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The latest in treating canine lymphoma

Chemotherapy, antibody therapy and immunotherapy continue to provide hope

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Everybody reading this article has likely had their life touched by cancer, either personally or through a friend, family member or beloved pet. Cancer is something we all want eradicated.

While a complete cure may prove unachievable, making the disease more manageable is possible with the new technologies and advancements coming to the field of canine lymphoma.

Why the Type Matters

Canine lymphomas are a diverse group and among the most commonly diagnosed cancers in dogs. They collectively represent from 7 to 24 percent of all cancers diagnosed in dogs, according to the National Canine Cancer Foundation.

More than 30 types of canine lymphoma have been described, and each can vary tremendously in its behavior. Some progress rapidly and are acutely life-threatening without treatment, while others advance slowly and are managed as chronic diseases.

Lymphomas may affect any organ in the body, but they most commonly originate in lymph nodes before spreading to organs such as the spleen, liver and bone marrow.

Chemotherapy

The term lymphoma refers to a type of cancer derived from a white blood cell called a lymphocyte. In general, lymphoma can be divided into two classes, each with its own prognosis. These two classes—B- or T-cell lymphoma—are based on the cell of origin.

The Madison Wisconsin Chemotherapy Protocol (CHOP) is a multidrug rotational chemotherapy and the current standard of care in the treatment of canine lymphoma. Remission duration with CHOP therapy depends on which type of lymphoma a dog has. B-cell lymphoma has an average remission of nine or 10 months and T-cell four to five months with CHOP chemotherapy.

Current chemotherapy treatment options use drugs brought over from human medicine, with protocols modified for dogs. One chemotherapy drug designed for and labeled for animals—Tanovea-CA1, from VetDC of Fort Collins, Colo.—has received conditional approval from the U.S. Food and Drug Administration.

Antibody Therapy

Monoclonal antibodies have been used in concert with traditional chemotherapy in human medicine for the last 10 years. They act by assisting the immune system to identify which cells are cancerous.

Cancer cells are notorious for tricking the host’s immune system into believing they are part of the host and, thus, need to be left alone. Monoclonal antibodies utilize proteins that the cancer cells express, bind to them and then flag them so the immune system can recognize them more easily as foreign so they can be eliminated.

Monoclonal antibody therapy in veterinary medicine will not replace traditional chemotherapy like CHOP, but it will instead be added to the treatment protocol to improve the outcome.

David Vail, DVM, MS, Dipl. ACVIM, an oncology professor at the University of Wisconsin School of Veterinary Medicine, believes that monoclonal antibodies specific to canines will become part of the standard of care for lymphoma treatment within five years.

Transplantation

Bone marrow and stem cell transplant therapy have been used in dogs diagnosed with lymphoma.

Bone marrow transplant has been successful in a small number of cases, as it is available as a treatment option at only a few sites in the United States. Some evidence exists that it may be more effective with B-cell lymphoma, according to Brenda Phillips, DVM, Dipl. ACVIM of Veterinary Specialty Hospital in San Diego.

The option is expensive for the pet owner. In addition, bone marrow matching for dogs is poorly advanced compared with the human side.

Stem cell transplants are easier on the donor than bone marrow transplants. Both treatment options need to advance to the point where they are cost effective and have high cure rates and low numbers of adverse events.

Immunotherapy

Immunotherapy is a relatively new treatment modality for treating cancer in dogs. Its purpose is to enhance the dog’s natural defenses to fight cancer. Because of this effect, immunotherapy offers potential advantages over traditional cancer therapy, such as chemotherapy.

With traditional anticancer therapy, the goal is to directly target and kill cancer cells. Although the response rate may initially be high, the cancer inevitably mutates and acquires the ability to become resistant. With immunotherapy, the treatment is directed at the noncancerous immune system and not the cancer itself. Thus, resistance is less likely to occur and longer lasting responses to treatment are possible.

Adoptive T-cell immunotherapy is able to sidestep the long-term side effects of conventional chemotherapeutic protocols. Moreover, the modified T-cells persist in the circulation and help guard against the cancer’s recurrence. It also has the advantage of a positive response possibly lasting a long time.

The concept of treating cancer by harnessing an animal’s immune system to recognize and suppress abnormal cells is the basis of immunotherapy. Timothy Stein, DVM, Ph.D., Dipl. ACVIM, of Austin Veterinary Emergency and Specialty said that while more studies are necessary, “the initial studies evaluating adoptive T-cell therapy provide optimism that we may be able to move beyond the current plateau we’ve reached treating canine lymphoma with conventional chemotherapy.”

Another novel option for immunotherapy comes from Elias Animal Health of Olathe, Kan. The company’s platform, called the Elias Cancer Immunotherapy (ECI), triggers the immune system to attack and eliminate cancer cells.

Each patient’s cancer is unique, and cancer therapy itself must be unique, CEO Tammie Wahaus said.

