What were the highlights of 2020? Should we think about 2020? Yes, there were amazing things in the world of cancer and cats and dogs in 2020. So let’s talk about it. And the great thing about this is that it’s a taste of some of the cool stuff that will be available to us as veterinary professionals and pet owners in 2021. Welcome to the last article of 2020. Thank goodness right? I’m sure many of us are eager to change the calendar to 2021. But you know, there have been some truly amazing advancements in the world of cancer for dogs and cats. So, I thought, since we’re all eager to change the calendar to 2021, let’s take a look at some of the really shocking things that are happening in the world of dog and cat cancer. And I think if we go through them, a lot of them are almost examples of what will continue to affect oncology, IMHO in 2021. And many of these will, in fact, be previewed some of the upcoming articles I’m on. to work. Let’s do it. Let’s analyze it. Let’s take a look and highlight what happened in 2020. And what will happen in 2021?
No doubt pause for me. I know it was a little cheesy, but seriously, I am very excited about Stelfonta’s FDA approval for the treatment of mast cell tumors. And we can expect Stelfonta to complete our internship at the beginning of 2021. And one of my first articles I’m going to do will be about Stelfonta. So we dive deep into Stelfonta there. If you are looking for more information, I will give you a brief description here. But at the end of 2019, I had the opportunity to go to Australia to treat a number of dogs with Tigilanol tiglate, which is now known as Stelfonta. This is an intratumoral mast cell tumor treatment for that common malignant skin cancer we see in dogs. It is then injected directly into the mast cell tumor. It does not replace surgery. But it is another resource in the toolbox. Another treatment option we’ll have for dogs with mast cell tumors. In the new article, I will discuss some of the requirements. There are certain size limitations. It is for all types of skin mast cell tumors. And for subcutaneous mast cell tumors, they should be placed distally below the elbow or hock joint.
So there will certainly be things to know. And they must be less than 10 cubic centimeters. So again, we’re going to get into that, but I think it’s so good to have a new option for mast cell tumors, especially those unresectable mast cell tumors, mast cell tumors in difficult locations at the end of the legs, on the face. So I’m really excited about Stelfonta, and again, more information is coming and Virbac will spread it. It’s manufactured by an Australian company called Qbiotics. And again, very excited. What excites me most is that it was approved by the FDA in late November 2020. And, as I said, it should be available in veterinary practices in early 2021. I think oncologists like me will have it available first as soon as they start. the implementation. One of the things you are probably wondering is okay,
But I have to provide some information. I can’t move on to the next one without giving you some information. So we see a response of about 75% around day 28 after injection. And for dogs that need a second injection, I think it goes up to 85%. And they watchdogs for a year. So the disease-free interval at 12 months later, 88% of the dogs were still disease-free after that. So a very viable option for dogs with mast cell tumors. Read the next article in early 2021.
The second thing that excites me is a new blood cancer screening test from a company called Volition Veterinary. And the test is called Nu.Q Vet Cancer Screening Test. And this is something new that I am premiering here. In fact, I also made a Facebook post at the end of 2020. This test will start in early 2021, 2021. Sounds strange to say. So this trial is about to start and will be available to GPs. And this is one blood test that you as a pet owner might want to consider in your dog’s annual blood test. And if you are a vet, you would also consider running for middle-aged dogs. So what is this test measurement, and again, I’ll be writing an article on this next year as well. But it measures something called nucleosomes, which is part of the DNA, the chromatin in all cells. And when cancer and other serious inflammatory conditions are present, it is released into the blood. So we know that this score will be very low in healthy dogs without cancer. And in dogs with certain types of cancer, the score will be high and high. So we can use this as a cancer screening test. And some of the cancers that the Nu.Q Test can properly detect are things like lymphoma and DiMaggio’s sarcoma. Tests are currently underway, also looking at some other cancers, such as certain mast cell tumors and histiocytic sarcoma. So this is a really exciting test.
Recommendations at this point would be something you would consider for middle-aged and older dogs as part of your routine blood work. They must fast. So again, something to think about. You should discuss this with your vet in early 2021. Another application of the Nu.Q test is varieties with a high risk of cancer. So Golden Retrievers, Rottie, German Shepherds, some of those breeds. You may even want to consider taking the test before you reach middle to old age. So people always say to me,
“Will regular blood tests detect cancer?”
