Overview for Canine Stem Cell Therapy Market Helps in providing scope and definitions, Key Findings, Growth Drivers, and Various Dynamics.

Canine Stem Cell Therapy Market Data and Acquisition Research Study with Trends and Opportunities 2019-2024The study of Canine Stem Cell Therapy market is a compilation of the market of Canine Stem Cell Therapy broken down into its entirety on the basis of types, application, trends and opportunities, mergers and acquisitions, drivers and restraints, and a global outreach. The detailed study also offers a board interpretation of the Canine Stem Cell Therapy industry from a variety of data points that are collected through reputable and verified sources. Furthermore, the study sheds a lights on a market interpretations on a global scale which is further distributed through distribution channels, generated incomes sources and a marginalized market space where most trade occurs.

Along with a generalized market study, the report also consists of the risks that are often neglected when it comes to the Canine Stem Cell Therapy industry in a comprehensive manner. The study is also divided in an analytical space where the forecast is predicted through a primary and secondary research methodologies along with an in-house model.

Download PDF Sample of Canine Stem Cell Therapy Market report @ https://hongchunresearch.com/request-a-sample/112484

Key players in the global Canine Stem Cell Therapy market covered in Chapter 4:Aratana TherapeuticsOkyanosMagellan Stem CellsStem Cell VetVetStem BiopharmaMedregoRegeneus LtdMediVet BiologicCell Therapy Sciences

In Chapter 11 and 13.3, on the basis of types, the Canine Stem Cell Therapy market from 2015 to 2026 is primarily split into:Allogeneic Stem CellsAutologous Stem Cells

In Chapter 12 and 13.4, on the basis of applications, the Canine Stem Cell Therapy market from 2015 to 2026 covers:Veterinary HospitalsVeterinary ClinicsVeterinary Research Institutes

Geographically, the detailed analysis of consumption, revenue, market share and growth rate, historic and forecast (2015-2026) of the following regions are covered in Chapter 5, 6, 7, 8, 9, 10, 13:North America (Covered in Chapter 6 and 13)United StatesCanadaMexicoEurope (Covered in Chapter 7 and 13)GermanyUKFranceItalySpainRussiaOthersAsia-Pacific (Covered in Chapter 8 and 13)ChinaJapanSouth KoreaAustraliaIndiaSoutheast AsiaOthersMiddle East and Africa (Covered in Chapter 9 and 13)Saudi ArabiaUAEEgyptNigeriaSouth AfricaOthersSouth America (Covered in Chapter 10 and 13)BrazilArgentinaColumbiaChileOthersRegional scope can be customized

For a global outreach, the Canine Stem Cell Therapy study also classifies the market into a global distribution where key market demographics are established based on the majority of the market share. The following markets that are often considered for establishing a global outreach are North America, Europe, Asia, and the Rest of the World. Depending on the study, the following markets are often interchanged, added, or excluded as certain markets only adhere to certain products and needs.

Here is a short glance at what the study actually encompasses:Study includes strategic developments, latest product launches, regional growth markers and mergers & acquisitionsRevenue, cost price, capacity & utilizations, import/export rates and market shareForecast predictions are generated from analytical data sources and calculated through a series of in-house processes.

However, based on requirements, this report could be customized for specific regions and countries.

Brief about Canine Stem Cell Therapy Market Report with [emailprotected]https://hongchunresearch.com/report/canine-stem-cell-therapy-market-size-2020-112484

Some Point of Table of Content:

Chapter One: Report Overview

Chapter Two: Global Market Growth Trends

Chapter Three: Value Chain of Canine Stem Cell Therapy Market

Chapter Four: Players Profiles

Chapter Five: Global Canine Stem Cell Therapy Market Analysis by Regions

Chapter Six: North America Canine Stem Cell Therapy Market Analysis by Countries

Chapter Seven: Europe Canine Stem Cell Therapy Market Analysis by Countries

Chapter Eight: Asia-Pacific Canine Stem Cell Therapy Market Analysis by Countries

Chapter Nine: Middle East and Africa Canine Stem Cell Therapy Market Analysis by Countries

Chapter Ten: South America Canine Stem Cell Therapy Market Analysis by Countries

Chapter Eleven: Global Canine Stem Cell Therapy Market Segment by Types

Chapter Twelve: Global Canine Stem Cell Therapy Market Segment by Applications 12.1 Global Canine Stem Cell Therapy Sales, Revenue and Market Share by Applications (2015-2020) 12.1.1 Global Canine Stem Cell Therapy Sales and Market Share by Applications (2015-2020) 12.1.2 Global Canine Stem Cell Therapy Revenue and Market Share by Applications (2015-2020) 12.2 Veterinary Hospitals Sales, Revenue and Growth Rate (2015-2020) 12.3 Veterinary Clinics Sales, Revenue and Growth Rate (2015-2020) 12.4 Veterinary Research Institutes Sales, Revenue and Growth Rate (2015-2020)

Chapter Thirteen: Canine Stem Cell Therapy Market Forecast by Regions (2020-2026) continued

