Posted on January 29, 2017
Lymphoma’s Newest Enemy
For the first time in a very long time, a new drug has been approved for dogs with lymphoma. The drug is called Tanovea-CA1 and it is produced by VetDC Inc., a startup company associated with Colorado State University. Earlier this month, Tanovea-CA1 received conditional approval from the Food and Drug Administration for treatment of dogs with lymphoma.
What is lymphoma?
Lymphoma is one of the most commonly diagnosed forms of cancer in dogs. Golden Retrievers are the unfortunate poster-puppies for this disease. Lymphoma arises from lymphocytes, normal white blood cells involved in the immune system. In dogs, lymphoma most commonly arises within the lymph nodes, spleen, and bone marrow, but because lymphocytes circulate virtually everywhere, it makes sense that lymphoma can grow anywhere within the body.
Lymphoma cells tend to be quite responsive to chemotherapy and radiation therapy, and it’s not unusual to achieve complete remission (no obvious trace of the cancer remaining) in response to treatment. What is very rare, however, is for lymphoma to be cured. Invariably, there is relapse of the cancer. While “rescue chemotherapy protocols” are often capable of zapping the cancer back into remission, over time those crafty lymphoma cells figure out how to develop significant drug resistance. With rare exception, lymphoma is a terminal disease.
Tanovea-CA1
The active ingredient in Tanovea-CA1 is rabacfosadine, first developed for use as a cancer-fighting drug in people. In dogs rabacfosadine has been documented to have anti-tumor activity in “naïve” lymphoma patients (those who have not yet been treated) as well as in those with a relapse of their cancer following treatment with other chemotherapy drugs. Tanovea-CA1 is an every-three-week treatment administered intravenously for up to five dosages. For now, Tanovea-CA1 has received “conditional” FDA approval, meaning it can be given to a dog for up to one year. The conditional approval may be extended with ongoing evidence of effectiveness.
How does Tanovea-CA1 compare?
The gold standard treatment for canine lymphoma utilizes a drug called doxorubicin that is often combined with three other drugs (cyclophosphamide, vincristine, and prednisone) in what is called a CHOP protocol.
In a study combining Tanovea and doxorubicin in 54 dogs with lymphoma, an 81% positive response rate was observed. This Tanovea/doxorubicin one-two punch was found to be generally safe and well tolerated.
The rate of response and duration of remission using the Tanovea/doxorubicin combination were both comparable to CHOP regimen results. Here’s the big difference. The CHOP protocol typically requires 12 to 16 treatment visits to complete. The Tanovea/doxorubicin treatment protocol was accomplished in only six visits. What a monumentally positive difference this would make, not only for the dogs, but for their human companions as well. I don’t yet know how pricing of the two protocols compares.
From my point of view, this is really great news on the canine lymphoma front. I’m on board with anything that makes effective treatment of this disease more efficient and less taxing for everyone involved.
Have you ever cared for or known a dog with lymphoma? If so, what was the breed?
Best wishes,
Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook
Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.
I lost my 7 y/o German Shepard to lymphoma last year. He had no S&S. One day he could not stand up. My mobile vet came and found low blood sugar. We dosed him with maple syrup. By the time I got him to the emergency vet, he was standing. After an ultrasound it was found he had lymphoma all over his abdomen. Every abdominal organ was involved. He was beyond treatment and I euthanized him. He never acted or looked sick until hat last day.
Our 7 year old lab / poodle was diagnosed with stage 1 lymphoma. We went through CHOP but it had no effect. We lost him 2 months after diagnosis.
My beloved Black Labrador Retriever, Madison, was diagnosed with Lymphoma. There were enlarged lymphnodes in her stomach. It took way to long to diagnose her. (7 weeks). Her only symptom was diarrhea. She had an appetite and still wanted to do agility. So of course she was on chicken and rice and Flaygl. (She really wanted to eat her kibble.) Then my vet put her on a different medication hoping she had inflamatory bowel disease. After 2 weeks it had not gone away so my vet sent me to an internist for an ultrasound. It revealed her lymphodes in stomach were swollen. So the internist did an aspiration on her back leg lymphnode and she sent it to a lab. After she performed the aspiration she stated it most likely will be inconclusive. I was not happy that she performed it and then tells me. What should have been done was a punch biopsy of the back leg lymphnode. (which my vet kept asking if he could do that instead) So more time was wasted. By the time the biopsy was performed and having to wait almost a week for the results, she was far to gone. I tried Chemo but she did not go into remission like they usually do after the first or second treatment. (they dont stay in remission). We did one more treatment but it did nit work. The only thing I can tell you, is if they find enlarged lymphonodes do a punch biopsy right away and skip the aspiration!!
