Immunotherapy has transformed cancer treatment. It works with the immune system to attack malignancies that have evaded the body’s natural defenses. This advance offers an alternative to treating cancer with surgery or chemotherapy and radiation, which can attack healthy tissue and cause extreme side effects.
The treatment is not only scientifically complex but also expensive. Investing money and time makes sense when it comes to saving people. But what about when it comes to dogs?
Dr. Hans Klingemann has worked and researched cancer immunotherapy for decades, with leading departments at Rush University Medical Center in Chicago and Tufts Medical Center in Boston. Now, he is the chief scientific officer for cellular products at ImmunityBio, which develops immunotherapy drugs for humans. But he has also written two papers investigating whether new treatments might one day extend the lives of dogs.
The interview below has been condensed and edited for clarity.
What interests you about immunotherapy and dogs?
I love dogs. I have dogs: Sophie and Maximiliano. They are about 18 pounds each, a mix of a bichon and a cavalier spaniel.
Did they get cancer?
Luckily they haven’t got cancer… Yet. But when dogs get older, many get cancer. Are there any benefits of immunotherapy? Could we make life easier, the rest of life, for dog and owner?
In most cases, dogs actually receive chemotherapy. We don’t know how much these treatments affect the quality of the rest of life and, in most cases, it’s not even very clear how effective these treatments are.
Your first paper on the subject found significant obstacles to the development of immunotherapy for dogs. Can you describe them?
Pharmaceutical companies are very financially conscientious. They haven’t really developed monoclonal antibodies or other more targeted immunotherapies for dogs. It doesn’t make sense financially for them. For example, an antibody treatment for a dog could easily cost thousands of dollars and no insurance company would pay for it, and — with the occasional exception, of course — no dog owner would. So there really isn’t a market for big pharma.
At the time, was there any evidence that these drugs worked in dogs?
Veterinary research centers will treat 12 to 15 dogs with drug X, but there was no real comparison. How would they do with another drug, like Drug Y? These comparisons offer the most controlled studies, which have not been done systematically in dogs. Also, the risk of cancer depends on race. The risk depends on the dog’s breed and age. It is difficult to get, say, 20 dogs for a breed. Therefore, it is difficult to get clean data.
And in humans, we can measure benefit versus harm because a doctor can ask us how we feel. But you can’t ask the dogs. They just lie in the corner and don’t like what we do.
You also made the point in your first paper that human drugs may not work for dogs because our genetics are different.
Dogs and humans share 80% to 85% genetic homology. While this sounds good enough, it is not enough to simply give a dog an immunotherapy that has been shown to work in humans.
Efforts are being made to evaluate dogs for how well they receive immunotherapy and cancer treatment in general. Some centers try to find a scale for how an animal feels and the response rate to treatment.
A recent study looked at whether a human immune protein can be given by inhalation to dogs that have extensive metastatic disease from melanoma or bone cancer in their lungs. It showed promising results. determine the dose tolerated in dogs, showing encouraging survival times in treated dogs and good tolerability. It will pave the way for future studies using human immunoreactive cytokines in dogs.
However, there has not yet been much push to develop new immunotherapies for dogs. There was little progress, a stagnation. It’s a bit harsh, but that’s basically right. I hope that in a few years, we will be able to have more targeted immune-based therapies for our dogs — but they have to be affordable.
Has this realization made you rethink the eventual death of your dogs?
What I am currently wondering is how we can make the rest of life after a cancer diagnosis for the dog (and the owner) more bearable with palliative treatment options that extend life but also preserve the quality of the rest of life. That’s all I would ask, and I know many dog ​​owners feel the same way.
How are your dogs?
Sophie is 3. Maximilian is 13. he took a walk on the beach today. He is not sick at all. He just gets tired because he is older and sleeps a lot. But I totally get it.