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List of tablesList of Tables and Figures Table Global Canine Stem Cell Therapy Market Size Growth Rate by Type (2020-2026) Figure Global Canine Stem Cell Therapy Market Share by Type in 2019 & 2026 Figure Allogeneic Stem Cells Features Figure Autologous Stem Cells Features Table Global Canine Stem Cell Therapy Market Size Growth by Application (2020-2026) Figure Global Canine Stem Cell Therapy Market Share by Application in 2019 & 2026 Figure Veterinary Hospitals Description Figure Veterinary Clinics Description Figure Veterinary Research Institutes Description Figure Global COVID-19 Status Overview Table Influence of COVID-19 Outbreak on Canine Stem Cell Therapy Industry Development Table SWOT Analysis Figure Porters Five Forces Analysis Figure Global Canine Stem Cell Therapy Market Size and Growth Rate 2015-2026 Table Industry News Table Industry Policies Figure Value Chain Status of Canine Stem Cell Therapy Figure Production Process of Canine Stem Cell Therapy Figure Manufacturing Cost Structure of Canine Stem Cell Therapy Figure Major Company Analysis (by Business Distribution Base, by Product Type) Table Downstream Major Customer Analysis (by Region) Table Aratana Therapeutics Profile Table Aratana Therapeutics Production, Value, Price, Gross Margin 2015-2020 Table Okyanos Profile Table Okyanos Production, Value, Price, Gross Margin 2015-2020 Table Magellan Stem Cells Profile Table Magellan Stem Cells Production, Value, Price, Gross Margin 2015-2020 Table Stem Cell Vet Profile Table Stem Cell Vet Production, Value, Price, Gross Margin 2015-2020 Table VetStem Biopharma Profile Table VetStem Biopharma Production, Value, Price, Gross Margin 2015-2020 Table Medrego Profile Table Medrego Production, Value, Price, Gross Margin 2015-2020 Table Regeneus Ltd Profile Table Regeneus Ltd Production, Value, Price, Gross Margin 2015-2020 Table MediVet Biologic Profile Table MediVet Biologic Production, Value, Price, Gross Margin 2015-2020 Table Cell Therapy Sciences Profile Table Cell Therapy Sciences Production, Value, Price, Gross Margin 2015-2020 Figure Global Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Global Canine Stem Cell Therapy Revenue ($) and Growth (2015-2020) Table Global Canine Stem Cell Therapy Sales by Regions (2015-2020) Table Global Canine Stem Cell Therapy Sales Market Share by Regions (2015-2020) Table Global Canine Stem Cell Therapy Revenue ($) by Regions (2015-2020) Table Global Canine Stem Cell Therapy Revenue Market Share by Regions (2015-2020) Table Global Canine Stem Cell Therapy Revenue Market Share by Regions in 2015 Table Global Canine Stem Cell Therapy Revenue Market Share by Regions in 2019 Figure North America Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Europe Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Asia-Pacific Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Middle East and Africa Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure South America Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure North America Canine Stem Cell Therapy Revenue ($) and Growth (2015-2020) Table North America Canine Stem Cell Therapy Sales by Countries (2015-2020) Table North America Canine Stem Cell Therapy Sales Market Share by Countries (2015-2020) Figure North America Canine Stem Cell Therapy Sales Market Share by Countries in 2015 Figure North America Canine Stem Cell Therapy Sales Market Share by Countries in 2019 Table North America Canine Stem Cell Therapy Revenue ($) by Countries (2015-2020) Table North America Canine Stem Cell Therapy Revenue Market Share by Countries (2015-2020) Figure North America Canine Stem Cell Therapy Revenue Market Share by Countries in 2015 Figure North America Canine Stem Cell Therapy Revenue Market Share by Countries in 2019 Figure United States Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Canada Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Mexico Canine Stem Cell Therapy Sales and Growth (2015-2020) Figure Europe Canine Stem Cell Therapy Revenue ($) Growth (2015-2020) Table Europe Canine Stem Cell Therapy Sales by Countries (2015-2020) Table Europe Canine Stem Cell Therapy Sales Market Share by Countries (2015-2020) Figure Europe Canine Stem Cell Therapy Sales Market Share by Countries in 2015 Figure Europe Canine Stem Cell Therapy Sales Market Share by Countries in 2019 Table Europe Canine Stem Cell Therapy Revenue ($) by Countries (2015-2020) Table Europe Canine Stem Cell Therapy Revenue Market Share by Countries (2015-2020) Figure Europe Canine Stem Cell Therapy Revenue Market Share by Countries in 2015 Figure Europe Canine Stem Cell Therapy Revenue Market Share by Countries in 2019 Figure Germany Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure UK Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure France Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Italy Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Spain Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Russia Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Asia-Pacific Canine Stem Cell Therapy Revenue ($) and Growth (2015-2020) Table Asia-Pacific Canine Stem Cell Therapy Sales by Countries (2015-2020) Table Asia-Pacific Canine Stem Cell Therapy Sales Market Share by Countries (2015-2020) Figure Asia-Pacific Canine Stem Cell Therapy Sales Market Share by Countries in 2015 Figure Asia-Pacific Canine Stem Cell Therapy Sales Market Share by Countries in 2019 Table Asia-Pacific Canine Stem Cell Therapy Revenue ($) by Countries (2015-2020) Table Asia-Pacific Canine Stem Cell Therapy Revenue Market Share by Countries (2015-2020) Figure Asia-Pacific Canine Stem Cell Therapy Revenue Market Share by Countries in 2015 Figure Asia-Pacific Canine Stem Cell Therapy Revenue Market Share by Countries in 2019 Figure China Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Japan Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure South Korea Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Australia Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure India Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Southeast Asia Canine Stem Cell Therapy Sales and Growth Rate (2015-2020) Figure Middle East and Africa Canine Stem Cell Therapy Revenue ($) and Growth (2015-2020) continued

About HongChun Research: HongChun Research main aim is to assist our clients in order to give a detailed perspective on the current market trends and build long-lasting connections with our clientele. Our studies are designed to provide solid quantitative facts combined with strategic industrial insights that are acquired from proprietary sources and an in-house model.

Contact Details: Jennifer GrayManager Global Sales+ 852 8170 0792[emailprotected]

NOTE: Our report does take into account the impact of coronavirus pandemic and dedicates qualitative as well as quantitative sections of information within the report that emphasizes the impact of COVID-19.

As this pandemic is ongoing and leading to dynamic shifts in stocks and businesses worldwide, we take into account the current condition and forecast the market data taking into consideration the micro and macroeconomic factors that will be affected by the pandemic.

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Canine Stem Cell Therapy Market Analysis by Size, Share, Trends, Growth, Segmentation, Key Manufacturers, Revenue, Global Industry Demand and Forecast...

Keeping track of all thats going on with clinical trials in the sector and on the ASX can be tricky. Until now.

As life sciences investors know, clinical research is what drives success or failure for biopharmaceutical companies.

Welcome to Stockheads inaugural clinical trials tracker an effort to list the clinical trials underway and planned in the near term for nearly every ASX-listed life sciences company.

Last week, we published all the trials under way or proposed for 2021.

As a small-cap publication, weve excluded research by CSL (ASX:CSL) from this tracker. Readers interested in the 25 different clinical trials underway by the $122 billion blood products giant can find a list here.

We also dont include pre-clinical research such as that conducted on animals or human cells in a test tube (in vivo and in vitro tests).

Today, for those who like a longer view, weve pulled together the best idea we can of those trials slated for 2022-2025.

Heres your look into our medical future.

Clinical Trials Tracker: First-quarter 2022

Noxopharm (ASX:NOX) interim results from the DARRT-2 phase 2 study evaluating escalating doses of Noxopharms Veyonda suppository in conjunction with radiotherapy to induce an anti-cancer immunological response in 100 to 150 cancer patients.

Second-quarter 2022

Hexima (ASX:HXL) Phase 2b clinical trial testing its plant defensin peptide HXP-124 in 132 Australian and New Zealand patients with toenail fungal infections (onychomycosis). Coronavirus travel restrictions have delayed enrollment in the trial, with results are now expected in the second quarter of next year. Hexima listed in December 2020.

2022

AdAlta (ASX:1AD) phase 1 clinical trial testing the Melbourne biotechs AD-214 drug candidate which mimics a protein first found in sharks in about 98 patients with interstitial lung disease. Dosing of 34 healthy volunteers finished in December.

Ecofibre (ASX:EOF) phase 2 Coala-T-CBD study, testing the effect of CBD gelcaps on up 100 patients suffering from chemotherapy-induced peripheral neuropathy (CIPN), a painful common side effect from the cancer treatment. Ecofibre says the research, being conducted at the Lankenau Institute for Medical Research in Philadelphia, USA, is the first in the United States to study the impact of hemp-derived full-spectrum CBD on CIPN.

Pharmaxis (ASX:PXS) phase 1/2 clinical trial evaluating the companys drug candidate PXS-5505 in the treatment of 24 patients with myelofibrosis, a bone marrow cancer.

Telix Pharmaceuticals (ASX:TLX) phase 2 trial evaluating if Telixs diagnostic research agent can show prostate cancer on a PET/CT scan even when PSA levels are very low.

Late 2022

Kazia Therapeutics (ASX:KZA) phase 1 trial assessing its paxalisib in combination with radiation therapy in 36 patients with solid brain tumours.

Clinical Trials Tracker: 2022/2023

Kazia Results from the paxalisib arm of GBM AGILE study, which is assessing new therapies for the aggressive brain cancer glioblastoma. Up to 200 patients will be treated with paxalisib, and these will be compared to a roughly similar number of patients in a control group. Kazia said in January 2021 that the enrollment was expected to last 30 to 36 months, although the study could conclude earlier.

