A brand new strategy to canine most cancers
Cancer is the word no one wants to hear in connection with themselves or their loved ones, including their dogs. However, statistics show that one in four dogs will be diagnosed with some form of cancer at some point in their life, and that humans and dogs are about equally likely to get cancer. Fortunately, science, technology, and human determination are at work looking for ways to improve the odds for our collective favor. This is the story of one of those breakthroughs.
The Covid-19 pandemic has thrown several curveballs into our daily lives, including the difficulty of getting timely access to veterinary care. Part of that is due to the number of dogs (and other pets) adopted during these troubled times, and part of it has to do with veterinary response to public health protocols.
Many clinics have restricted customers (owners) to the waiting room or eliminated their presence altogether and set up a system where the customer calls when they arrive outside the clinic and a masked and dressed technician comes out to pick the patient up. In general, dogs cannot be left alone in an exam room while waiting to be seen by the veterinarian. Therefore, an employee of the clinic stays with you. This time-consuming process reduces the number of patients a veterinarian can see each day. This is a major factor in the difficulty many face when planning an appointment.
When it comes to routine vaccinations, implanting microchips, or checking into a chronic but treated condition, this situation would be worrying but not critical. But, to continue with the sports metaphor, when we talk about diagnosing or treating cancer, it's a different ball game altogether.
With most cancers, time is of the essence. If we can't get our dogs to see the vet when symptoms appear, or if it takes four to six weeks to schedule treatment after a cancer is diagnosed, we are unlikely to see results in terms of longevity or quality of life I would hope to achieve.
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However, an approach taken by a California biotech company appears to be tailored to these complicated times. A year ago, One Health – a company that describes itself as "bridging the gap between cancer therapeutics in dogs and humans" – introduced FidoCure®, a targeted treatment that uses genetic testing to identify mutations that cause cancer and then deliver tailored attack therapy the cancer cells. Treatment in pill form can be done at home. According to the company, it is "cheaper than chemo and the first human-grade treatment for dogs".
It's called precision medicine, and it's an approach that has been used to treat cancer in humans for some time – but not so much for veterinary cancer, where chemotherapy and radiation are still the norm. Ironically, Cheryl London, DVM, PhD, DACVIM (oncology) of Tufts University (and a veterinary advisor from FidoCure) noted, “There is usually a large body of safety data on targeted therapies for humans and, by and large, much of the testing performed on dogs. "
Because humans and dogs are known to develop similar cancers, researchers often study one species as a model for the other. For example, the National Cancer Institute has been conducting clinical trials focusing on dogs for more than two decades as part of its comparative oncology studies that identify treatments that preserve the quality of life of dogs and are transferable to the treatment of cancers in humans.
According to Christina Lopes, CEO of FidoCure, targeted therapies have another major advantage over chemotherapy: "While chemotherapies kill all rapidly dividing cells indiscriminately, targeted therapies only inhibit the growth of those cells with a certain mutation."
Here's how it works. The vet, usually a veterinary oncologist, sends a tissue sample to FidoCure for DNA sequencing in a CLIA-certified laboratory. From this, a personalized report is created that is specific to the individual dog and the type of cancer, identifying mutations that may affect treatment and recommending FDA-approved cancer drugs. (With one exception, all veterinary oncology drugs were originally developed to treat cancer in humans. The Animal Medicinal Drug Use Clarification Act of 1994, which allows veterinarians to use FDA-approved drugs, gives them an "extra label" for Pets prescribed will treat pets without taking additional regulatory action.)
The company is working with an FDA-approved compounding pharmacy to develop appropriate dosages for the drugs. The pharmacy will titrate the drugs based on the specific needs of the dog patient, including sometimes adding flavoring (reportedly beef liver is very popular). Most pet insurances cover this treatment.
FidoCure therapy “is intended for patients whose tumor has a specific gene mutation that can be assigned to a precise therapy.” It is also used in patients whose cancer has not responded to other therapies, has spread or is inoperable. While all cancers are eligible for FidoCure, the company states that hemangiosarcoma accounts for the majority of cases to date, along with bladder cancer and some rare canine cancers such as histiocytic sarcoma. According to the company, roughly half of the cases they saw came to them when the patient's cancer failed to respond to conventional therapies.
One Health is also helping to complete the utility loop by applying data from patient outcomes and genomic studies to cancers in humans. For example, as Lopes says, "We could look at a mutation and a biomarker in a dog that is in a different location from a human, but the data may still be relevant."
Signs and symptoms
The following may indicate a developing cancer and should be checked by your veterinarian immediately.
• Abdominal swelling.
• Bleeding from your mouth, nose or other body orifices.
• Difficulty breathing.
• Difficulty eating.
• Lumps, bumps, or discolored skin.
• Non-healing wounds.
• Persistent diarrhea or vomiting.
• Sudden changes in weight.
• Unexplained swelling, heat, pain, or lameness.
• Visible mass / tumor.
More refinements in fighting pet cancer are either here or on the horizon. Elias Animal Health has developed a treatment platform that describes a combination of pre-treatment with cancer vaccinations and activated "killer" T-cell immunotherapy. A study is currently underway at Cornell College of Veterinary Medicine of a type of lymphoma that is common to both humans and dogs. A story in the Cornell Chronicle said: “If the project is successful, one day oncologists may be able to use a patient's metabolic profile and the DNA of the tumor to create an accurate medical treatment plan. Genetic data shows what mutations a tumor has, but metabolomics shows what is actually happening in the cells. "
From our place, FidoCure is part of the avant-garde providing veterinarians with more sophisticated tools to better understand their patients' specific medical needs and treat them more effectively. This again shows that dogs are not only our best friends and colleagues – pilots, but also part of solving health problems that may affect us all.