Hi Meghan,
So sorry that your Frenchie has lymphoma. The Tanovea is supposed to be available this spring- not sure quite when though. It certainly might be worth a try. Unfortunately, I don’t know of any herbal or natural supplements that are effective against lymphoma. Are you working with a board certified oncologist?
Best wishes,
Dr. Nancy
Hi Dr. Nancy,
My 7 year old French Bulldog has been fighting lymphoma for 2 years now. She went through the CHOP protocol and was in remission for a few months but is now fighting again and does not seem to be responding to chemo any longer. I am wondering if Tanovea is worth trying for her. I am also curious about any natural or herbal supplements that any of you have had luck with?
Thank you in advance!
My Bichon Frise had cutaneous lymphoma at the age of 15. It was heartbreaking to see him suffer so badly. He lived in six months after his diagnosis.
Hi Dagmar,
Wow, thanks for sharing your amazing story. This just goes to show ya, you never know!
Best wishes,
Dr. Nancy
Hi Paige,
I am so sorry for your loss. It is always unpredictable which dogs will respond with lengthy remission times and which ones will not.
Warm best wishes,
Dr. Nancy
Hi Elizabeth,
So sorry to hear about your Ridgeback- such a youngster…. If you’ve not already done so, I encourage you to get a second opinion from a veterinarian who specializes in oncology (www.acvim.org) to discuss Tanovea as well as other potential options.
Best of luck,
Dr. Nancy
I rescued this 11 year old boxer and as he turned 12 he was diagnosed with a very aggressive kind of T-cell lymphoma. The vet gave him 4-6 weeks, if we are lucky. We could try chemo which would potentially (no guarantee) buy him up to 6 months.
Due to his age and me being an Animal Therapist I decided against chemotherapy and instead worked out a regime of herbs and supplements together with a herbalist/naturopath.
3 weeks into using the herbs one of Buddy’s lymph nodes was enlarged and I nearly gave up. But then – what did we have to lose? I continued the herbs (Buddy loved them! They seem to know what is good for them) and the lump started to shrink! 2 weeks later it was gone.
6 weeks into the herbs I went to our regular vet and he was surprised to see Buddy again, he could not believe he was still alive. The vet said, ok – IF he is still alive, bring him back after 3 months.
6 months (!) later I went back to the vet and asked him to confirm the lymphoma diagnose. He had to admit, he cannot confirm it any longer and that Buddy was officially in remission!
Buddy lived for another year after that.
I lost my 10 year 7 month old Bernese Mountain Dog last year to lymphoma. It is certainly a ray of hope in the options for treating the disease. For most of Holly’s course we were part of a Facebook group for lymphoma that was very helpful and supportive. I consider us very lucky in that Holly pretty much breezed through the 26 week CHOP protocol with few if any side effects and no delays in continuing due to low blood counts. She had 17 great months feeling very much herself.
There is a relatively new blood test that purports to detect recurrence of the disease before clinical symptoms would otherwise indicate. What I didn’t realize was that her use of Metacam (for her torn ACL since surgery was not an option) likely masked the results and failed to indicate her recurrence until it was full blown and her disease more extensive than when originally diagnosed.
What I did learn from the Lymphoma FB group was that we were relatively fortunate in her treatment – both achieving a remission the first time around and having very few side effects. There are a number of dogs in the group who have achieved remissions now measured in years – some with only the original course of treatment, others with one or more rescue protocols – but there were also a significant number who failed to achieve any remission or for whom it was very short and did not last through completion of the initial chemotherapy protocol.
Tanovea and the other drugs in the pipeline provide some hope that there will be other options to consider for those facing this disease.