First-quarter 2023

Paradigm Biopharmaceuticals (ASX:PAR) phase 3 study evaluating Zilosul in patients with osteoarthritis. The study will recruit from up to 55 sites in the USA and up to 10 in Australia.

Clinical Trials Tracker: 2023

Chimeric Therapeutics (ASX:CHM) phase 1 dose escalation study of the newly listed CAR T companys cell study in approximately 18 patients with glioblastoma, an aggressive brain tumour.

Cynata Therapeutics (ASX:CYP) phase 3 SCUlpTOR clinical trial evaluating Cynatas CYP-004 stem cell infusion in up to 440 Australian patients with osteoarthritis of the knee.

Late 2023

Mesoblast (ASX:MSB) phase 1b/2a study testing remestemcel-L stem cell infusions in 24 patients with Crohns colitis.

Clinical Trials Tracker: 2024

Kazia St Jude Childrens Research Hospital phase 1 study testing Kazias GDC-0084 drug in 27 pediatric patients with a high-grade brain tumour known as a diffuse intrinsic pontine glioma.

Clinical Trials Tracker: 2025

Kazia phase 2 study testing Kazias PI3K inhibitor GDC-0084 in 150 patients with solid tumors that have spread to the brain.

Telix Phase 2 trial evaluating the effectiveness of a PET/CT scan using fluciclovine in planning radiation therapy for patients with prostate cancer.

Clinical Trials Tracker: Studies planned to begin in 2021

Actinogen Medical (ASX:ACW) said in December it was planning to commence two phase 2 trials in the first half of 2021, testing Xanamem to treat mild cognitive impairment due to Alzheimers disease and anxiety, sleep and behavioral problems in adolescents with Selected Fragile X syndrome. The companys lead compound, Xamamem blocks the production of a stress hormone in the brain.

Alterity Therapeutics (ASX:ATH)said in October it was working towards a phase 2 clinical trial evaluating its lead compound in the treatment of Multiple System Atrophy, a neurodegenerative disease similar to Parkinsons.

Antara Lifesciences (ASX:ANR) said in December it is planning a study evaluating its colon-targeted formulation in adults with depression or anxiety.

Auscann (ASX:AC8) says an investigator-led phase 2a study into its hard-shell cannabis capsules to treat chronic neuropathic pain is expected to begin in the second quarter of 2021.

Botanix Pharmaceuticals (ASX:BOT) has a phase 3 study planned into its BTX 1503 antimicrobial synthetic cannabis formulation to treat moderate to severe acne. The medical marijuana company has met with the FDA over the design of the study and says it is poised to begin once COVID-19 restrictions are lifted in Australia and New Zealand.

Botanix also said in December it plans to begin in the near future a phase 1b study evaluating its antimicrobial gel to treat rosacea, an inflammatory skin condition.

Dimerix (ASX:DXB) is planning for a phase 3 study of its drug candidate DMX-200 to treat a rare kidney disease known as focal segmental glomerulosclerosis, or FSGS. The trial is scheduled begin in the first half of 2021, with interim data due next year, and the results could form the basis of a new drug approval submission.

Immuron (ASX:IMC) has two clinical trials planned to evaluate the efficacy of its drug in moderate to severe campylobacteriosis and infectious diarrhea caused by e.coli bacteria.

Incannex Healthcare (ASX:IHL) in December announced it was partnering with Monash University to conduct a world-first trial testing magic mushrooms, or psilocybin, to treat generalised anxiety disorder in 72 patients.

Invex Therapeutics (ASX:IXC) said in December it was planning a phase 3 study investigating the diabetes drug Exenatide to treat raised intracranial pressure, a condition that can cause debilitating headaches. The treatment passed a phase 2 clinical trial last year.

Medlab Clinical (ASX:MDC) is preparing for a phase 3 trial to study the use of its cannabis-based NanBis formulation to treat cancer-induced bone pain, and expects to begin recruitment this year.

MGC Pharma (ASX:MXC) said in December it was evaluating holding a phase 3 trial testing the use of its ArtemiC anti-inflammatory treatment, following a successful phase 2 trial.

Neurotech (ASX:NTI) plans in the first quarter of 2021 to begin phase 1 clinical trials evaluating compounds from its novel Dolce/NTI strains of hemp to treat neurological disorders.

Neuroscientific Biopharmaceuticals (ASX:NSB) has said it plans this year to begin two phase 1 studies evaluating its regenerative peptide, EmtinB, in both ocular and neurology conditions.

Noxopharm announced in November it was partnering with Bristol Myers Squibb (NYSE:BMY) to test its Veyonda suppository in conjunction with Bristol Myers nivolumab in 30 cancer patients. The first patients will be recruited early this year for the IONIC-1 study, but theres been no word on how long it will last.

Opthea (ASX:OPT) plans to begin two phase 3 trials in early 2021 assessing OPT-302 to treat wet age-related mascular degeneration. Each trials will enroll at least 900 patients worldwide and follow them for two years, so would presumably read out in 2023.

Patrys (ASX:PAB) said in November it expects to begin a phase 1 clinical trial into its PAT-DX1 anticancer antibody drug candidate in the first half of 2022.

PharmAust (ASX:PAA) said in December that in October 2021 it would begin a phase 1/2 clinical trial evaluating the use of monepantel to treat motor neuron diseases such as Lou Gehrigs disease/ALS.

Race Oncology (ASX:RAC) is investigating the cost and scope of a proof of concept phase 1/2 clinical trial testing its flagship drug Bisantrene in combination with the chemotherapy drug cyclophosphamide.

Vectus Biosystems (ASX:VBS) said in November it had hired Syneos Health (NASDAQ:SYNH) to conduct a phase 1 safety study of its VB0004 drug candidate to treat fibrosis.

At Stockhead we tell it like it is. While Dimerix, Neuroscientific, Neurotech and Incannex are Stockhead advertisers, they did not sponsor this article.

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Clinical Trials Tracker: 2022 and beyond - Stockhead

Life for Miro, a 5-year-old German shepherd, has been what his owner describes as an emotional roller coaster over the past two years. Several peaks and valleys have dotted his metaphorical landscape as he has gone from premiere fitness to dealing with injuries and disease. But a clinical trial at the UC Davis veterinary hospital may have put him back on a positive track.

Working as a patrol dog with his handler/owner Martin Gilbertson, a ranger with California State Parks, Miro spent three years performing duties that required him to be at the top of his game. In early 2019, he was just that, having won the top dog award for his department.

By that summer, however, things started declining for Miro. He was diagnosed with lumbosacral intervertebral disc disease that caused spinal cord compression. UC Davis veterinary neurosurgeons performed a surgical decompression, and Miro eventually recovered after a lengthy recuperation period.

Miro with his handler Martin Gilbertson

Life was great, said Gilbertson. By early December 2019, Miro was cleared to return to work. I thought all the troubles were behind us.

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It only took a few weeks, though, until the roller coaster cleared a peak and started to descend.

In late December 2019, Miro collapsed for no apparent reason and started shaking in a way Gilbertson had never seen. So, the pair returned to UC Davis where Miro was diagnosed with myasthenia gravis, a disease in which there is a malfunction in the transmission of signals between the nerves and muscles. This causes muscle weakness, and an inability to walk or run properly, as well as potentially devastating neuromuscular disorders.

Gilbertson was devastated.

