This page is dedicated to current research or treatments that provide insight and direction on how to approach treatment for your furry baby.
Quickly starting Chemo makes a difference
https://avmajournals.avma.org/view/journals/javma/259/7/javma.259.7.749.xml
“Median overall survival time for dogs with a TI amp-chemo ≤ 5 days (445 days; 95% CI, 345 to 545 days) was significantly longer than that for dogs with a TI amp-chemo > 5 days (239 days; 95% CI, 186 to 291 days).”
Summary: Dogs who received chemotherapy five days or less after surgery survived significantly longer than dogs who did not. The sample size in this study was 168 dogs, which is big for a dog study. If your treatment plan will include amputation and chemo, please show this to your oncologist.
Infections and longer life
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556346/
“The development of a surgical-site infection has been reported to prolong survival times in dogs undergoing limb-sparing surgery in 2 prior studies.19,27 The 20 dogs that developed a surgical-site infection in the present study had significantly longer survival times after 1 year. The median survival time of this group after 1 year was 180 days (range 25 to 1,899 days), which was significantly (P = 0.002) longer than the median survival time for the dogs without a surgical-site infection (28 days; range, 8 to 282 days). This warrants further investigation.”
Summary: Dogs that receive a limb-sparing/salvage surgery tend to get infection more than dogs that get a full amputation. In the cases where a limb-sparing surgery was used and infection occurred, the dogs lived significantly longer. This information seems to be more widely known, but may be a good introduction to why immunotherapies work.
At face, this may encourage you to go for limb sparing/salvage surgery. There are other considerations to take into account, cost and quality of life being the most important. First, the cost for the limb sparing/salvage surgery can be 2-3x the amount of amputation. Second, recovery is very hard with keeping part of the limb. It may be two months before your dog walks again, whereas with the amputation they’ll walk the next day. And if there is an infection, there may need to be antibiotics or even another surgery done to correct it.
In my opinion, go with the amputation and focus on extending life and enjoying it with your furry friend. The immunotherapy treatments created with the cancer sample post amputation and/or EGFR vaccines are a better route than hoping for an infection with limb sparing/salvage surgery.
The EGFR/HER2 vaccine.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379704/
“The median survival time is 478 days (95% CI; 418–617 days) and the mean survival time is 496 days (95% CI; 426–565 days).”
” As a first open-label canine clinical trial, these data demonstrate that immunization with a specific EGFR/HER peptide induces cell-mediated and humoral responses in canine recipients and could be a promising immunotherapeutic strategy for canines with tumors that express ErbB family proteins.”
Summary: Researches at Yale have developed a vaccine that could help. The vaccine, which can be made without a sample of the tumor, is only available in Washington. Survival time is significantly increased. The cost of this vaccine is very small, you only pay for the vet visit (total cost of treatment with it a few hundreds).
More info here – https://medicine.yale.edu/intmed/raci/rheumatology/research/caninecancer/
This is my favorite treatment at the moment! It has proven results and is very affordable. We need to make sure this vaccine is more readily available.
Please donate to the Yale team to continue development of this vaccine, every dollar helps!
Two Drugs That May Delay Spreading To The Lungs
Losartan + Toceranib
https://pubmed.ncbi.nlm.nih.gov/34580111/
“Results: Human and canine OS cells secrete CCL2 and elicit monocyte migration, which is inhibited by losartan. Losartan PK/PD studies in dogs revealed that a 10-fold-higher dose than typical antihypertensive dosing was required for blockade of monocyte migration. Treatment with high-dose losartan and toceranib was well-tolerated and induced a clinical benefit rate of 50% in dogs with lung metastases.”
Summary: The results do a pretty good job summarizing it. Losartan + Toceranib, which are readily available drugs, inhibit metastasis, and show 50% clinical benefit..
Immunotherapy Vaccine By ELIAS
https://pubmed.ncbi.nlm.nih.gov/32649801/
“Results: Autologous cancer cell vaccine and activated cellular therapy (ACT) products were successfully generated. Toxicity was minimal after premedicants were instituted before ACT. With premedication, all toxicities were grade I/II. Median disease-free interval for all dogs was 213 days. One dog developed cutaneous metastasis but then experienced spontaneous complete remission. Median survival time for all dogs was 415 days. Five dogs survived >730 days.”
Summary: The ELIAS vaccine is a newer immunotherapy which may have much longer survival times. The sample size in their study was small; however, it was promising. Showing a median survival time of 415 days. The vaccine is no longer in clinical trials and requires purchasing. The cost is significant (well over $10k). The vaccine also requires the vet doing the surgery to send in a sample to ELIAS to make a vaccine for it. The steps are outlined here – https://eliasanimalhealth.com/treatment/ .
Fluoxetine shows promise in laboratory testing
“In our study, the MTT assay demonstrated fluoxetine significantly reduced viability of U-2 OS cells. Next, target protein RANK/RANKL expression were also downregulated by fluoxetine in dose dependent manner. Besides, STAT3 mediated NF-κB activity, were also inactivated by fluoxetine. Additionally, the expression of PARP1 (DNA damage related, and several oncogenes such as XIAP and Cyclin D1 were also downregulated by fluoxetine in dose dependent manner. Moreover, the inhibition of tumour angiogenesis by fluoxetine has also proven by using aorta ring assay. Further in vivo experiment may need to be performed to identify anti-tumor efficacy of fluoxetine.
In sum, fluoxetine can be used anti-tumour adjuvant of OS therapy and the detailed mechanism or further combination strategy may be worth exploring.”
Fluoxetine, which is a drug commonly given to dogs for anxiety or aggression, may have off-label use for fighting osteosarcoma. The above laboratory testing study showed that the drug can slow down mechanisms of the body that are linked to osteosarcoma. Although this mechanism wasn’t verified in studies involving dogs with osteosarcoma, it shows promise.