University of Minnesota, research updates

Last week, we had the opportunity to catch up with Dr. Jaime Modiano about the current state of hemangiosarcoma research, and learned about some interesting topics that we'd like to share with our readers.

The first thing Dr. Modiano mentioned is that they are learning hemangiosarcoma is not just one disease, but many. He mentioned 3 subtypes that appear to behave differently in terms of how quickly they progress. The 3 subtypes he mentioned were:

  • inflammatory
  • angiogenic
  • adipogeic

The first 2 subtypes are much more common, and for that reason, more information is becoming available about them. Although the information is still preliminary, dogs with inflammatory hemangiosarcoma seem to have better odds of becoming long term survivors. Further research to confirm this observation could one day be beneficial for pet owners, since treatment decisions could be made based on which subtype of the disease their dog has, and could provide more realistic expectations around survivorship as well. This topic will be something I will read more about in the upcoming weeks, and potentially add a section to the website that will provide more details.

Another exciting update is that a company has licensed eBAT, a drug that was developed at the University of Minnesota and has been shown to improve survival time in dogs with hemangiosarcoma (see this research article for more info, where the drug was shown to improve "6-month survival from <40% in a comparison population to approximately 70%" ). This company will be testing the drug in new clinical trials, and we will be following up in the next few months to learn the outcomes of these studies.

Finally, the University of Minnesota's Shine On project, which aims to improve early detection of hemangiosarcoma, has entered Phase 3 of the study. The study is progressing as planned and we look forward to hearing whether or not the new blood test can be used to detect this cancer, and whether eBAT treatment might be an option to prevent the disease in dogs at risk.

So what's next for us? I've been a little less active on the website for the last couple of months, and taking a break during that time has helped with the healing process. But I know there are a lot of dogs and pet owners who could benefit from the resources we're putting together here, so I will be stepping up my involvement again in the upcoming weeks, reaching out to more researchers, putting together more pages (including one about stem cell research, which we have learned more about recently at the request of one of our readers), improving the existing content, and more. I appreciate everyone who has reached out to us, and my heart is with anyone who has been impacted by this disease. 

Puplift

It's been a few weeks since our last update. During that time, we gained 501(c)(3) status from the IRS for our organization, Puplift. This is a huge milestone for us, and will give us new opportunities for raising money for hemangiosarcoma research. We are still figuring out the the best way to raise money for research, but we're talking to a couple of companies that I think may be able to help us out. For example, we may end up creating some sort of product (cute dog collars, dog toys, etc) and offering that in turn for donations (or donating any profits if we sell these directly). I think the product-based approach may provide a steadier stream of research funding than simply asking people for donations, and that is the main idea we are pursuing now.

It's been a quiet few weeks in terms of contact with the universities we had previously been speaking with. I hope to reconnect once we're a little further along with some of the ideas mentioned above. Until then, we are using the Puplift name to build an audience of dog lovers on both Instagram and Facebook, and I hope this audience will eventually join us in our fight against canine cancer.

We also added a new pup to our In Memory page. This cute dog, named Maggie, is yet another reminder about why our organization exists, and what exactly we're fighting for.

Finally, Elyse and I will be going to Edisto Beach in April to spread some of Bear's ashes in one of the places he loved the most. The video of Bear playing fetch in the ocean (see the home page) was taken in Edisto, and we have some many great memories there. It only seems fitting that we spread some of his ashes there.

 

5K Planning

A couple of weeks have past since our last update. Things got a little busy during that time, but one item I have been looking into over the last few days is the organization of a 5K. I spoke with the organizer of Atlanta's second largest 5K, the O4W5K, and will be joining their next board meeting to see what I can learn that might be applicable to our own run. I'll provide an update shortly after with more details about this meeting, which is set for Thursday.

I have also been continuing to donate time to the Australian Shepherd Health and Genetics Institute, and am looking for new volunteer opportunities as well. I hope that this volunteer work will allow us to start building relationships that may one day help fight hemangiosarcoma. together.

If you want to go fast, go alone. If you want to go far, go together

- African Proverb

Finally, we followed up with the canine DNA testing company that we mentioned in the previous blog post. They proposed a study that would help determine whether or not certain genetic mutations are present in dogs that develop hemangiosarcoma. However, I believe that without the ability to detect HSA earlier, or treat it effectively, telling pet owners that their dog may have a genetic marker associated with this disease wouldn't be actionable at this point in time. So, we would like to circle back around to this idea in a few weeks, but look further into studies around earlier detection and more targeted treatment techniques as a potential precursor to this study, in the meantime.