To go from the pinnacle of our profession to potentially being a couch potato at best for the rest of his life was a real gut check, he said.

But hope appeared a few weeks later when Neurology/Neurosurgery Service faculty members Drs. Pete Dickinson and Bev Sturges informed Gilbertson of a myasthenia gravis clinical trial they were beginning with the help of the schools Center for Companion Animal Health (CCAH) and the Veterinary Institute for Regenerative Cures.

I thought, What do we have to lose? stated Gilbertson. Dr. Dickinson told me that Miro would be the first dog to ever receive this new treatment. We were excited and grateful to be able to participate.

A computer program shows Miro's stride pattern on the Tekscan Strideway pressure walkway.

Over the next few months, Miro received three stem cell treatments, as well as traditional medications to treat myasthenia gravis. Additionally, part of Miros recovery involved examining his gait, which utilized a new piece of equipment aimed at better analyzing a dogs stride pattern. Thanks to CCAH funding, the school recently acquired a Tekscan Strideway pressure walkway that allows clinicians and researchers to better gauge a patients step pattern and make decisions about their optimal care and recovery. To fully understand a patients gait abnormalities associated with injuries or neuromuscular diseases, veterinarians and researchers rely on objective, quantitative ways to assess locomotor function. The Strideway system complements the force plates in the schools J.D. Wheat Veterinary Orthopedic Research Laboratory, which captures extensive information, but only for one gait step. The new pressure walkway expands the capabilities to quantify pressure, vertical force, and stride parameters (timing and spacing) on all limbs for several strides during walking, trotting or landing. Miros progress was able to be tracked with pinpoint accuracy throughout his recovery.

Before the trial, Miro could only walk about 10 steps before falling down. After the trial, he seemed fully recovered, and blood tests revealed no trace of antibodies to the disease. While the disease may not be completely gone from his system, the clinical trial seems to have repressed the disease to a point where it no longer inhibits Miro from his normal activities. Retired from his job, Miro now enjoys life as a family pet.

It is true that Miro is now in remission, but until more analysis of data is completed, it is still too early to determine if the stem cells were the driving force behind his recovery, since they were administered at the same time as standard-of-care medications. Miros results are being closely examined, along with the results of two other dogs that have completed the trial, to see if this stem cells treatment truly can be considered a cure for myasthenia gravis. Regardless of the final outcome of the study, Miros recovery, in one way or another, came from a novel combination of treatments pioneered at UC Davis.

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Novel Treatment Leads to Dog's Recovery - The Bark

Articles OnMS Alternative and Complementary Therapies MS Alternative and Complementary Therapies MS Alternative and Complementary Therapies - Stem Cell Therapies for MS

Multiple sclerosis (MS) is an autoimmune disease. Your immune system attacks your central nervous system and damages your nerve fibers. That makes it hard for your brain to "talk" with the rest of your body and causes symptoms like weakness, tingling or numbness in your limbs, trouble speaking, chronic pain, depression, and vision loss.

Several medications are used to treat MS. They can cause serious side effects, and over time, they can stop working for some people. But a new treatment involving stem cells may work for people who have relapsing-remitting MS (RRMS) and haven't been helped by other medicines.

With RRMS, you'll have no symptoms or very mild ones for a periodof time. Then you'll have severe symptoms, which is called a relapse, for a short while. RRMS eventually can turn into another form of the disease, where your symptoms don't ever go away.

Stem cells can turn into different kinds of cells in your body. Hematopoietic stem cells make blood cells. Some doctors use a type of stem cell treatment called hematopoietic stem cell transplantation (HSCT) to treat RRMS. But more research is needed to know how well HSCT works against it.

With HSCT, doctors give you medication to help you make more bone marrow stem cells. Then they take some blood and save the stem cells from it to use later. You'll next get high doses of chemotherapy and other strong medications to severely slow down your immune system. This is done in a hospital, and you may need to stay there up to 11 days.

Your doctor puts the stem cells into your bloodstream so they can become new white blood cells and help your body build a new, healthy immune system. You'll also get medicines like antibiotics to help fight off infections and other illnesses until your immune system can do its job again.

Treatment usually takes several weeks. Recovery may take several months. Every person is different, but when treatment is successful, your immune system should be back to full strength in 3 to 6 months.

HSCT doesn't work for everyone with MS. Most people who get it are taking part in research studies called clinical trials that test if a treatment or medication is safe and effective.

One trial of 24 people with RRMS found that 69% who had stem cell therapy didn't have a relapse in MS symptoms or new brain lesions, which are caused by MS, 5 years after treatment.

Scientists are also looking for other ways to use stem cells to treat the disease.

Stem cell therapy has serious risks. During HSCT, your immune system isn't at full strength. That raises your chances of getting an infection.

A weak immune system also ups your odds of kidney, lung, or gastrointestinal (gut) problems as well assepsis, a serious and potentially deadly reaction to an infection. That's why some experts say more research needs to be done before stem cell therapy becomes a standard treatment for MS.

No. It's still considered experimental. Some clinics in other countries use HSCT for MS. But only a few medical centers in the U.S. offer it, and only for people who meet certain requirements.

For example, you might be a candidate if you have highly inflammatory RRMS. That means you've had serious MS relapses and your symptoms have gotten worse quickly because other treatments haven't helped. You probably will need to have had MS for 10 years or less and be able to walk.

Ask your doctor about clinical trials that are testing HSCT. These trials are a way for people to try new medicines that aren't available to everyone. They can tell you if one of them might be a good fit for you.

SOURCES:

National Institutes of Health: "Stem Cell Transplant Induces Multiple Sclerosis Transmission," "What Are Clinical Trials?"

National Multiple Sclerosis Society: "Stem Cells Hold Promise for MS," "FAQ about HSCT (Hematopoietic Stem Cell Therapy) in MS."

Tisch MS Research Center of New York: "FDA Advises Tisch MS Research Center to March On: Preparation to Begin For Phase II of Stem Cell Trial For MS."

Health News from NHS Choices: "Risky Stem Cell Treatment 'Halts Progress of Multiple Sclerosis.'"

Multiple Sclerosis News Today: "HSCT for MS From the Inside: A Patient's View."

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Stem Cell Therapy for Multiple Sclerosis (MS) Treatment

By Amy Norton HealthDay Reporter

THURSDAY, Jan. 21, 2021 (HealthDay News) -- Stem cell transplants may have long-lasting benefits for some people with aggressive cases of multiple sclerosis, a new study suggests.

Italian researchers found that among 210 multiple sclerosis (MS) patients who received a stem cell transplant -- with cells from their own blood -- two-thirds saw no worsening in their disability 10 years out.

That included 71% of patients with relapsing-remitting MS, the most common form of the disease.

The sustained level of effectiveness is "pretty dramatic," said Bruce Bebo, executive vice-president of research programs for the National Multiple Sclerosis Society.

At the same time, there are important caveats, said Bebo, who was not involved in the study.

For one, the patients were not part of a clinical trial that directly tested stem cell transplants against standard MS medications. They all underwent transplants at various Italian medical centers between 1997 and 2019.

So it's unclear exactly how such transplants measure up against the most effective MS drugs now available.

Beyond that, Bebo said there are ongoing questions about which MS patients are the best candidates for a transplant, and the optimal timing for it.

Those are no small matters, since a stem cell transplant is a major undertaking, he pointed out.

"And it's not reversible, like a medication you can change when it's not working," Bebo said.