I certainly hope it proves to be a viable option in more widespread clinical use.
my 2 year old Rhodesian Ridgeback was diagnosed with stage 4 lymphoma 3 wks ago. we didn’t do chemo because of it’s poor prognosis in extending her life significantly. I have been supporting her with bovine colostrum and Life Gold . her nodes went down but her submandibular did notgo down until we started prednisone. she is eating normally, does not seem to be in pain and is active. her coat is shiney and she doesn’t look sick. would Tanovea CA1 be of any benefit.
The pup I adopted out to my neighbors and kept 2 – border collie, sharpie, shepherd mix – made it to her 5th birthday and despite chemo treatment, lost her battle in a matter of weeks to lymphoma. Never heard of a mutt going through this so fast – prolapsed rectum, bladder cancer cells, cancer lymph cells and trouble breathing. Started before Thanksgiving and ended after Christmas despite weekly chemo of different therapies.
We had a Springer Spaniel that had lymphoma. She was 8 and went quickly too. That was about 8 years ago, so I’m sure what treatment she had, if any.
My 3yo bullmastiff Capone was diagnosed with lymphoma. Underwent CHOP, remission for 1 month, we lost him not long after it came back.
Great question! No, it’s not approved for use in cats, and I’m not sure if the company is working on this.
Wow, 3.5 years! That’s impressive!!
My a golden Retriever had lymphoma . He survived 3 1/2 years with 2 rounds of chemo. Happy to see that Hope is on the horizon.
How about lymphoma in cats? Does this new approved drug also work for them?
Hi Joellen,
I am sorry for Rudy’s diagnosis, but am pleased that he is currently doing well. Such was not the case for another Border Collie described in another comment posted in response to this blog. When it comes to being your dogs’ medical advocate, I trust that you have great intuition. Follow your gut on this one after considering what the oncologists at UCD have to say.
Best wishes,
Dr. Nancy
Hi Carole. My heartfelt very best wishes are with you during this difficult time. So sorry for stirring up painful memories. It sounds like you were a wonderful advocate for your Sage.
Best wishes,
Dr. Nancy
Too late for my sweet Sage: my Sage, a Border Collie, died last month shortly after her 14th birthday, of Lymphoma, metastisized to her lungs. It was only diagnosed a few weeks before. If she were younger and I didn’t have two other senior dogs, I would have searched for another way. My vet could only offer CHOP or straight prednisone, and we put Sage on pred. She exhibited no symptoms, save the swollen lymph nodes until the last day, when she collapsed and had difficulty breathing. It’s no use for me to bemoan the fact that we didn’t know about Tanovea. The time between diagnosis and death was very short, and I’m not even sure I would have wanted to put her through treatment. She had the most life of any dog I ever had, and I miss her terribly.
My Rudy, a 10 year old Border Collie was diagnosed with lymphoma on November 1st. He has been being treated with the CHOP protocol, along with Chinese herbs, medicinal mushrooms, and acupuncture. He is currently in full remission. We just went to UCD to see if we qualified for their Tenovea trial, which we do not since he is in remission, but if/when he comes out, we will qualify. They did offer half body radiation in conjunction with the CHOP protocol, but I am on the fence as to whether I want to do that. I was going to email you privately, Nancy, to get your input. Time is if the essence since we missed our first optimal window of opportunity, and the second window is in about 3-4 weeks. Feel free to respond privately, if you like, or on this forum. I need a candid opinion.
Rudy is doing great! He feels great and is full of energy! Molly beat the odds living far longer with TCC than anyone expected, hoping Rudy will do the same with lymphoma.
I’m so sorry for the loss of your most special dog.
I recently lost my heart dog, 10 1/2 yo Clumber Spaniel, to lymphoma. We went with the max protocols and I was so hopeful that we could have quality time left.
He did not respond well to treatment, was sick most of the time, did not go into remission, and he was gone within 4 months of diagnosis. I still find this painful.
This drug was not an option at our time.
My 6 Year Old Tibetan Terrier had lymphoma – did not respond to the beginning Vincristine Treatment – already in Stage 4 – He went quickly. So much to suffer through at such a young age – no Family History of this cancer in his Breed Line