments of the body. Indeed, low levels of free-circulating drugs for a short time produced low toxicity, whereas, a higher intracavitary PTX concentration can have major pharmacological efficacy. To our knowledge, this is the first time that mesothelioma has been treated using such a procedure, and this should be considered as a novel therapeutic approach. The low systemic absorption suggests the possible role of MFAT-PTX for loco-regional/intratumoral therapy also useful in other types of tumors, and further investigation is warranted.

Copyright © 2021 Zeira, Ghezzi, Pettinari, Re, Lupi, Benali, Borgonovo, Alessandri, Petrella, Paroni, Dei Cas, Tremolada, Coccè and Pessina.

In plain English

This veterinary case report described one dog in Italy with mesothelioma of the pleura, pericardium and peritoneum. The article does not mention asbestos or any cause of the disease. The 6-year-old dog received the chemotherapy drug paclitaxel carried in tiny fragments of its own fat tissue (MFAT-PTX). This was injected into the chest and abdomen under ultrasound guidance 17 times over 22 months. The authors reported no major short- or long-term adverse effects, and blood counts stayed normal. Each treatment began by draining fluid. After each drainage and injection, the dog's condition improved for an average of 30 to 40 days. Abdominal fluid stopped forming after the fourth treatment. Chest fluid decreased over the first 6 months but later slowly increased, so treatments became more frequent. Blood drug levels peaked at 28.8 ng/ml two hours after the first treatment. The dog was euthanized after 22 months as its condition worsened. Two other treated dogs with mesothelioma were already in advanced condition and died within a month of cardiopulmonary failure. The authors concluded the approach was feasible and said many more patients are needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: veterinary case report of a single dog (the authors treated other animals but chose to report one case)
• Who was studied: One 6-year-old, mixed-breed, 24-kg neutered dog with mesothelioma diagnosed by biopsy of the pleura, pericardium and peritoneum, treated at San Michele Veterinary Hospital, Italy; dates of treatment not given
• Exposure: No asbestos or other fiber exposure is described. The article studied a treatment: 7 ml of paclitaxel-loaded microfragmented autologous adipose tissue (MFAT-PTX, 1 mg/ml), equal to 0.29 mg/kg of drug, injected into the abdominal and chest cavities after fluid drainage
• Main results:
  • The dog received 17 treatments over 22 months, on average one every 38 days (shortest interval 14 days, longest 70 days)
  • Each procedure began with drainage of fluid from the abdomen and chest, followed by injection of MFAT-PTX
  • No major short- or long-term adverse effects were recorded in the dog; monthly blood counts and biochemistry showed no abnormalities
  • The dog's general condition improved after each fluid drainage followed by the injection, lasting an average of 30 to 40 days
  • Monthly chest X-rays in the first 6 months showed progressive reduction of the severe pleural effusion
  • Intervals between treatments averaged 52 days in the first 15 months and 24 days in the last 7 months; the shorter intervals were due to a slow, progressive increase in chest fluid
  • Abdominal fluid production stopped completely after the fourth treatment
  • After the first treatment, no paclitaxel was found in blood at 30 minutes. Plasma levels were 28.8, 19.25 and 4.89 ng/ml at 2, 4 and 8 hours. Peak was 28.8 ng/ml at 2 hours, half-life 5 hours, estimated volume of distribution 243 liters, AUC 117 ng*h/ml
  • Thirty days after the 10th treatment, residual paclitaxel was 3.6 ng/g in the pleura and 13.3 ng/g in the pericardium
  • The dog was euthanized after 22 months because its clinical condition worsened
  • Two other dogs with mesothelioma given the same procedure arrived in advanced condition and died within 1 month of cardiopulmonary failure
• The authors' conclusion: The authors concluded that delivering paclitaxel-loaded microfragmented adipose tissue into the peritoneal and thoracic cavities was feasible and well tolerated in this dog. They described it as a novel approach and said further investigation is warranted.
• Limitations the authors state:
  • The authors stated that a much larger number of patients is needed to explain why the chest and abdominal cavities responded differently
  • The report covers a single case selected from more than one treated patient

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pericardial, Peritoneal Mesothelioma, Ultrasound.

Related studies

• Extracellular vesicles isolated from adipose tissue-derived mesenchymal stromal cells as carriers for Paclitaxel delivery — A. Marcianti, E. Spampinato, et al. (2025)
• Pathological Findings of Canine Idiopathic Pericarditis and Pericardial Mesotheliomas: Correlation with Clinical and Survival Data — M. Levi, F. Parenti, et al. (2021)
• Sarcopenia, Precardial Adipose Tissue and High Tumor Volume as Outcome Predictors in Surgically Treated Pleural Mesothelioma — O.G. Verhoek, L. Jungblut, et al. (2022)
• Intra-abdominal fat. Part III. Neoplasms lesions of the adipose tissue — A. Smereczyński, K. Kołaczyk, et al. (2016)
• Feasibility and safety of outpatient medical thoracoscopy at a large tertiary medical center: a collaborative medical-surgical initiative — Z.S. DePew, D. Wigle, et al. (2014)
• Unilateral pulmonary artery pre-operative occlusion test: technical feasibility and safety prior to pneumonectomy or pleuropneumonectomy for malignancy — M. Shimohira, T. Hashizume, et al. (2018)

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