On the Horizon: Hemangiosarcoma Studies

Every veterinarian who has treated a dog with HSA wishes for better early diagnostics and more effective therapies to stop the growth of the HSA tumors. “The wish list for every veterinary oncologist starts with trying to find some way to deal with hemangiosarcoma,” says Rodney Page, DVM, MS, Professor of Oncology, Director of the Flint Animal Cancer Center, and Principal Investigator for the Golden Retriever Lifetime Study. “It’s a tumor that’s relatively unique to dogs and has completely evaded all attempts to understand what’s going on in a way that’s able to be modified in the patient. It’s a rapidly fatal cancer and one that desperately needs better diagnostic tools and treatments.” (Quoted from “Cancer Research: Looking Back, Moving Forward,” morrisanimalfoundation.org, March 27, 2019.) Fortunately, research on HSA is taking place in many locations: 

• Ethos Veterinary Health’s Canine Hemangiosarcoma Molecular Profiling (CHAMP) project is a multi-faceted prospective study of canine splenic HSA. One of its first undertakings was to assess the value of personalized medicine in dogs with HSA and then validate the usefulness of a potentially prognostic test. Through a collaboration between Ethos and the Translational Genomics Research Institute (TGen), the molecular characterization of genomic alterations in HSA was recently completed. CHAMP hopes to identify dogs with distinct prognoses and develop molecularly targeted therapies for each patient.
• Ethos Discovery (a division of Ethos Veterinary Health, LLC) is evaluating Rapamycin to determine whether it can improve treatment outcomes for dogs with HSA and to gain an understanding of which HSA genotypes may benefit most from its use. Rapamycin is known to have an immunosuppressive that provides significant anticancer activity and has been approved for use in treating several human cancers.
• At the Flint Animal Cancer Center at Colorado State University in Fort Collins, researchers are evaluating the effectiveness of VDC-597 administered orally to dogs with Stage I and II splenic HSA who have undergone splenectomy. VDC-597 is an oral agent that has antitumor and antimeta-static activity in human and mouse cancer models as well as in canine HSA cell lines.
• The Veterinary Clinical Investigations Center at the University of Pennsylvania in Philadelphia, in partnership with NovaVive, are in the follow-up stage of a study on the efficacy of treating canine splenic hemangiosarcoma with intravenous Immunocidin, the mycobacterial cell wall fraction derived from non-pathogenic Mycobacterium phlei, stimulating anti-tumor activity. It is currently approved for the treatment of mammary cancer in dogs.
• The University of Minnesota Veterinary Medical Center, Purdue University, and University of Pennsylvania are collaborating on a study to determine whether propranolol (a blood pressure medication) used in combination with standard-of-care doxorubicin chemotherapy can improve outcomes for dogs with HSA. Propranolol can kill HSA cells in the laboratory; it has also been effective in reducing disease progression and increasing survival time in humans with angiosarcoma (which is similar to canine HSA).
• A study at the New York State College of Veterinary Medicine at Cornell University aims to find and test new drugs that can prevent tumor growth. The long-term goals of this project are to identify better procedures and drugs to treat canine HSA as well as to test the ability of newer targeted drugs in preventing tumor growth or recurrence.
• The Shine On Project, led by Jaime Modiano, VMD, PHD, at the University of Minnesota College of Veterinary Medicine, is designed to detect HSA cells in the blood at the earliest onset by way of a new, targeted drug called eBAT. The drug was developed at the University of Minnesota with the goal of destroying the cells responsible for tumor formation, thereby stopping the formation of malignancies. The process “will use a blood test to look for the cells responsible for establishing and maintaining the disease, and then use an experimental drug treatment that attacks those same cells in order to prevent development of the tumor.” Researchers at the college have been studying the biology and the behavior of HSA for more than 10 years.
• A recent retrospective multicenter observational cohort study of 406 dogs determined that the risk of HSA diagnosis in dogs presenting with blood accumulation in the abdomen could be predicted using a simple risk score modeled on four predictors: body weight, total plasma protein, platelet count, and thoracic radiograph finding. This evaluation process could aid in identifying and treating dogs at lower risk for this diagnosis. (“Development and validation of a hemangiosarcoma likelihood prediction model in dogs presenting with spontaneous hemoabdomen: The HeLP score,” Schick et al, Journal of Veterinary Emergency and Critical Care, Volume 29, Issue 3, 17 April 2019.)
• Michigan-based Metta Pets is currently enrolling dogs at select referral centers around the United States for a clinical trial, “Investigation of a traditional Chinese medicine herbal therapy protocol for treatment of dogs with Stage II splenic hemangiosarcoma after splenectomy.” They will evaluate the impact of a standardized bupleurum-based herbal formula administered with vitamin D supplementation, Yunnan Pai Yao, and coriolus mushroom granular extract in canine patients diagnosed with stage II splenic HSA following splenectomy. To date, no toxicities from the treatment have been noted, including one dog who received a significant repeated overdose due to client non-compliance. Preliminary data suggest improved survival times when compared to chemotherapy treatment and an increase in the number of patients living to one year or more. This study will assist in determining if these promising findings are repeatable when a larger number of patients are evaluated.

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