“This proprietary combination approach utilizes pretreatment with a personalized cancer vaccination followed by ex vivo activated patient-derived cancer neoantigen specific effector T-cells that specifically target the patient’s cancer cells, not normal cells,” she said.

One downside, Wahaus said, is that “some patients experience side effects similar to those that the body generates when rejecting an infectious disease such as a flu virus, which can be medically managed with anti-inflammatories.”

She also said the dual approach is what makes ECI distinct from other cancer immunotherapies.

Yet another technology on the horizon is called checkpoint inhibitors, which act as immunological checkpoints, or brakes, to prevent overactivation of the immune system on healthy cells.

Tumor cells utilize these checkpoints to escape detection by the immune system. Inhibitor therapies are being used in people diagnosed with melanoma or lung cancer. They are commonly utilized in conjunction with anticancer vaccination to enhance the vaccine’s activity.

Checkpoint inhibitors are showing “exciting” preliminary results in people, Wisconsin’s Dr. Vail said, and “have the potential to be game-changing as an adjunct treatment for certain [canine] cancers.”

Veterinary Goals

The oncologists interviewed for this article agreed that industry and researchers should strive to produce:

  • Better products with better treatment outcomes.
  • Treatment options that are more affordable for pet owners.
  • Treatment options that require fewer client visits.

Conclusion

The veterinary profession needs to do a better job of defining cancer from a genetic perspective. Transitioning from a blanket treatment approach based on tumor type to a more precise method based on the exact disease a patient has on a genetic level is paramount. Knowing this information would steer oncologists to use one therapy, or a combination, for a lymphoma patient instead of a one-size-fits-all approach.

The future of cancer treatment is personalized medicine to allow for a more manageable disease, a good quality of life and not an automatic death sentence.


Dr. Meghan E. Burns owns Connect Veterinary Consulting. Her expertise includes marketing, product and business development, key opinion leader management and medical writing.

28 thoughts on “The latest in treating canine lymphoma

    1. Don’t panic, because you have time, and there are cures.

      Ed Sullivan of Bellingham Veterinary in Bellingham Wash does T-cell therapies and Bone Marrow Transplants, Steve Suter does BMT’s in NC at NCSU. Google searches can turn up contact info for both. There is an open BMT study supposedly in Washington at Fred Hutch, but I paid $1500 to pull samples to get in, all the while being told my guy was in, but when the time came, they closed the door and said the USDA guy wouldn’t let him in, so your mileage may vary. If funds are short, be careful, and get a written guarantee before spending your own cash.

      Talk to Ed before doing anything, unless your dog is already at death’s door. You usually have a week or two to gather info. Chemo at your vet with CHOP will almost always be a first step, and it will be very effective for a while, but if you want to do some therapies you may need to grab cells before Chemo begins.

      There are other studies in different areas, from a telomerase vaccine, to a cell based vaccine which takes lymphoma cells and puts bacterial proteins on them to create a vaccine. Google them, but none seem to be cures though. Novartis has an antibody which might be able to be given every few months to hold things off indefinitely, but you would have to appeal directly to Novartis for it on compassionate use grounds as it is not yet approved, and I have no idea if they would do it.

      Only a BMT is a real cure, and only a matched-allogenic BMT is a good chance of a cure.

      Good luck.

    2. My dog was diagnosed with B cell lymphoma in late July/early August 2017. We agreed with the Veterinary oncologist and pursued the Madison Wisconsin protocol. We are now 17 weeks into the 25 week protocol and we were told at week 7 that she was in remission. I dread hearing that the cancer has returned and hope she remains in remission for a fair while. All I can do is hope and provide her with the best life she can possibly live for the rest of her time. I’ve been told by a friend she will stay as long as she is meant to stay and that’s a good way to look at it all. Good luck with your journey

  1. October 2015 My golden retriever, Daisy was diagnosed stage four T cell lymphoma… Due to many factors I chose not to do full on chemo. This was daisies third type of cancer. After a grueling 24 hours of research, many conversations with my vet and an appointment at a canine Cancer Center here in Connecticut… I chose not to do a full on chemo. I chose the rescue protocol lomustine to hopefully get a comfortable month or two from her… We changed her diet I now cook for her and she’s on some immune boosting supplements. It is now 26 months later and Daisy is better than she ever has been in her life. I am fully convinced had I done the full on chemo treatment she would not be here.

    1. Debbie, may I ask specifically what your cooked diet consists of? I too switched to a totally homemade cooked diet for my dog after she finished CHOP protocol for lymphoma in May 2017. I “formulated” this diet after doing a lot of research on the internet – it’s a high protein, moderate fat, low carb diet (with supplements because I know it’s not a “balanced” diet). My Vizsla girl has been doing great and so far is still in remission. 🤞

      1. Debbie,
        My sweet Mako is now out of remission we discovered Friday. Please share your diet. I can’t bear to think of him not being with us but don’t want him to suffer. Maybe your diet will give us some more time. Please help us!