Thank you for reading, look for another update soon.

Genetic Testing - Follow up

This week, I met with one organization that specializes in canine DNA testing, and two universities that are actively researching different treatment methods for hemangiosarcoma, to learn more about how genetic testing could:

  • help determine if some dogs are genetically predisposed to hemangiosarcoma,
  • be used as a method for early detection of this disease,
  • enable more targeted treatment plans

I have broken this article into 3 sections based on the bullet points above. The goal here was to explore a topic that may be of interest to people whose dogs have hemangiosarcoma, and try to present the information in a way that is useful for pet owners. I am not a doctor, veterinarian, or researcher. I am a pet owner who lost his best friend, Bear, to hemangiosarcoma, and I am simply trying to help someone else who is forced to confront this terrible disease in the future.


Predisposition

Picture this: you bring your new puppy to the vet for a checkup. Your vet notices that your puppy is a high risk breed, and recommends a DNA test to determine whether or not your dog contains any known genetic markers that are associated with hemangiosarcoma. A week later, the results of the DNA test come back, and your puppy is found to have a few genetic mutations that are associated with this disease. This does not mean your dog will develop cancer later in life, it just means their risk for developing this disease may be higher. Your vet says not to worry, but when your puppy reaches age 5, the usual physical check ups should be supplemented with more sensitive cancer-screening procedures. This allows you, as a pet owner, to be proactive in screening against a type of cancer that usually goes undetected until it's too late. More aggressive screening could lead to earlier detection, which in turn, could lead to better treatment outcomes. (end hypothetical).

Current reality: according to all three of the organizations we met with, the road to making the above scenario a reality is a long one. That's not to say it shouldn't be pursued though, but there are a lot of things to consider. For example, hemangiosarcoma is very likely to be the result of multiple causes (e.g. a cumulation of genetic changes + environmental factors), so a simple DNA test to determine an individual's predisposition may not be possible. However, the fact is, scientists simply haven't looked yet, so it's not something that we can rule out. 

Another challenge that one of the researchers mentioned is that "markers are not actionable". In other words, if a dog is determined to be predisposed to developing hemangiosarcoma later in life (given the results of a DNA test), there isn't much a pet owner can currently do to address it. For example, in the above scenario, we mentioned more sensitive cancer-screening procedures being employed after your dog reaches a certain age. However, there actually aren't a lot of screening procedures that would help at this point. Based on information we received from both veterinarians and researchers, echocardiograms, ultrasounds, and other methods may not be sensitive enough to detect hemangiosarcoma at an early stage (the Early Detection section below discusses some promising research in this area, though). The question then becomes, is it useful or ethical to let a pet-owner know that their dog may be more likely to develop an incurable, aggressive cancer, when there isn't anything they can do about it?

Future Research: The canine DNA testing company we spoke with expressed an interest in subsidizing research (in their own labs) to help identify genetic markers associated with hemangiosarcoma. Whether or not this is something we can participate in will be discussed in a follow up call later this month. We want to do everything we can to support the right research, but given the costs of a long term study and the challenges mentioned above, we may need to raise more money first, or pursue a different kind of strategy for fighting hemangiosarcoma.


Targeted Treatment

Picture this: your dog is diagnosed with hemangiosarcoma. However, what used to be standard therapy (surgery + chemo), has recently been replaced by a more personalized treatment plan. The first step is still the same - the primary tumor is removed via surgery. However, instead of resorting to chemotherapy, which floods your dog's system with drugs that indiscriminately kill both healthy cells and cancer cells, your dog is given something called a gene inhibitor, which prevents the expression of certain genes involved in tumor generation. Your dog's life is extended without the decrease in quality of life that is often associated with chemotherapy. (end hypothetical).

Current reality: The recently published (November, 2017) work at the University of Pennsylvania, which you can read about here, has already put us on the path to this type of personalized medicine. Two of the researchers we spoke with explained that not every tumor is the same, and that cancer is often driven by different mutations. However, using a DNA test to detect which mutations are involved for a given case would allow doctors to find the so-called Achilles' heel for an individual tumor, and then use certain gene inhibitors to prevent the expression of the genes involved. If fighting cancer is like war, chemotherapy is like the machine gun that kills wildly and indiscriminately. The new regime (surgery + gene regulation), however, is more like a sniper (in the sense that it doesn't aim to kill everything in it's path, but to take calculated shots, instead).