MS is a neurological disorder caused by a misguided immune system attack on the body's own myelin -- the protective sheath around nerve fibers in the spine and brain. That leads to symptoms such as vision problems, muscle weakness, numbness, and difficulty with balance and coordination.

About 85% of people with MS initially have the relapsing-remitting form, according to the MS society. That means symptoms flare for a time and then ease. Most people, though, eventually transition to a progressive form of the disease, and their disability worsens over time.

Why treat MS with a stem cell transplant? Stem cells from the bone marrow are the building blocks of the immune system, and the goal of the transplant is to "reboot" the faulty immune system, Bebo explained.

The procedure involves removing stem cells from a patient's own blood, then using powerful chemotherapy drugs to knock down the existing immune system.

After that, the stored stem cells are infused back into the patient, and the immune system rebuilds itself over time.

It requires a long hospital stay, plus a period of months when patients are severely immunocompromised, Bebo said.

In the current study, three patients died after their transplant, though none occurred after 2007.

"This is important evidence," said Dr. Alexander Rae-Grant, a neurologist and fellow of the American Academy of Neurology. "But it doesn't prove [stem cell transplant] is better than the standard treatments we currently have."

Still, Rae-Grant said, the longer-term data do offer some reassurance on the safety of the procedure for MS patients, and additional evidence that it is "a reasonable approach."

Like Bebo, he pointed to the bigger-picture issue: When is it best to try a stem cell transplant?

Right now, Rae-Grant said, the general thinking is that the approach may be best for patients with relapsing-remitting MS who are relatively young and have "very active" disease despite medication.

The trick, according to Rae-Grant, is to strike a balance: Doctors would not want to be overly aggressive in using stem cell transplants, but would also want to intervene early enough to forestall disability as much as possible.

Clinical trials, including one in the United States called BEAT-MS, are underway to directly test stem cell transplant against the most effective MS medications.

Ideally, eligible patients would get into a clinical trial, said Dr. Matilde Inglese, one of the researchers on the current study.

Otherwise, they should consult one of the small number of medical centers with extensive experience in using the procedure for MS, said Inglese, head of the Multiple Sclerosis Center at the University of Genoa, in Italy.

Bebo stressed that point. This is not, he said, an undertaking that can be done at self-described "stem cell clinics" that advertise their services for various conditions.

Even when done at a reputable medical center, other issues loom, including cost.

Bebo said he's seen figures in the $150,000 to $250,000 range, and people may or may not be able to get their insurance to cover it.

The findings were published online Jan. 20 in Neurology.

More information

The National Multiple Sclerosis Society has more on stem cell transplants for MS.

SOURCES: Matilde Inglese, MD, PhD, head, Multiple Sclerosis Center, University of Genoa, Italy, and adjunct professor, neurology, Icahn School of Medicine at Mount Sinai, New York City; Bruce Bebo, PhD, executive vice-president, research programs, National Multiple Sclerosis Society, New York City; Alexander Rae-Grant, MD, fellow, American Academy of Neurology, Minneapolis; Neurology, Jan. 20, 2021, online

WebMD News from HealthDay

Pagination

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Stem Cell Therapy: A Breakthrough Against MS?

The Canine Stem Cell Therapy Market size was valued at US$ 118.5 Mn in 2018 and is expected to grow at a CAGR of 9.3% for the forecast period ending 2026 reaching a Market value of US$ 240.7 Mn. The Canine Stem Cell Therapy Market report provides a competitive analysis mainly focusing on key players and participants of Canine Stem Cell Therapy Industry consist with in-depth data related to the competitive landscape, market positioning, business profiles, key strategies adopted, and product-profiling, etc. to get a clear idea of market growth and potential.

The Canine Stem Cell Therapy market report is a comprehensive study of various trends and affecting factors of the Canine Stem Cell Therapy Industry. These variables have helped decide the behavior of the market during the forecast period of 2021-2026 and empowered our specialists to make effective and precise predictions about the market future. The primary data for Canine Stem Cell Therapy Market has been collected from multiple trustworthy sources like journals, websites, white papers, annual reports of the businesses, and mergers. to form better decisions, generate maximum revenue, and enhance business profit, this market research report may be a great solution. This study helps to provides a detailed overview of the present scenario of the global market, latest updates, product launches, joint ventures, capacity, production value, mergers, and acquisitions supported several market dynamics.

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The report specifically highlights the market share, company profiles, regional outlook, product portfolio, a record of the recent developments, strategic analysis, key players in the market, sales, distribution chain, manufacturing, production, new market entrants as well as existing market players, advertising, brand value, popular products, demand and supply, and other important factors related to the market to help the new entrants understand the market scenario better.

Major Key Players Covered in Report are:

Canine Stem Cell Therapy Market Segmentation by Type:

Canine Stem Cell Therapy Market Segmentation by Application:

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Canine Stem Cell Therapy Market Segmentation by Region:

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Canine Stem Cell Therapy Market research report is the new statistical data source added by A2Z Market Research.

Canine Stem Cell Therapy Market is growing at a High CAGR during the forecast period 2021-2027. The increasing interest of the individuals in this industry is that the major reason for the expansion of this market.

Canine Stem Cell Therapy Market research is an intelligence report with meticulous efforts undertaken to study the right and valuable information. The data which has been looked upon is done considering both, the existing top players and the upcoming competitors. Business strategies of the key players and the new entering market industries are studied in detail. Well explained SWOT analysis, revenue share and contact information are shared in this report analysis.

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Top Key Players Profiled in this report are:

Aratana Therapeutics, Okyanos, Magellan Stem Cells, Stem Cell Vet, VetStem Biopharma, Medrego, Regeneus Ltd, MediVet Biologic, Cell Therapy Sciences.

The key questions answered in this report:

Various factors are responsible for the markets growth trajectory, which are studied at length in the report. In addition, the report lists down the restraints that are posing threat to the global Canine Stem Cell Therapy market. It also gauges the bargaining power of suppliers and buyers, threat from new entrants and product substitute, and the degree of competition prevailing in the market. The influence of the latest government guidelines is also analyzed in detail in the report. It studies the Canine Stem Cell Therapy markets trajectory between forecast periods.

Global Canine Stem Cell Therapy Market Segmentation:

Market Segmentation: By Type

Allogeneic Stem CellsAutologous Stem Cells

Market Segmentation: By Application

Veterinary HospitalsVeterinary ClinicsVeterinary Research Institutes

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Regions Covered in the Global Canine Stem Cell Therapy Market Report 2021: The Middle East and Africa (GCC Countries and Egypt) North America (the United States, Mexico, and Canada) South America (Brazil etc.) Europe (Turkey, Germany, Russia UK, Italy, France, etc.) Asia-Pacific (Vietnam, China, Malaysia, Japan, Philippines, Korea, Thailand, India, Indonesia, and Australia)

The cost analysis of the Global Canine Stem Cell Therapy Market has been performed while keeping in view manufacturing expenses, labor cost, and raw materials and their market concentration rate, suppliers, and price trend. Other factors such as Supply chain, downstream buyers, and sourcing strategy have been assessed to provide a complete and in-depth view of the market. Buyers of the report will also be exposed to a study on market positioning with factors such as target client, brand strategy, and price strategy taken into consideration.

The report provides insights on the following pointers:

Market Penetration: Comprehensive information on the product portfolios of the top players in the Canine Stem Cell Therapy market.

