Companions Lead the Fight Against Cancer
Advancing translational medicine through clinical trials offers hope for improved health in pets and people
- Emily's story was featured by CBS News. Read and watch more about how Experimental brain cancer treatment for dogs could one day help humans.
- As of June 2019, Emily's last four MRIs have showed no growth of the tumor. She celebrated her 11th birthday this past March.
When Emily, a 10-year-old Portugese water dog, started having seizures in early 2018, her owner Laura Kamienski of Portersville, Pennsylvania, was shocked and scared. A specialist in Pittsburgh performed an MRI of Emily’s brain, and the results showed a brain tumor. Kamienski was devastated. “I sat in the middle of the exam room at the hospital and sobbed,” she said.
Kamienski was referred to the college’s Veterinary Teaching Hospital to enroll Emily in a clinical study led by John Rossmeisl, the Dr. and Mrs. Dorsey Taylor Mahin Professor of Neurology and Neurosurgery in the Department of Small Animal Clinical Sciences.
The study aims to determine the safety of a new chemotherapeutic drug—molecularly targeted cytotoxins—and drug delivery method in the treatment of brain tumors in dogs. Funded by the National Institutes of Health (NIH), it is a collaboration between the college and the Thomas K. Hearn Brain Tumor Research Center at the Wake Forest School of Medicine.
After performing an MRI, Rossmeisl confirmed that Emily had an aggressive glioma brain tumor, notoriously difficult to treat—in both animals and people—and always fatal. It is the same type of cancer that claimed the lives of Senator John McCain in August and his colleague Ted Kennedy in 2009. Without treatment, Emily had two-and-a half months to live.
A life-extending decision
Radiation therapy was the only option in Pittsburgh, and specialists there estimated it would have given Emily just a few additional weeks. Kamienski, wanting the best possible option for her beloved companion, decided to enroll Emily in the trial led by Rossmeisl, making her the trial’s 15th participant.
“I had to sign her up—she’s a member of my family, she’s my everything,” Kamienski said. “She has gotten me through some serious hardship over the years. It was my turn to do the same for her.”
Kamienski paid for the cost of the initial MRI to confirm Emily’s diagnosis; the study covered the treatment and follow-up examinations.
Rossmeisl explained that response to the experimental treatment has varied among study participants. “There are multiple sub-types of gliomas. The tumors are different, so their genetics are different,” he said. “We’ve had some tremendous success stories with dogs living for a year with their tumor shrinking and others having no response.”
In addition, the study design called for the drug dosage to increase progressively; it has doubled six times since the study began in 2014.
Emily received the treatment in April. The drugs, which are designed to affect only cancerous cells while leaving healthy cells unharmed, were injected directly into her tumor using a procedure called convection enhanced delivery—performed by inserting specialized brain-specific catheters directly into the tumor, and slowly infusing the drugs over a several hour period. During the MRI-guided procedure, Rossmeisl’s team watched the drug cover the tumor, confirming they had achieved the treatment goals.
Back at home, Kamienski noted Emily’s seizures had ceased and “she’s back to being herself.” A follow-up MRI in June showed the drug was killing parts of the tumor, which had shrunk by more than 50 percent. According to Kamienski, Emily resumed enjoying her favorite activities with her companion Leo, a 2-year-old Portugese water dog, especially romping in the woods and swimming in lakes and creeks.
December marked eight months since Emily’s treatment in the study. “We are just enjoying each day that we have,” Kamienski said. “If it weren’t for this trial, she’d be gone by now. I knew at the start that it’s not a cure,” Kamienski said. “But it gave me hope and has given her more time.”
Advancing treatment from canine to human patients
The study’s results thus far are promising, so much so that the NIH’s National Cancer Institute recently awarded a $9.2 million grant to help a research team—including Rossmeisl and other cancer researchers, engineers, surgeons, and veterinarians from Virginia Tech and Wake Forest University—in advancing the same treatment methods into human trials within the next several years. The five-year grant will fund four different approaches to treating glioblastoma, the most common and deadliest form of brain cancer in adults.
Waldemar Debinski, director of the Brain Tumor Center of Excellence at Wake Forest Baptist Medical Center, is the principal investigator for the grant. The team’s work started 16 years ago when Virginia Tech and Wake Forest researchers set out to find a treatment for glioblastoma, which has a median human survival rate of about 14 months in its most aggressive form, according to the American Brain Tumor Association.
Rossmeisl explained that clinical research involving canine companions with naturally occurring cancer can be a pathway to accelerate drug development for human cancers.
“The canine model is as close as you can get to doing it with a person,” said Rossmeisl, explaining that the FDA has said that it is willing to use the dog data from the trials as a safety indicator for developing human trials. “The dogs are benefiting from this treatment, and eventually these drugs are intended to benefit humans. The data from our study in dogs will inform both animal and human trials, so it’s mutually beneficial.”