Future Research: Out of the three organizations I spoke with, continuing research that explores personalized medicine (via gene therapy) as a method to fight hemangiosarcoma was the priority of only one. After talking to this university briefly about their goals and their current work, the direction felt very progressive to me. As we continue to develop our own direction, we will definitely be having more conversations with this university to see how we can support their work.


Early detection

Picture this: you bring your dog to the family vet for a routine checkup. In addition to the usual routine of weighing your pup, checking teeth and gum health, etc, your vet draws some blood and sends it off to a lab. A few days later, the results come back, and a small number of tumor cells were detected in your dogs blood. Your dog has shown no signs of cancer or any other health issues, but the extremely sensitive blood test has picked up on microscopic disease. Not only that, but technicians were able to extract DNA from the circulating tumor cells. Now, instead of allowing the tumor to grow for a few more months or years in silence, you can start addressing the issue now. (end hypothetical).

Current reality: Research is currently underway to develop methods for detecting a small number of tumor cells in the blood. One notable study is the Shine On Project at the University of Minnesota. This study is employing a blood test to see if hemangiosarcoma can be detected early by looking for certain cells in the blood stream. If these kinds of tests are also sensitive enough to detect the DNA that belongs to the tumor, then the types of targeted treatments we mentioned above could potentially be employed in the earliest stages of the disease. However, one of the researchers we spoke with warned that it could be several years before this type of screening in available for pet-owners and their dogs.

Future Research: Unfortunately, we didn't get a chance to talk much about this type of research during this week's conversations. However, we will be exploring this topic again as we continue researching material for our awareness campaigns.


Thanks

I hope the information above helps someone, somewhere. Thank you for reading.

Genetic Testing

As we continue to research content for this site, one idea that I keep coming back to as a means for fighting hemangiosarcoma is genetic testing. A recent research article that was published in November, 2017 (less than 2 months from the time of this writing) identified mutations in 4 genes that could potentially pave the way for new types of treatment. As we discuss on the Treatments page, if your dog is believed to have hemangiosarcoma, your vet will mostly likely recommend surgery, chemotherapy, or both. These treatment methods have existed for a long time, and given the poor prognosis of dogs who undergo these treatments, I think the idea of a new, more targeted type of treatment is very promising.

That is why we are dedicating this week to the exploration of genetic testing as not only a means for more targeted treatments, but also as a method for determining whether or not certain individuals are predisposed to this type of cancer. In order to do this, we plan to leverage the knowledge of both canine geneticists and hemangiosarcoma researchers in a series of meetings later this week. Our first meeting, on Wednesday, will allow us to discuss these ideas with a canine DNA testing company. Then, on Friday, we have meetings with researchers at 2 universities who have also expressed an interest in these ideas.

I am optimistic that improving our understanding of hemangiosarcoma at the genetic level will lead to better treatment and earlier detection. Given the small sample size of many HSA studies, however, more research may be needed before any of the current findings are incorporated into a test. But there will be always be challenges; we just need to understand and overcome them so that one day, we can give dogs, like Bear, a shot at beating this disease. I hope that our meetings will shed some light on genetic testing as a potential solution for fighting hemangiosarcoma, and I will be providing an update next Saturday (Jan. 13) about what we learn in the upcoming days.

 

Year of the Dog - 2018 Strategy

According to the Chinese Zodiac, 2018 is the Year of the Dog. That's exactly what we think, too. Today, we published our strategy for fighting cancer in 2018, and the 4 key areas we will focus on are:

  • Building partnerships
  • Establishing a presence
  • Aiding Research
  • Raising awareness

We have set some specific goals for each of these areas, and have detailed them here. We are already working on some of the goals that are outlined in that document. For example, over the next 2 weeks, we have a couple of meetings with other organizations that I hope will lead to new partnerships to fight hemangiosarcoma.

Another exciting update is that we are going into the New Year with a new logo, courtesy of Elyse Seymour.

BearVector_profile_watercolor.png

Anyways, I hope you have a wonderful New Year, and look for our next update sometime next week. 

