Clinical trials unite veterinary oncologists with pet owners to help unravel cancer mysteries
Sarah and Cameron Rollins with Rhett outside the Veterinary College.
The Animal Cancer Care and Research Clinic (ACCRC) is increasing its clinical trials as it seeks to develop better treatments for several types of cancer. Clinical trials are essential for modern medicine, enabling research and development of new therapies, drugs, and techniques to fight diseases. But these advances can only happen with the support of pet owners and their participating pets.
For Sarah Rollins, receiving a cancer diagnosis for her 6-year-old dog Rhett was gut-wrenching. "We’d just returned from our honeymoon, the Thursday before the July 4th weekend, and Rhett had started not to eat. When we got the results back, what do we do? I was going crazy, googling everything."
Finding the right path forward after a cancer diagnosis can be tough. It means considering available options, weighing up possible outcomes, and exploring clinical trials–all in fairly short order.
Rollins responded to Rhett’s diagnosis by asking a lot of questions. "For me, the vets at the ACCRC are some of the few vets that can genuinely give you the A to Z of your options for treating this disease. Everyone was so helpful and amazing at explaining things."
Benefits for animals and humans
Ilektra Athanasiadi, an assistant professor of radiation oncology, describes her job as a blessing.
Athanasiadi recently opened a study to test a medical device that delivers chemotherapy drugs directly to oral tumors in dogs. By delivering treatment straight to the tumor site, she hopes to increase the effectiveness of the chemotherapy and reduce systemic side effects.
The device used in this study has been used successfully in other cancers, but it has never been tried before in dogs with oral cancer. The goal is to one day use this device to help treat both pets and people.
The possibility of translating companion animal therapies to humans and vice versa exemplifies a common thread in the motivations of Athanasiadi and others who work in the field of veterinary clinical trials. The work they do to treat their four-legged patients can also benefit human medicine, as humans often have similar cancers. The ACCRC is strategically located on Virginia Tech's Health Sciences and Technology campus in Roanoke, near human medical facilities, to facilitate precisely this type of translational medicine and collaboration.
According to Athanasiadi, "It's a blessing that I found a place where I can do my dream job and help animals and help the community here with their pets, but also that it has the potential to translate this work to human medicine."
Improving the odds
A cancer camp for children inspired Joanne Tuohy's journey.
Tuohy, a surgical oncology assistant professor, concentrates on histotripsy, a technique that employs ultrasound to create bubbles that target tumors. This treatment, which destroys tissue without radiation or heat, is being examined for canine osteosarcoma therapy. Her research aims to assess histotripsy's effectiveness in treating dogs with osteosarcoma, ultimately promoting the development of histotripsy as a non-surgical treatment alternative.
An influential moment early in Tuohy's career came when she volunteered at a children's cancer camp. "The children were suffering from various types of cancer, with many having osteosarcoma,” Tuohy said. “Realizing their prognosis hasn't improved in the past 30 to 40 years was heart-wrenching, and the survival rates for humans and dogs have remained stagnant. Witnessing those children's struggles was incredibly difficult.
This commitment to oncology is a common thread among all the specialists at the ACCRC. "My goal is to enhance survival chances, not only for dogs but for humans as well," said Tuohy.
Owners are a crucial part of a team
Initially, Paula and Jay Williams were hesitant to pursue cancer treatment for their dog Astro, who had been diagnosed with a soft tissue sarcoma. "Honestly, my mother passed away from breast cancer 28 years ago, and Jay's father died from kidney cancer. We were reluctant to undergo all the radiation and chemotherapy, along with the numerous trips to Roanoke, and Astro would have struggled with it all at his age," Paula Williams said.
A clinical trial using high-intensity focused ultrasound presented an alternative approach better suited to Astro's requirements and disposition.
"With the clinical trial, there were only a few treatment visits, followed by a couple of ultrasounds and checkups, as well as the screening. So, it wasn't difficult for him at all," Paula Williams asid.
The family's cancer history strongly influenced the choice to participate in the clinical trial.
"We were aware that they were attempting to bring [high-intensity focused ultrasound] into human use," she said. "That's crucial. It might be us, after all. The more discoveries they can make, the better. They treated Astro as if he were a show dog, not a $50 dog from the shelter.”