If it’s your vet, you already know, then you can go to the Volition website even if you have a pet. They have a lot of information, articles, we have. I recommend to them. So they have pet owners brochures and veterinary information, articles, and the like. So stay tuned for more information. As I said, you can go to their website and I’ll be posting some links below as well. The third thing that really turns me on is Tanovea, one of the drugs for lymphoma. It’s not new for 2020. But what really impresses me about Tanovea, a lymphoma chemotherapy drug, is how I use it more and use it more in my practice. And it is still conditionally approved. So it’s not fully approved yet, but it’s coming. And it has really had a huge impact on lymphoma treatment. And as more studies go on, I think the way we treat dogs with lymphoma will evolve.
So the standard of care, and we’ll link to my lymphoma articles below, remains CHOP’s multi-agent chemotherapy protocols. So it’s not for Tanovea. But Tanovea has made rapid progress as part of my Plan B protocol for dogs with B cell lymphoma. Historically, I would treat them with doxorubicin as monotherapy. And now I often treat it with doxorubicin, alternating with Tanovea.
And my first rescue protocol for a dog that doesn’t pass CHOP chemotherapy is Tanovea. So we learn a lot more about it. And so I am very excited. And I think it has really had a huge impact on the treatment of lymphoma in dogs. So of course I have more articles on lymphoma. In fact, I recently wrote a summary article on that. So for me it is something that I am looking for more. And more studies have been done on it. And it really has had such a positive impact on lymphoma treatment. And since it’s one of the most common cancers I’ve treated, you know, in practice every day. I’m thrilled about it. And, as I said, although it is not new, it continues to have an impact on my daily practice and a positive impact on the dogs I treat, and I had to put it on the list.
The fourth topic I want to talk about in my 2020 review is immunotherapy. We are seeing more immunotherapy treatment options coming into play for dogs and cats, especially dogs, at this point. You know, we also saw an update on one of the immunotherapies already available. And that’s also a great reminder that just because a new therapy is available doesn’t mean the end of everything. Or that it is something that we should now adopt as a therapy standard and try a new therapy. So it’s really important and people always want what’s experimental, what’s new. But it doesn’t always mean it’s the best. We have to do those clinical trials. We have to make sure that the data shows that these treatments are effective and safe.
So the only immunotherapy that’s no longer available, according to some, you know, updated safety studies, immunotherapy, was the canine osteosarcoma vaccine. And that was based on the results showing that there were some side effects of listeria. It is a vaccine against weakened listeria. And when some results came out, they saw some listeria positive dogs. And the vaccine was originally developed by Aratana, which was later acquired by Elanco. And in January 2020, it was announced that they would no longer develop the vaccine. And then we won’t get a few more updates on that until October. So that was very sad news because it was like this immunotherapy, treatment for dogs with osteosarcoma.
It had been super exciting and this would have been in other articles that I, you know, am super excited to get so excited about these new treatments. You know, for the dogs that got amputations and chemotherapy, this immunotherapy slowed the metastasis. Very exciting. But you know, now we’re looking at the safety issues that got the dogs sick and there were, you know, positive cultures. They contracted listeria infections, and there were also concerns about zoonotic potential. So owners get listeria, you know, infections too. But I’m still excited about immunotherapy and I think it still has the potential to positively impact cancer treatments. One of the other immunotherapies we have been using safely for years is the melanoma immunotherapy vaccine for dogs with oral and finger melanoma. That has been available for over 10 years. Another new immunotherapy that I am excited about and has good evidence for is ELIAS and which is immunotherapy for cancer. It’s adoptive cell therapy. And they just published some studies. And these were dogs that underwent amputation, without chemotherapy, and then underwent this immunotherapy regimen. And, in a recent study of just 14 dogs, I find it’s a very small number. The median survival time was 415 days for one year, i.e. without chemotherapy.
