With nearly 6 million new diagnoses each year, cancer is a common disease for our beloved canine companions. Yet, with only 600 veterinary oncologists in the United States, the reality is that most of these dogs will never see a specialist. This disparity in care is a heart-wrenching situation for millions of pet owners.
The good news is that precision oncology — an approach to cancer treatment that matches patients with personalized treatment based on the unique DNA signatures of their tumors — is becoming increasingly accessible to the 130,000 general practice U.S. veterinarians. It allows non-specialist veterinarians to provide potentially highly effective targeted cancer drugs to canine patients to meaningfully increase their survival times and maintain a high quality of life.
Most precision medicine approaches in veterinary oncology involve oral medications given at home by the pet owner. Any side effects are relatively easy for the doctor to manage. This approach makes the treatment more convenient for the pet and owner and allows for close monitoring and adjustment by the veterinary professional.
The Beginning
Human oncology has used precision medicine for decades, and it is well-established that drugs designed for human cancer patients are highly effective in dogs because of the high concordance of the disease across these species. Personalized cancer treatments have only recently become widely available to veterinarians due to advances in key technologies such as artificial intelligence and genomic sequencing. The results are staggering.
Over the past few years, my colleagues and I have studied the results of thousands of dogs treated by hundreds of U.S. veterinarians using a platform we developed to match canine cancer patients with precision cancer drugs at the point of care. The platform represents the largest clinicogenomic canine cancer database ever created, and our results show that mining the data to match dogs with cancer and small molecule drugs can extend the lives of these pets by up to three times compared to conventional treatments such as chemotherapy.
A Case Study
Two of our patients, Maggie and Pixelle, represent what veterinarians can accomplish by bringing the tools of precision oncology out of the lab and into the clinic. Maggie, a 12-year-old pug, was diagnosed with aggressive oral melanoma that recurred rapidly after surgery. Her prognosis was so poor that, at one point, her family considered euthanasia. Fortunately, genomic testing revealed tumor mutations that suggested she might respond to olaparib, a targeted therapy. Within weeks of starting the treatment, Maggie’s cancer began to shrink, and within four months, her oncologist reported no visible cancer in her mouth.
Similarly, Pixelle, a 13-year-old Shih Tzu with metastatic adrenocortical carcinoma, saw her cancer progress despite multiple surgeries and chemotherapy rounds. When traditional methods failed, her oncologist turned to genomic testing. The results revealed two mutations that suggested she might benefit from olaparib and another targeted therapy, rapamycin. After starting the therapies, Pixelle’s tumors shrank significantly, decreasing by over 60% from their original size.
Maggie, Pixelle and thousands of other canine cancer patients have benefited from new precision treatments, which recently were accessible only by participating in clinical trials run at a handful of research centers across the United States.
Easier for Everyone
Fortunately, veterinarians and pet owners have benefited, too. Many targeted therapies are oral medications, which are much easier to administer than chemotherapy. Furthermore, veterinarians can adjust the treatments based on how their patients respond to therapy, providing flexibility in treatment options.
Precision oncology platforms democratize cancer care by making advanced treatment modalities accessible to all veterinarians without requiring specialized oncology training or expensive equipment. Pet owners can access precision treatments through their veterinarian at a price point comparable to conventional treatments like chemotherapy.
This paradigm shift in canine cancer treatment will have profound long-term effects. One of the biggest will be opening the door to massive, continuous clinical trials for precision treatments. In the past, this research involved relatively small cohorts of dogs, and each trial focused on a particular type of cancer and drug pairing. By moving precision treatments from laboratories to the point of care in local veterinary practices, however, we can dramatically increase the clinicogenomic data on canine cancer patients to accelerate the discovery of new lifesaving drug-cancer combinations.
All this isn’t a hypothetical, either. Over the past five years and in partnership with U.S. veterinary clinicians, we have sequenced more canine cancer tumors than all previous comparative oncology trials combined. That achievement shows the immense power of moving research and treatment on canine cancer to the point of care. We have used the world’s largest clinicogenomic canine cancer database to identify several new mutational hotspots overlapping human and canine cancers. That feat can help point the direction to new precision treatments that can be applied in the veterinary clinic. Countless other potentially lifesaving insights are surely hidden among the constellation of billions of data points waiting to be discovered.
Group Learning
The impact of genomic sequencing canine tumors at scale — made possible only due to advances in artificial intelligence — cannot be overstated. One of the most beautiful things about this approach is that every time dogs newly diagnosed with cancer receive a precision treatment, they benefit from the data provided by all the dogs before them, and all the dogs treated after them will benefit, too. As precision oncology becomes the new norm in veterinary clinics over the next decade, we’ll see the genomic cancer data grow exponentially and, along with it, our ability to identify powerful cancer-treatment pairings.
The precision oncology revolution in veterinary medicine comes at a critical time. Pet owners are increasingly demanding human-level care for their pets, and nearly 3 out of 4 seek specialty care after their dogs receive a cancer diagnosis. Research has shown that veterinary clients weigh various factors in their decision to pursue canine cancer treatment, but one of the biggest determinants is how they balance their pets’ quality of life against length of life. Now, however, veterinarians can help them make more informed treatment decisions based on the experiences of thousands of other dogs with cancer that share similar tumor mutations.
For too long, most veterinarians have lacked access to precision cancer treatments that can help patients live longer, healthier lives. The rapidly falling cost and increasing sophistication of AI and genomic-sequencing platforms enable all veterinarians to offer advanced cancer treatments at the point of care and help accelerate the discovery of precision treatments that will benefit countless dogs in the future.
WHAT STUDIES SHOW
- “Analyses of Canine Cancer Mutations and Treatment Outcomes Using Real-World Clinicogenomics Data of 2,119 Dogs,” go.nature.com/3ZY24yh
- “Shared Hotspot Mutations in Oncogenes Position Dogs as an Unparalleled Comparative Model for Precision Therapeutics,” go.nature.com/4dKRA8s
- “Optimizing Palliative Care and Support for Pets: Perspectives of the Pet Parent and the Veterinarian,” bit.ly/4gW0z9T