Precision Medicine and Canine Hemangiosarcoma
April 30, 2019
Canine hemangiosarcoma is a very aggressive and common cancer that spreads (i.e. metastasizes) quickly and has a poor overall prognosis. Derived from endothelial cells (blood vessel cells), it shares many similarities with the aggressive human cancer angiosarcoma. Canine hemangiosarcoma can develop in any part of the body but most commonly arises in the spleen. It is often discovered during an emergency visit caused by a splenic tumor rupture and internal bleeding.
Current Treatment Options
A splenectomy, removing the spleen, is an initial treatment with survival times ranging from 30-90 days after surgery. Survival in dogs following splenectomy is often limited due to the metastasis of the cancer to other parts of the body. Numerous studies have evaluated the use of chemotherapy along with surgery and reported survival times ranging from 140 to 202 days. However, even with chemotherapy, in most dogs the cancer continues to spread. New treatments to improve quality of life and prolong overall survival are clearly needed. Because removal of the spleen is a common part of clinical care, there is an opportunity to collect tissue and blood samples to understand the genomic features of this tumor and potentially deliver improved treatment outcomes.
Precision Medicine as an Alternative Option
Precision medicine, also known as personalized medicine, involves the use of genomic analysis of tumors or other patient samples (i.e. cell free tumor DNA circulating in the blood) to identify disease targets that can be matched to specific treatments. The intent of precision medicine is to halt cancer spread by stopping molecular events that lead to disease progression and therefore improve patient outcomes. The promise of this approach to cancer therapy has been suggested in recent human studies and is under evaluation in several prospective human trials; put simply, treating cancer is not “one size fits all.”
We have previously reported on the feasibility of genomically-directed medicine for cancer animals (Paoloni, Khanna, and colleagues: Prospective Molecular Profiling of Canine Cancers Provides a Clinically Relevant Comparative Model for Evaluating Personalized Medicine (PMed) Trials. PlosOne 2014).
There are limited therapeutic options for the treatment of hemangiosarcoma, with none currently providing a significant opportunity for long-term survival. Ethos Discovery’s previous work in hemangiosarcoma has taught us that hemangiosarcoma is not a single cancer, but is rather at least four different subtypes of cancer, each characterized by a different genomic mutation. Previous studies evaluating drugs for the treatment of HSA have shown variable results and the discovery of these different subtypes could explain this phenomenon.