Communication matters
For Shawna Klahn, associate professor of medical oncology, it's about communication.
"I'm interested in communication in general: how does cancer make unwitting accomplices of your normal cells? Can we find ways to disrupt this communication?" Klahn asked.
In her latest clinical trial for dogs with soft tissue sarcomas, Klahn focuses on histotripsy to improve the likelihood of obtaining liquid biopsies from tumors. Like her colleagues at ACCRC, she is enthusiastic about the potential of histotripsy.
"When a tumor is removed and regrows, which is a frequent issue, it may not be suitable for surgical intervention, and radiation may not be repeatable in the future. Histotripsy offers an alternative as it destroys the tumor mechanically without incisions or heat and is well-tolerated by patients. It's got a lot of promise, and I'm excited to get this into real clinical practice."
Klahn's focus on communication also extends to advice for pet owners to "inform themselves and seek expert guidance to make a well-informed choice." She asserts that regardless of whether the owner opts for standard-of-care treatment, participates in a clinical trial, or takes an alternative approach, it's crucial to possess all the necessary information before deciding.
She is excited about the potential of pet owners and researchers collaborating.
"Educating pet owners about clinical trials is extremely crucial. Some people assume that they’ll have to relinquish their dog and that it will be taken away; however, that isn’t true. We operate as a cohesive unit. If we believe the patient is not faring well at any stage, we remove them from the trial. We might decide that the patient needs surgery instead. The entire process involves collaboration between the referring vet and the owner, with all parties deeply concerned for the patient's well-being."
Personal fulfullment
An early inspiration for Nick Dervisis was his aunt, an oncology nurse.
Nick Dervisis, as part of the National Cancer Institute’s Comparative Oncology Trials Consortium, is establishing a clinical study in dogs with lymphoma and solid tumors using a novel monoclonal antibody that targets the immune system. This immune checkpoint inhibitor is similar to those that have been approved for human use for several years.
In both pets and people, cancer cells have mastered the art of confusing and evading the immune system, which would normally recognize and eliminate threats. By blocking the interaction between checkpoint proteins and their counterparts, immune checkpoint inhibitors unleash the power of the immune system to eliminate cancer cells effectively.
Like his colleagues, Dervisis is passionate about combating cancer. "Cancer poses a significant threat to dogs, cats, and humans, and I believe this is an area where I can create an impact. The opportunity to simultaneously assist both animals and humans provides a real sense of personal fulfillment for me," he said.
A significant early influence for Dervisis, an associate professor of medical oncology, was his aunt, who worked as a chemotherapy and oncology nurse in a human hospital in Greece.
"I spent considerable time with her, learning about her profession and witnessing her struggles and limited options firsthand. During my time in veterinary school in the mid-’90s, there was only one veterinary oncologist across the entire European Union. I realized that animals were dying from cancer every day without anyone being able to help, so I began my journey in the U.S. And now, here I am."
And Rhett?
Rollins is delighted that Rhett enjoys his visits to the ACCRC.
"He eagerly pulls me toward the entrance, whines in the parking area, and they pamper him with treats all day. He genuinely adores being there, making it much simpler for me to take him for chemotherapy. The staff is incredible, treating him as one of their own and sharing anecdotes about his antics during the day. It's frightening to leave your fur baby behind after receiving a severe diagnosis, but their stories always reassure me. It's clear that they love our pets just as much as we do," she said.
"Each animal is unique, but the transformation in my dog's life amazed me. Once he began treatment, it was like a complete turnaround, which left me astounded. How could anyone not opt for that?"
To learn more about open clinical trials, eligibility requirements, and how to participate in clinical trials, interested pet owners are encouraged to contact Clinical Trials Manager Mindy Quigley at mindyq@vt.edu. More information on trials can be found on the ACCRC website. Pet owners should work with their local veterinarian to confirm eligibility requirements.
The ACCRC is a comprehensive cancer care and clinical research center offering integrated services, including medical, surgical, and radiation oncology and frontline cancer diagnostics and treatment for dogs and cats. As a center of excellence for comprehensive animal cancer care and research, the 18,000-square-foot, purpose-built space treats all types of veterinary cancer. It offers opportunities for dogs and cats to be enrolled in clinical research trials.