    2. Debbie,

      your post gives me hope. my golden doodle just turned 3 and was diagnosed with early stages of lymphoma. our oncologist appointment is tomorrow and we are already against chemo and other harsher treatments. can you give me details into your diet and other advice you touched on. i appreciate it greatly during this hard time.

    3. Hi Debbie,

      My six and half year old Aussie “Rocky” has just been diagnosed with lymphoma. We are just beginning process working with oncologist. The specific type has not been diagnosed yet hopefully next week. We are very interested in specifics on diet and supplements. Look forward to hearing from you soon. Thank-you for your time. Your story is an inspiration to us.

    4. Please send me your diet and supplement informatuon. My golden was just diagnosed with t cell lymphoma. I have an oncologist appt. Thursday.

      1. Hi Beth Ehlert,
        Just wonder if Debbie replied to u? I see many people asked her but i don’t see a reply. I would like to find out the food that she cooked for her dog too. Coz my dog also suspected lymphoma cancer

    5. My dog was just diagnosed and he is 13 so I would rather not do chemo at this point of his life. Can you please send me the diet that your dog is on. Right now my dog is on a lot of supplements and is doing great but I would like to change his diet as well. Thank you.

    6. Hi Debbie,
      Sounds like you are as passionate about your golden with T cell lymphoma as I am about my boxer with the same. Would you be willing to share what diet you’ve been preparing and what supplements you’ve added? My 6-year old Greta is now out of remission for the second time – I think we’ve been through all the chemo there is out there, and I’d like to take a more holistic approach.
      Thank you kindly,
      Heather

    7. Hi Debbie I have a boxer pit 5 years old with t cell lymphoma and we are doing lomustine can I talk with you for advice

  2. My Boston Is starting chemo on January 8,2018 I need to give her the best chance at this.. my Christmas is a fog..any information on supplements and food that I can boost her immunity would be greatly appreciated thank is only 5 and so much a part of our family. My vet said she’s no more than stage 2 thanks in advance

  3. debbie,

    my golden retriever has just been diagnosed with lymphoma and is in early stages. can you be specific as to what your diet is for her and anything else you touched on. my pup just turned 3 and we would hate to put her through harsh treatments.

    thank you!

  4. My beagle was diagnosed with lymphoma in Nov of 2017. My oncologist has her on the modified Wisconsin protocol at this point. We did try Tanovea on her at first with a bad gastrointestinal results. She had been responding but now some of the chemo meds are not working and is having a great impact on her appetite inspite of the anti-nausea and appetite stimulant medications. I’m looking for an alternative to give her a fighting chance at remission.

    1. We must be dopplegangers, as my beagle was diagnosed in October 2017. We did the CHOP protocol, alternating between vinchristine, chlorambucil, and doxyrubicin. She has had so many GI issues. She has to take pheno and proin (compounded capsules, from a pharmacy god knows where, because she will not eat the chewables) twice daily. I give her Cerenia for anti-nausea, antiemetic, & increase appetite. And Prilosic every evening to heal her tummy. But give her any treat, pillpopper treat, anything!, and she sniffs her nose up. She’s got to have her meds, so unfortunately for the both she and me, I have to crush it all up, dissolve in water, add some pepto for the burning tummy, put it all in a syringe, and down the hatch. She hates me for a few minutes, I hate myself. ANYWAY, it does seem she is in remission for the lymphoma. We only did 11 weeks treatment, but soon, we’ll have to start again when the lumps get big again. 🙁

    2. Michelle, i’m so sorry to hear this – how old is your beagle. Our beagle is 6 and was just diagnosed today. There are not any oncologists in our area, they are 3-4 hrs away.

    3. My Aussie, Tracker, went through the same thing with Tanovea. The first session went well but the second one almost killed him! He didn’t eat, was losing almost a pound a day, became lethargic, had gastric problems, developed a rash on his entire groin area. It was horrible. We decided not to give him his third session because of his condition. It’s now been almost six weeks since session two and he’s finally himself. Just a warning to all out there, Tanovea is a very strong drug and there are other options. He goes back in this week for blood work and an exam. I don’t think he is in remission, since this is his second go around of Lymphoma, but we will not give him Tanovea!

  5. We did T cell infusion following CHOP and are just shy of three years remission now. If anyone is looking for bone marrow or stem cell transplant, or T Cell Therapy support and information, I have this Facebook group for pet owners (we do not at this time allow medical practitioners since it is an owner support group): https://www.facebook.com/groups/1260458577324887/?hc_ref=ARQrgWtoZ7ETRogsrCt6Gn-Jbx6cVB2UyTBezMOJEZ9RNr_5ihes4FHMwXlh-LWvoPc I wrote about my dog’s experience here: https://www.somepets.com/tys-canine-t-cell-infusion-therapy-for-lymphoma/

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