This year, approximately six million dogs will be diagnosed with cancer.1 Although the incidence of canine cancer is nearly three times higher than human cancer, veterinarians have far fewer tools at their disposal to effectively treat their patients.
Today, the first line of treatments for canine cancer patients are surgery, radiotherapy, and chemotherapy—one-size-fits-all solutions that do not account for cancer’s astonishing genetic variety. As human oncology moves toward precision genomic treatments, it presents an unprecedented opportunity for veterinarians to repurpose these interventions to improve treatment outcomes for their canine patients.
As recently demonstrated in a study, when veterinarians combine these precision treatments with new tools, such as artificial intelligence (AI), they can accelerate the development of cancer drugs that will save the lives of both pets and their owners.2
Challenges
Although oncologists have known for decades that genetics play a major role in the onset, progression, and treatment response of cancer, collecting enough data to develop precision genetic treatments is remarkably challenging.
One reason for this is most human cancer patients do not participate in clinical trials, which means cohorts of genetically similar patients are often quite small.
Another challenge is human patient data is protected by strong Health Insurance Portability and Accountability Act (HIPAA) restrictions that make it difficult or impossible to conduct large-scale longitudinal analyses of patient cancer journeys.
Finally, human cancer patients are also subject to rigorous standards of care that often prevent them from participating in clinical trials until they have tried and failed to respond to more conventional protocols, such as chemotherapy.
This is where veterinarians have an opportunity to advance human and canine oncology. A growing body of research has revealed the similarities between human and canine cancers,3 which means veterinarians can leverage research from human oncology to make informed decisions about how best to treat their canine cancer patients.
Pet parents can decide to bypass chemotherapy entirely or combine it with precision genetic therapies, such as small-molecule drugs, based on biological indicators, rather than a strict protocol. This decision should be made in close consultation with their veterinarian, who can provide important information about the risks and likelihood of success of alternatives to chemotherapy.
Leveraging data
Despite evidence showing precision human cancer drugs can significantly improve outcomes for canine cancer patients,2 they remain an underutilized treatment in veterinary offices. To advance precision oncology in veterinary medicine, it is imperative to make it easier for veterinarians to access relevant data that will lead to improved treatment outcomes.
Comparing outcome data based on the type of treatment, the genetic profile of a dog, and the genetic profile of the dog’s cancer will allow veterinarians to determine the best precision intervention for their patients. However, the problem is this data does not exist for most canine cancer patients.
Even if it does, it is siloed in individual veterinary clinics and research institutions, which makes it difficult to access for large-scale, longitudinal analysis. If data was collected in a common database that includes the dog’s basic health information, the genetic profile of their cancer, the types of treatments they have received, and their outcomes, it will help all veterinarians find the best possible treatment for their canine cancer patients.
For nearly a decade, researchers at One Health Company have been building this system. The company’s flagship FidoCure platform contains a comprehensive canine cancer clinico-genomic dataset, with data from real world dog patients. The platform is found in hundreds of veterinary clinics across the U.S.
When a veterinarian first diagnoses a canine cancer patient, they take a tissue biopsy of the tumor and send it to One Health scientists for genomic sequencing. This data is then uploaded to the FidoCure database, where the veterinarian can compare various treatments based on the characteristics of their patient (i.e. age, breed, weight, etc.), the genetic profile of the dog’s tumor, and the outcomes of similar dogs. This empowers the veterinarian to recommend precision treatments to pet owners based on data collected from thousands of canine cancer patients.
It is a new approach to veterinary oncology, but the most important question is, “Does it actually improve outcomes for canine cancer patients?”
Methodology
In 2019, One Health Company launched a three-year study that attempted to answer this question. Using the FidoCure platform, the company tracked the cancer journeys of more than 1,000 dogs that received cancer treatment—both chemotherapy and precision small molecule treatments—to better understand the overlap between human and canine cancers and the effectiveness of 10 small molecule drugs that had already been approved for human cancer patients.