And so we traditionally think, you know, dogs need chemotherapy after amputation to extend their survival after four to five months. And there were five dogs in that study who lived longer than 730 days. And that was recently published by Doctor Flesner et al. In the Journal of Veterinary Internal Medicine. Very exciting. So again, we may have new immunotherapy options for dogs with osteosarcoma. Very exciting. That’s me, you know, my topic on, you know, what’s exciting and new I think is immunotherapy. But again, as we get new data, we still need to analyze it, make sure it’s safe, and run larger clinical trials. And make sure it is not only effective but also safe. But this is the one that turns me on. Again, this is ELIAS immunotherapy for cancer and I intend to do another article for you as well. And hopefully, something with which I will also be involved in my practice. So stay tuned, I’ll be sure to give you more information. And you can also visit their website if you are looking for more information.
What else has had such a positive impact on my practice this year? Not only this year, but also medicines for appetite loss. And actually, I have them at home and I don’t even have dogs undergoing chemotherapy. But, Entyce for dogs. this is a ghrelin agonist. So ghrelin is the hunger hormone. It mimics the hunger hormone and makes unwilling dogs think they are hungry. And Cerenia, a medicine for nausea and vomiting. So basically I always have them on hand for my Labrador at home in case they get sick. And if you follow me on Instagram, I have lemons, melibea like a lemon. And for cats, there’s Mirataz, which is mirtazapine, which is topical, so you don’t even have to give your cat who doesn’t want to eat topical medication a pill. And by 2021, the makers of Entyce will have an FDA-approved version for cats, which is great too. So another option for lack of appetite for cats. And while I love Mirataz, which is great, sometimes your animal needs more than one medicine. I am going to post a link to my articles and what to do if your pet is not eating as that is very important. That’s one of the things that I’m passionate about, you know, what to do when a pet isn’t eating? Because it is stressful if they don’t want to eat. And it’s important that we have drugs that can help them when they don’t want to eat, you know?
If there’s a chemotherapy patient, a cancer patient, a pet with kidney disease, heart disease, you know, many different things can cause loss of appetite. So these drugs have improved my life as an oncologist because pets will eat more and, you know, we can help them through their treatments. So so important. You know, these aren’t just new for this year, of course. But you know, there is every day catching up. So so shocking. And I am grateful to them. And if you have a pet undergoing chemotherapy, make sure you have it on hand. I will post links. You must go home with them on the first day of your treatment. Cats and dogs have to go home with my gift bag of recommended medications.
We will also make sure to link to that article. And, as much as I would love to ignore COVID, I don’t think we can have a review for 2020, without talking about COVID-19, and how it impacted our lives as veterinary professionals, pet owners, and just plain humans. in society. And then, you know, it was a scary time, right? Because of the concern about how COVID can be transmitted to pets. Can we get it from pets? Can we make our pets sick? So such a scary moment on so many levels, quarantine, social distancing, wearing masks. All those different things really have, you know, it’s hard to even sum it up. But I think one of the things for me as a vet has been so difficult, you know, checking in at the curb and not being able to be in the exam room with my clients. Especially when we’re talking about cancers and cancers coming out of remission and talking about different treatment options. And, for pet owners, you know, waiting while I do chest X-rays and ultrasounds and make various diagnoses. And I know you’re waiting in the car and how scary it is. And I really want to get back to normal, back to the exam room, face to face with my clients. And I just know how hard it has been for pet owners to get through this. To the vets reading, thank you for everything you do. Technicians, everyone. The whole Practices team, you know, it was a really challenging year. It has been a grueling year on many different levels.
In fact, I am dealing with COVID at my home right now. So it has been a very tough and difficult year. I look forward to 2021. I look forward to more progress in oncology. I hope I can help you navigate this crazy world of cancer and just get through it. So without getting too excited, thank you very much for your love and support. See, I will get emotional. I almost stopped writing articles this year because it has been a lot. So thank you for your love and support. I really can’t believe it. I really appreciate you and everything you do. And your love and support. I already said that. Thank you very much for reading. Stay tuned in 2021, I have a lot planned. Keep sending me your comments. Some people have given me great suggestions. Here I have a list of different topics we are going to cover. Who knows what they’ll throw at us, but we’ll get through it together. Happy holidays. Stay safe, stay healthy, and hope to see you again in the next article.