Taking a synergystic, additive approach
According to Rossmeisl, the projects of the new grant are novel in that they use newer, improved versions of the technologies or drugs based on results obtained in the lab as well as in clinical trials. “We are evaluating various combinations of these unique approaches as they may have synergistic and additive anti-cancer effects,” he said.
The multidisciplinary team also includes Virginia Tech researchers Rafael Davalos, a professor of biomedical engineering and mechanics who co-wrote the grant; John Robertson, a research professor of biomedical engineering and mechanics; and Scott Verbridge, an assistant professor of biomedical engineering and science. Also on the team are Chris Rylander, formerly of Virginia Tech and now an associate professor at the University of Texas at Austin, and Akiva Mintz, formerly of Wake Forest and now a professor of radiology at Columbia University Medical Center.
In addition to these research partnerships, the college is a member of the Comparative Oncology Trials Consortium (COTC), a network of 20 academic comparative oncology centers, centrally managed by the NIH National Cancer Institute’s Comparative Oncology Program, which runs clinical trials in dogs with cancer. Through the consortium, the college and other COTC centers are united with study sponsors to support multicenter clinical trials of investigational therapeutics.
Creating more opportunities for cancer research
The college is now expanding enrollment in comparative oncology studies—those involving spontaneous, naturally occurring cancers in companion animals to advance the diagnosis and treatment of cancer in pets and people—like the one that helped Emily.
Dogs often develop the same or similar cancers as humans, and they get cancer at roughly the same rate as humans. Cancer will affect one in three dogs during their lives, and is now the leading cause of death in dogs and in cats over age 10.
Some trials at the college provide pets with access to leading-edge technologies and novel therapies that have already been tested and used in human patients. For example, a current study in canine patients is investigating the use of high-intensity focused ultrasound (HIFU) in the treatment of solid tumors, which has been shown to activate the immune system in humans, leading to more effective destruction of cancer cells.
The future of cancer care and research
To accommodate this program expansion, the college’s new Comparative Oncology Research Center—currently under construction on Virginia Tech Carilion’s (VTC) Health Sciences and Technology Campus in Roanoke, Virginia, and scheduled to begin seeing patients in spring 2020—will serve as a center of excellence for comprehensive animal cancer care and research, including comparative oncology trials. Housed in the VTC Biomedical Research Addition, the clinic’s unique colocation alongside human clinicians and researchers will allow veterinary oncology specialists and technicians to employ a One Health approach to cancer care and research, offering hope for a brighter future for pets and people battling cancer.
Bridging laboratory discoveries and patient care
In addition to nationally recognized oncology research, the college’s clinical research program includes specialties in cardiology, neurology, internal medicine, radiology, and regenerative medicine. Using a translational “bench-to-bedside” approach, researchers aim to take laboratory findings directly to clients in a clinical setting to achieve meaningful health outcomes.
Working closely with veterinary patients and their owners, referring practitioners, as well as funding partners—including federal agencies, private foundations, individual donors, and biotech and pharmaceutical companies—the college’s Veterinary Clinical Research Office (VCRO) facilitates clinical trials and translational research studies that advance a common goal of improving animal and human health. Current studies are tackling diseases such as mitral valve disease and glioblastoma in dogs, hyperthyroidism and inflammatory bowel disease in cats, and equine protozoal myeloencephalitis (EPM) in horses.
“Through our work in translational medicine and research, we further the college’s mission of providing compassionate clinical care and creating new medical knowledge,” said Gregory B. Daniel, interim dean of the college. “Our ability to develop and deploy new approaches to diagnosing and treating disease is due to the shared commitment of our faculty experts and their collaborators, the clients who bring their animals to our hospitals for treatment, our sponsors and donors, and our referring practitioners, including specialists in our Collaborative Research Network.”
The collaborative research network
Established in 2014, the Collaborative Research Network enables specialty practices in Virginia and Maryland to build unique partnerships with researchers as well as to participate in the college’s cutting-edge research. For example, when a practice in the network identifies a mass on an MRI that looks like a glioma, they reach out to the college’s VCRO to connect the patient’s owners with relevant clinical trials happening at the college
“Because the number of cases seen in the greater Washington, D.C., Richmond, and Baltimore areas far exceeds the number seen in Blacksburg, this specialist referral network has increased our ability to complete clinical trials quickly,” said Mindy Quigley, clinical trials coordinator at the college. “And by increasing the number of cases within our studies, the results and findings have greater scientific merit."
“We want the very best for our patients,” said Quigley. “I love connecting an owner with an innovative care option for their beloved pet and knowing that our efforts made a difference in a patient’s health outcome.”
Written by Alison Elward
Jenny Kincaid Boone, university writer; Olivia Coleman, mobile journalist; and Mindy Quigley, clinical trials coordinator, contributed to this article.