Machine learning was used to analyze the data, which revealed human and canine cancer journeys—from diagnosis to treatment to outcome—are similar. The data showed small molecule drugs developed for humans can improve the outcomes of canine cancer patients. For example, the drug lapatinib is often used to treat human patients whose tumors have a mutation in the serine/threonine-protein kinase B-Raf gene, which is commonly associated with melanomas. The research showed the same is true for dog patients, which you might expect based on the similarities between human and canine cancers.
Further, the research shed light on two “off-target” drug/mutation combinations that proved to be highly effective,2 yet had not been approved for those applications in humans. One of these combinations was with the drug dasatinib and the BRCA1 mutation.
This mutation is most often associated with breast cancer, but dasatinib had only been approved by the U.S. Food and Drug Administration (FDA) for treating a certain type of chronic myeloid leukemia (a cancer of the white blood cells) in humans. Dogs whose cancer had a BRCA1 mutation and received dasatinib saw a significant improvement in outcomes, and in some cases increased their survival rates by a factor of three.2
Findings
The data suggested a precision human cancer drug developed to target one specific type of tumor mutation may be highly effective in treating cancers with a completely different type of tumor mutation in dogs. This provides veterinarians with a new tool to treat canine cancer patients, made possible by AI, to analyze data collected from real world canine cancer patients.
Veterinarians can use their discretion to treat patients with “off-target” cancer drugs, which creates opportunities to study the effectiveness of those drugs in cancers with different genetic profiles. In other words, veterinarians can participate in what is effectively a continuous, nationwide “clinical trial” that can lead to significantly better outcomes for their patients.
The similarities between human and canine cancers have recently led to an influx of research interest and funding in comparative oncology.4,5,6 The basic idea is studying dog cancers and the way they respond to treatments can provide valuable insights that can lead to improvements in human oncology, too.
The One Health canine cancer dataset has already doubled in size as more veterinarians join the platform and contribute information from their canine cancer patients. The hope, of course, is every veterinarian in the U.S. will one day participate in this network, as it becomes more effective with each new contributor.
The veterinary community has a unique opportunity to combine two technologies—genomics and AI—to save lives on both ends of the leash and usher in the era of precision veterinary oncology.
Christina Lopes is CEO and co-founder of The One Health Company, which offers precision medicine for dogs with cancer. Lopes holds a bachelor’s from the University of Massachusetts, a master’s in international and political Affairs from Columbia University, and a doctoral coursework in Ethics at Princeton University. She loves dogs and bringing access to cutting edge healthcare. Lopes lives in Palo Alto, Calif., with her husband Ben and their two daughters.
References
- What is comparative oncology?. COP – Pet Owners – What is Comparative Oncology | Center for Cancer Research. (n.d.). https://ccr.cancer.gov/Comparative-Oncology-Program/pet-owners/what-is-comp-onc
- Wu, K., Rodrigues, L., Post, G., Harvey, G., White, M., Miller, A., Lambert, L., Lewis, B., Lopes, C., & Zou, J. (2023). Analyses of canine cancer mutations and treatment outcomes using real-world Clinico-Genomics Data of 2119 Dogs. Npj Precision Oncology, 7(1). https://doi.org/10.1038/s41698-023-00346-3
- Schiffman, J. D., & Breen, M. (2015). Comparative oncology: What dogs and other species can teach us about humans with cancer. Philosophical Transactions of the Royal Society B: Biological Sciences, 370(1673), 20140231. https://doi.org/10.1098/rstb.2014.0231
- Sommers, C. (2022, November 17). NCI-funded Canine Immunotherapy Clinical Trials. Division of Cancer Treatment and Diagnosis. https://dctd.cancer.gov/NewsEvents/20221117_canine.htm
- The V Foundation awards $1.5 million to Canine Comparative Oncology Research. V Foundation. (2022, November 1). https://www.v.org/story/the-v-foundation-awards-1-5-million-to-canine-comparative-oncology-research/
- Doerr, K. (2022, December 14). Comparative oncology research center at Purdue to be named for Evan and Sue Ann Werling. Purdue University. https://www.purdue.edu/newsroom/releases/2022/Q4/comparative-oncology-research-center-at-purdue-to-be-named-for-evan-and-sue-ann-werling.html