Product Development/Innovation: Detailed insights on the upcoming technologies, R&D activities, and product launches in the market.

Competitive Assessment: In-depth assessment of the market strategies, geographic and business segments of the leading players in the market.

Market Development: Comprehensive information about emerging markets. This report analyzes the market for various segments across geographies.

Market Diversification: Exhaustive information about new products, untapped geographies, recent developments, and investments in the Canine Stem Cell Therapy market.

Table of Contents

Global Canine Stem Cell Therapy Market Research Report 2021 2027

Chapter 1 Canine Stem Cell Therapy Market Overview

Chapter 2 Global Economic Impact on Industry

Chapter 3 Global Market Competition by Manufacturers

Chapter 4 Global Production, Revenue (Value) by Region

Chapter 5 Global Supply (Production), Consumption, Export, Import by Regions

Chapter 6 Global Production, Revenue (Value), Price Trend by Type

Chapter 7 Global Market Analysis by Application

Chapter 8 Manufacturing Cost Analysis

Chapter 9 Industrial Chain, Sourcing Strategy and Downstream Buyers

Chapter 10 Marketing Strategy Analysis, Distributors/Traders

Chapter 11 Market Effect Factors Analysis

Chapter 12 Global Canine Stem Cell Therapy Market Forecast

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The report on Canine Stem Cell Therapy, gives an in-depth analysis of Global Canine Stem Cell Therapy Market based on aspects that are very important for the market study. Factors like production, market share, revenue rate, regions and key players define a market study start to end. This report gives an overview of market valued in the year 2021 and its growth in the coming years till 2027. The report is based on the in-depth view of Canine Stem Cell Therapy industry on the basis of market growth, market size, development plans and opportunities offered by the global Canine Stem Cell Therapy market. The energetic aspects studied in this report include SWOT analysis, feasibility and forecast information.

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For the consumers to gain the in-depth analysis of the global Canine Stem Cell Therapy market and further growth of the market, the report offers significant statistics and information. Canine Stem Cell Therapy report studies the current state of the market to analyze the future opportunities and risks. Canine Stem Cell Therapy report provides a 360-degree global market state. Primarily, the report delivers Canine Stem Cell Therapy introduction, overview, market objectives, market definition, scope, and market size valuation.

Major companies of this report:

Aratana TherapeuticsMediVet BiologicStem Cell VetOkyanosCell Therapy SciencesRegeneus LtdMedregoVetStem BiopharmaMagellan Stem Cells

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Canine Stem Cell Therapy Market Segmentation by Type:

Allogeneic Stem CellsAutologous Stem Cells

Canine Stem Cell Therapy Market Segmentation by Application:

Veterinary HospitalsVeterinary ClinicsVeterinary Research Institutes

In addition, the report include deep dive analysis of the market, which is one of the most important features of the market. Furthermore, the need for making an impact is likely to boost the demand for the experts which are working in the market. Moreover, an in depth analysis of the competitors is also done to have an estimate for the market. The Canine Stem Cell Therapy market has its impact all over the globe. On global level Canine Stem Cell Therapy industry is segmented on the basis of product type, applications, and regions. It also focusses on market dynamics, Canine Stem Cell Therapy growth drivers, developing market segments and the market growth curve is offered based on past, present and future market data. The industry plans, news, and policies are presented at a global and regional level.

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Canine Stem Cell Therapy Market (Based on 2020 COVID-19 Worldwide Spread) 2021 Industry Analysis, Trends, and Forecast 2027:Aratana Therapeutics,...

An illustration of the equine musculoskeletal diseases discussed in the just-published review and the harvest sites for bone marrow (from the sternum), adipose tissue (from the tail head) and blood (from the jugular vein) for mesenchymal stem cell (MSC) isolation, respectively, for platelet-rich plasma (PRP) and autologous conditioned serum (ACS) preparation. Image: https://doi.org/10.3390/ani11010234

More studies using regenerative medicine in a bid to improve the welfare of laminitic horses can be expected, according to the authors of a just-published review.

Regenerative therapies in the field of laminitis have gained more interest in recent years, Iris Ribitsch, Gil Lola Oreff, and Florien Jenner noted in their paper in the open-access journal Animals.

The common and painful hoof condition can occur due to any number of systemic or local insults, in either an acute or chronic form. The prognosis depends on the initiating cause and is generally favourable to poor.

Current treatment options are mainly limited to pain management, cryotherapy, hoof support, and, depending on the cause, treatment of the underlying disease.

Since no curative treatment is available, high hopes are pinned on new regenerative treatment strategies, the trio, from the University of Veterinary Medicine Vienna, noted in their review exploring the use of regenerative medicine for equine musculoskeletal diseases.

They described the use of mesenchymal stem cells (MSCs) in one study in an attempt to regulate the severity of the inflammatory response in the hoof.

Nine horses with chronic laminitis were injected three times with MSCs suspended in platelet-rich plasma through the palmar digital veins.

All horses in the study had been treated previously with conventional laminitis treatments without much success. MSCs derived from the patient, as well as other horses, were used without any complications.

In the long term, a significant improvement could be noted in vascularity, structure, and function of the hoof.

The review team noted that the distribution of MSCs injected into the lower limb might be improved by using different injection methods, such as into an artery rather than into a vein, potentially improving the therapeutic benefit.

Platelet-rich plasma, which contains high levels of growth factors and anti-inflammatory factors, can aid in regulating inflammation, decreasing pain and assist with the development of new blood vessels.

Due to those abilities, it has also been proposed as a therapeutic option for chronic laminitis.

Although the literature reporting treatment of laminitis with platelet-rich plasma is limited to case reports, the results are encouraging, Ribitsch and her colleagues noted.

Chronic laminitis patients reportedly showed improvement in comfort and hoof conformation after injection of platelet-rich plasma through the coronary band.

The trio noted that lameness caused by musculoskeletal disease is the most common diagnosis in equine veterinary practice.

Many of these orthopaedic disorders are chronic problems, for which no clinically satisfactory treatment exists.

Thus, there are high hopes for regenerative medicine, which aims to replace or regenerate cells, tissues, or organs to restore or establish normal function.

They noted that some regenerative medicine therapies have already made their way into equine clinical practice with promising but diverse results, mainly to treat tendon and cartilage problems, and degenerative joint disorders.

In equine practice, several regenerative therapies, such as MSCs, platelet-rich plasma, autologous conditioned serum and autologous protein solution, have been used for various musculoskeletal problems over the last decade.

However, the field of regenerative medicine still has to live up to high hopes and expectations placed on it, both from a medical and financial viewpoint.

The authors noted that large placebo-controlled studies are still scarce despite promising results from multiple experimental and preclinical studies, case reports and small randomised and controlled studies.

Regenerative medicine also faces several challenges, such as the lack of well-defined cells to be used as therapeutics and insufficient understanding of their mode of action. Some mechanisms involved, such as the interplay of growth factors, cytokines, proteinases, and cellular mediators, remain poorly understood.

To exploit the full potential of tissues to heal, our understanding of how reparative processes are mediated and may be directed towards regeneration rather than scarring repair needs to be improved.

The field of equine regenerative medicine involves much pioneering work, they noted, with variable treatment protocols using different routes of administration and/or dosages of cells, which may contribute to the discrepancies between promising experimental results and clinical effectiveness.

Hence, intensive research efforts are still ongoing and required to find ways to exploit the maximal potential of regenerative medicine.

