You may have been researching potential treatment options for your pet online and come across many facilities or institutions that are partaking in or directly running clinical trials. Clinical trials are research studies that prospectively evaluate new or novel treatments or diagnostics for patients with particular disease processes (and, in our case, cancer).
Translational medicine is an ever-evolving term to describe the relationship between human and veterinary medicine. Through many years of research in our pets, there is increasing evidence that the biological and molecular behavior of cancers and other diseases are very similar to that in humans. Therefore, studying both allows for a translational approach; therapies used in human medicine may have benefits in veterinary patients, and new and novel therapies used in veterinary patients may have utility in human patients, accelerating drug development exponentially. Did you know many of the first limb-sparing (attempts at preserving the affected limb of patients with bone cancer) surgeries were performed in canine patients with osteosarcoma (bone cancer)?
Why are new treatments/diagnostics so important?
For many types of cancers, research into new protocols using our standard chemotherapy agents or using new and novel therapies allows us to make potential breakthroughs for treating such terrible diseases. The evaluation of new diagnostics also allows us to compare to gold-standard diagnostic options, promoting a better and more accurate diagnosis of cancer, detecting it earlier in the disease stage, or possibly prolonging life by providing more personalized medicine based on the genetics of an individual patient’s tumor. So, to advance both human and veterinary medicine, these clinical trials allow us to try new things, whether it be new therapies or new diagnostics, and to make the next step toward a cure.
Who is eligible?
Every clinical trial is different. Many clinical trials programs run through large institutions such as veterinary teaching hospitals or through large private practice referral facilities. Many will list specific criteria online or have contact information for you to reach a clinician or clinical trials coordinator to find out if your pet may be eligible. Clinical trials typically have quite strict inclusion-exclusion criteria to prevent bias when determining if a true and successful difference exists between patients. Your pet may be entirely eligible, but in the general sense, most pets must:
- Be generally healthy otherwise
- Be of a certain age and weight range
- Have a diagnosis of cancer with the type that fits the study criteria
- Either be currently undergoing therapy, or not have had therapy previously
- If your pet has had therapy, a time period may have to pass before being eligible (e.g., a 72-hour washout period from steroid medications like prednisone)
What are the benefits to animals and their pet-parents?
Clinical trials offer a plethora of benefits to patients and to their pet parents. We must always realize that when testing new and novel therapies, there is always the potential that no response may be achieved and disease could progress, regardless. However, there are many instances where clinical trials provide a financial incentive for pet parents (e.g., a new drug will be paid for or diagnostics through the treatment period of the study will be covered), while the new therapy may provide benefits for your companion. In the majority of cases, however, the diagnostics performed prior to enrollment to ensure your pet is eligible are usually not covered by the study. Typically, in the face of an unsuccessful treatment outcome with a new and novel therapy, your companion can still be treated with the standard of care protocol thereafter. Each clinical trial offers different incentives and different levels of involvement in terms of recheck visits, diagnostics performed, or collection and questionnaires that are performed by you, the pet parent.
Where is cancer therapy headed and how does this help advance human cancer treatments?
Cancer therapy in humans is currently at the leading edge of more personalized medicine; a patient’s tumor can be genetically diverse, and now that we have the tools to assess those changes, therapies can be catered to the patient’s specific tumoral makeup. Immunotherapy, or priming the patient’s own immune system to recognize the cancer as foreign, is becoming increasingly popular as well. Several of these diagnostics and agents are being used in clinical trials in humans and becoming ever increasingly used in human medicine.
Human cancer clinical trials for new therapies cost millions of dollars and take an extraordinarily long time to obtain FDA approval for use. Our companions breath our air, and are exposed to the same environments we are. The tumors evaluated in canine and feline patients also behave in similar manners, meaning our pets can be used as models for cancer in ourselves, allowing for accelerated growth and development of new and novel therapies and bridging the gap between human and veterinary medicine.
How do I find out more?
The AVMA lists many clinical trials currently underway. A search function allows for you to search by tumor type or institution. Clinical trials do fill up quickly and, as stated previously, have a specific set of inclusion and exclusion criteria. If you or your veterinarian believes that your pet could be participant in one of the listed clinical trials, contact the institution at which the clinical trial is being evaluated.
Chris Pinard, DVM, is an oncology clinical trials intern at Flint Animal Cancer Center in Colorado State University.