The authors traversed the current knowledge around MSCs, autologous blood products and the various applications of regenerative therapies.

They noted that most of the applied regenerative therapies are still at an experimental state and patients are treated within the scope of clinical trials.

Looking to the future, they noted that models of tissue injury and naturally occurring regeneration have shown the importance of the immune response for tissue repair, highlighting the necessity to regulate inflammatory processes to aid regeneration.

Traditional regenerative medicine focused on transplanting exogenously prepared cells or tissue while neglecting to consider the inflammatory and degenerative microenvironment.

Novel approaches try to work with, not against biology, to create an environment to induce regeneration within the horse.

To this end the genetic elements, regulatory pathways and specific cell populations that limit or allow intrinsic regeneration need to be identified to be able to use mammalian tissue development and regeneration as a blueprint to guide the development of novel regenerative therapies.

Ribitsch, I.; Oreff, G.L.; Jenner, F. Regenerative Medicine for Equine Musculoskeletal Diseases. Animals 2021, 11, 234. https://doi.org/10.3390/ani11010234

The review, published under a Creative Commons License, can be read here.

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Beyond laminitis: The potential of regenerative medicine to deliver better outcomes - Horsetalk

Introduction

Gastric cancer is the second leading cause of cancer-related deaths in Asia.1 After systematic first- and second-line treatments, approximately 2090% of patients receive active third-line or subsequent treatments;25 however, there are no standard advanced therapy protocols for metastatic gastric cancer, according to the National Comprehensive Cancer Network Guidelines. Preferred therapies include ramucirumab plus paclitaxel, taxane, irinotecan, TAS-102, fluorouracil plus irinotecan, apatinib, or pembrolizumab. A systematic review and meta-analysis of advanced gastric cancer indicated that the median overall survival of patients receiving third-line therapy is approximately 4.80 months compared with the 3.20 months for patients receiving only the best supportive care.6 Thus, the lack of effective third-line therapies for gastric cancer significantly restricts patient survival.

Herein, we present the case of a patient with advanced gastric cancer harboring the ERBB3 V104L mutation, who received pyrotinib plus irinotecan as a third-line therapy and achieved a progression-free survival (PFS) of 7.6 months with a high quality of life (QOL).

A 69-year-old man was diagnosed with gastric adenocarcinoma in July 2015 via endoscopic biopsy. He had a family history of cancer, as his sister had colon cancer. The timeline of his treatments is shown in Figure 1. First, he underwent radical gastrectomy with postoperative pTxN1M0 grade (in another hospital). Later, from August 2015 to February 2016, the patient underwent six cycles of treatment with fluorouracil plus oxaliplatin as adjuvant chemotherapy. In October 2016, via gastroscopy, the patient was confirmed to have relapsed. Therefore, a residual gastrectomy was performed, and the postoperative stage was pT3N2M0. After the surgery, the patient received four cycles of treatment with fluorouracil plus irinotecan from December 2016 to March 2017. However, he stopped chemotherapy due to the onset of adverse events, including thrombocytopenia and diarrhea. In January 2018, he underwent positron emission tomography-computed tomography (PET-CT) due to abdominal distension. The scans showed multiple metastases in the right diaphragm and peritoneum, with a large amount of fluid in the abdominal cavity and metastasis to the liver (S5 and S6), indicating extensive disease progression. The staining results of the abdominal wall nodules are shown in Figure 2.

Figure 1 The timeline of the treatment.

Abbreviations: IHC, immunohistochemistry; NGS, next-generation sequencing.

Figure 2 Histologic results of abdominal wall nodules. (A) Hematoxylin-eosin staining (magnification: 200). (B) Cytokeratin immunohistochemistry (magnification: 200). (C) Human epidermal growth factor receptor 2 (HER2) immunohistochemistry (magnification: 200).

In February 2018, immunohistochemical (IHC) analysis showed that the tumor was negative for human epidermal growth factor receptor 2 (HER2) (Figure 2C). The tumor tissues and matched blood samples were sent to the College of American Pathologists (CAP)-accredited and Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory (OrigiMed, Shanghai, China) for targeted next-generation sequencing (NGS). Written informed consent has been obtained from the patient to have the case details and any accompanying images for publication. The genomic results revealed a mutation in ERBB3 (V104L), accompanied by mutations in TP53 (R273C), KRAS (G12F), and AMER1 (Q577*), as well as amplification of CCNE1/FOS/GATA6/MCL1/MYCN/CIC. The tumor mutational burden was 13.6 muts/Mb. Programmed death-ligand 1 (PD-L1) expression was negative and no germline mutations were detected. In March 2018, he received two courses of peritoneal thermal perfusion therapy, followed by two courses of paclitaxel peritoneal administration (240 mg). The patient was then administered six cycles of capecitabine (1 g po bid d114 q3w) plus oxaliplatin (230 mg ivd qd d1 q3w). In July, the CT scan suggested that the disease was stable but without significant improvement. He continued maintenance treatment with four cycles of S-1 (60 mg po bid d114 q3w) plus apatinib (0.25 g po qd) until October 2018. However, due to intolerable adverse events, such as incomplete small bowel obstruction, the maintenance treatment was changed to apatinib (0.5 g po qd).

In December 2018, the disease progressed with new metastases in the right adrenal gland and right paracolic sulcus revealed by CT examination. Considering that his previous NGS test indicated the presence of an ERBB3 mutation, we administered irinotecan (330 mg ivd qd d1 q2w) plus pyrotinib (320 mg qd) starting on December 28, 2018. CT scans performed on March 12 and May 9, 2019, showed stable disease (Figure 3) with decreased effusion of the abdominal cavity. The patient experienced an improvement in abdominal distension, and no additional adverse events were observed. However, on August 6, CT scans showed an increase in the abdominal metastatic tumor as well as the abdominal and pelvic effusion, which suggested disease progression. Therefore, the PFS was 7.6 months.

Figure 3 The patients condition clinically improved after treatment with pyrotinib and irinotecan. (A) Liver S6 metastasis disappeared after treatment; (B) The diameter of the metastatic peritoneal cyst was reduced from 3.7 to 3.2 cm after treatment and maintained; (C) The diameter of the metastatic peritoneal reflex was reduced from 3.3 to 2.5 cm after treatment and maintained; (D) Ascites were significantly reduced after treatment. Red circles indicate metastatic tumor lesions.

Thereafter, the patient underwent chemotherapy, targeted therapy, and immunotherapy; however, he did not exhibit a good response. CT scans revealed multiple metastases in the abdomen and liver (S6). The patient died in March 2020.

The benefits of the existing third-line treatments for advanced gastric cancer are limited, and many patients cannot tolerate chemotherapy-related toxicity. In recent years, targeted therapy has provided a new treatment strategy for advanced gastric cancer with more convenience and fewer side effects. However, at present, only the treatment of HER2-positive advanced gastric cancer has been effective.7 Therefore, effective therapies targeting cancer driver genes are still warranted. Herein, we report a patient with HER2-negative gastric cancer harboring an ERBB3 mutation. He received pyrotinib plus irinotecan as a third-line treatment, which resulted in a PFS of 7.6 months and a high QOL. We believe that this case provides important medical evidence for the beneficial clinical application of pan-ErbB inhibitors.

ERBB3, encoded by the ERBB3 gene, is a member of the epidermal growth factor receptor (EGFR) family. Although its intracellular tyrosine kinase domain is weak, it can still form active heterodimers with other EGFR members, thus activating pathways involved in cell proliferation and differentiation.810 ERBB3 mutations have been identified in some cancers, including colon and gastric cancers,1119 which have ligand-independent and HER2-dependent transformation abilities.20 The ERBB3 V104L mutation is one of the main hotspot mutations in the extracellular domain and was identified in gallbladder cancer, rectal neuroendocrine tumors, and lung sarcomatoid carcinoma.19,2123

Some anti-ERBB3 drugs, such as patritumab, AZD8931, and U3-1402, are still under preclinical and clinical development.2426 Considering that ERBB3 needs to form a heterodimer with other EGFR members, antitumor drugs that target the EGFR/HER2 may be effective. Some clinical benefits have been observed with afatinib, trastuzumab plus lapatinib, and lapatinib alone, among other treatment regimens.22,27 For instance, a patient with a rectal neuroendocrine tumor harboring the ERBB3 V104L mutation was treated with trastuzumab and lapatinib as a third-line therapy, resulting in a stable disease and a PFS of 51 days.22 However, HER2-negative breast cancer patients with the ERBB3 G284R mutation, who received trastuzumab with lapatinib as a third-line treatment, showed only a partial response (PR) for more than 40 weeks.27 Additionally, a biliary tract carcinoma patient harboring an ERBB3 mutation achieved a PR after receiving trastuzumab plus lapatinib.33 Additionally, two metastatic urothelial cancers with ERBB3 V104M and G284R mutations achieved 6.3 months and 7 months of PFS, respectively, after treatment with the inhibitor afatinib (Table 1).32

Table 1 Reported Cases Harboring ERBB3 Mutations Treated with Targeted Therapy

Pyrotinib is an oral, irreversible pan-ErbB inhibitor capable of blocking EGFR/HER1, HER2, and HER4 activities.28 A Phase II study showed that pyrotinib was effective in treating HER2-positive breast cancer, with a superior response to lapatinib.29 In addition, preclinical studies have confirmed that pyrotinib successfully treated non-small-cell lung carcinoma with an HER2 exon 20 mutation and HER2-positive gastric cancer.30,31,33 However, its effects on HER2-negative gastric cancer remains unknown. Here, we showed that a patient with HER2-negative gastric cancer harboring an ERBB3 mutation who received pyrotinib plus irinotecan as a third-line treatment gained a PFS of 7.6 months with a high QOL, indicating the potential of pyrotinib in treating HER2-negative gastric cancer patients with ERBB3 mutations.

One limitation of this study is that administering pyrotinib and irinotecan at the same time made it difficult to distinguish which drug produced the therapeutic effect. However, compared with the previously used fluorouracil plus irinotecan, the patients clinical condition was significantly improved by the irinotecan and pyrotinib combination, and his PFS reached nearly 8 months, indicating that the use of pyrotinib may have contributed to the antitumor activity by targeting the ERBB3 (V104L) mutation in this case, since pyrotinib is a pan-ErbB inhibitor. In addition, further evaluations are warranted to confirm whether pyrotinib could be widely used in gastric cancer patients with ERBB3 alterations. Collectively, we believe that ERBB3 mutations should be considered a new target for the treatment of gastric cancer.

This study was approved by the ethics committee of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine. Written informed consent for this case report has been obtained from the patient.

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

This study was funded by The National Key Research and Development Program of China (grant number 2017YFC1700603). The funding agency had no role in the collection, analysis, and interpretation of data, writing of the report, or decision to submit the article for publication.

T.H. and W.W. declare personal fees from OrigMed outside the submitted work, and are employees of OrigiMed. The authors report no other potential conflicts of interest for this work.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394424. doi:10.3322/caac.21492

2. Kang JH, Lee SI, Lim DH, et al. Salvage chemotherapy for pretreated gastric cancer: a randomized Phase III trial comparing chemotherapy plus best supportive care with best supportive care alone. J Clin Oncol. 2012;30(13):15131518. doi:10.1200/JCO.2011.39.4585

3. Hironaka S, Ueda S, Yasui H, et al. Randomized, open-label, phase III study comparing irinotecan with paclitaxel in patients with advanced gastric cancer without severe peritoneal metastasis after failure of prior combination chemotherapy using fluoropyrimidine plus platinum: WJOG 4007 trial. J Clin Oncol. 2013;31(35):44384444.

4. Wilke H, Muro K, Van Cutsem E, et al. Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): a double-blind, randomised Phase 3 trial. Lancet Oncol. 2014;15(11):12241235. doi:10.1016/S1470-2045(14)70420-6

5. Li J, Qin S, Xu J, et al. Randomized, double-blind, placebo-controlled phase III trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction. J Clin Oncol. 2016;34(13):14481454. doi:10.1200/JCO.2015.63.5995

6. Chan WL, Yuen KK, Siu SW, et al. Third-line systemic treatment versus best supportive care for advanced/metastatic gastric cancer: a systematic review and meta-analysis. Crit Rev Oncol Hematol. 2017;116:6881. doi:10.1016/j.critrevonc.2017.05.002

7. Bang Y-J, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376(9742):687697. doi:10.1016/S0140-6736(10)61121-X

8. Shi F, Telesco SE, Liu Y, et al. ErbB3/HER3 intracellular domain is competent to bind ATP and catalyze autophosphorylation. Proc Natl Acad Sci U S A. 2010;107(17):76927697. doi:10.1073/pnas.1002753107

9. Collier TS, Diraviyam K, Monsey J, et al. Carboxyl group footprinting mass spectrometry and molecular dynamics identify key interactions in the HER2-HER3 receptor tyrosine kinase interface. J Biol Chem. 2013;288(35):2525425264. doi:10.1074/jbc.M113.474882

10. Littlefield P, Liu L, Mysore V, et al. Structural analysis of the EGFR/HER3 heterodimer reveals the molecular basis for activating HER3 mutations. Sci Signal. 2014;7(354):ra114. doi:10.1126/scisignal.2005786

11. Beji A, Horst D, Engel J, et al. Toward the prognostic significance and therapeutic potential of HER3 receptor tyrosine kinase in human colon cancer. Clin Cancer Res. 2012;18(4):956968. doi:10.1158/1078-0432.CCR-11-1186

12. Rajkumar T, Stamp GW, Hughes CM, et al. c-erbB3 protein expression in ovarian cancer. Clin Mol Pathol. 1996;49(4):M199M202. doi:10.1136/mp.49.4.M199

13. Yi ES, Harclerode D, Gondo M, et al. High c-erbB-3 protein expression is associated with shorter survival in advanced non-small cell lung carcinomas. Mod Pathol. 1997;10(2):142148.

14. Sergina NV, Rausch M, Wang D, et al. Escape from HER-family tyrosine kinase inhibitor therapy by the kinase-inactive ERBB3. Nature. 2007;445(7126):437441. doi:10.1038/nature05474

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16. Brand TM, Hartmann S, Bhola NE, et al. Cross-talk signaling between ERBB3 and HPV16 E6 and E7 mediates resistance to PI3K inhibitors in head and neck cancer. Cancer Res. 2018;78(9):23832395. doi:10.1158/0008-5472.CAN-17-1672

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[Full text] Gastric Cancer Harboring an ERBB3 Mutation Treated with a Pyrotinib&nd | OTT - Dove Medical Press