Christmas Eve

Today is Christmas Eve, and it's been a difficult holiday season without Bear. But one thing that has helped lift our spirits is the support we have received from family, friends, researchers, veterinarians, pet owners, and others, as we fight to raise awareness and research funds for hemangiosarcoma. So, to everyone reading this post, and to everyone who has helped us in some way: Thank You. We are eternally grateful for your support.

We have so many exciting things in the pipeline that we are almost ready to share with all of you, including our 2018 strategy, which we will be posting right before New Years. Also, we have a couple of small updates that we'd like to communicate in the mean time:

  • We are developing a new page that will provide pet owners with tips for identifying good / trustworthy research articles. We will be incorporating some tips that we received from multiple people who work at universities (who look through research on a regular basis), and will be rolling this page out sometime next week.
  • We have also added a subscription form to the bottom of our site, which will allow you to track updates to this blog whenever we create a new post. This is a minor update, but I think it will improve communication with our regular blog readers.

Anyways, thanks again to everyone who has supported us during this tough time. We hope you all have a Merry Christmas.

Treatments page

We are back from New York, and picking up where we left off. Today, we added the first version of the Treatments page, which will give pet owners a quick overview of the standard treatments available for hemangiosarcoma, and even an interesting alternative treatment that was studied by the University of Pennsylvania. We will be digging further into the treatment landscape in the next few days, and updating this page further with information tailored to pet owners.

One treatment that we will be including more information about is called eBAT. This drug was developed and studied at the University of Minnesota, who detailed some very promising results in an article that was published earlier this year. According to the research, eBAT improved median survival times from < 40% to 70%, with 6 out of 23 dogs surviving more than 450 days. This research gives me even more confidence that we chose the right organization to raise money for during our initial fundraising campaign.

Anyways, our next update will be shortly after Christmas. Our plan is to keep making content improvements to the site itself, and to also start detailing our plan for raising awareness and research funds in 2018. Thanks for reading!

New York

My wife and I will be in New York for the next 4 days, so our next update to this site will be sometime early next week. Bear is constantly on our minds, and usually at this point before a trip, we are taking him to our local vet for boarding. That was always the worst part of going somewhere, leaving Bear behind. I always preferred the trips where Bear tagged along, like when we would go camping at Edisto during the spring or summer, and take long walks by the beach with our pup. And we'd sleep in the same tent with our Bear, sharing the same ground, the same bed, the same air, and the same life. It's days like this that we feel his loss the most. We love you Bear, and we will never stop fighting for you.

New pages, new partnerships

In the last 2 days, we have added a couple of new pages. The What is HSA? page contains an overview about hemangiosarcoma, and the new Links page contains links to various research studies and articles that we find interesting. Both pages are likely to change and grow in the next few days as we continue to find new sources of information.

Also, we had our first veterinarian fill out the Veterinarian Questionnaire. This is a huge step in the right direction for us. We are trying to understand this disease from multiple perspectives, and leveraging the knowledge of veterinarians will ultimately improve the information we present to pet owners.

Finally, I have been in contact with the Australian Shepherd Health and Genetics Institute, and it looks like there is an opportunity to me to help them with some data preparation / cleaning. It will be a good opportunity for me to learn from an organization that has been around for awhile, and to incorporate some of what I learn into our efforts here at Cure HSA.

Partnerships

We've been in contact with researchers and veterinarians from the very beginning of our efforts to understand hemangiosarcoma, and raise awareness about this disease. However, today marked some additional progress with our goal of establishing relationships with other organizations.

Specifically, we've created a veterinarian questionnaire that will help us establish partnerships with licensed veterinarians, and understand hemangiosarcoma prevention, diagnosis, and treatment practices from the practitioner's point of view. In the next couple of days, we will also be launching a researcher questionnaire that will serve a similar purpose. 

We have also been reviewing some recent research around genetic predispositions to hemangiosarcoma, and even received some correspondence from one of the author's of this Golden retriever study. One of the goals of this website is to provide updates on research, and establishing relationships with researchers will make this a lot easier for us, so we're super excited about that.

Finally, we have started working on a Treatments page, that will contain information about standard therapy, and also more targeted therapy as well. It may take a few days to roll out the first version, so keep checking back, or join our newsletter by filling out this form

Non-profit formation

Today, we started the process for forming our non-profit. We created our Articles of Incorporation and submitted a name reservation request (which could take 5-7 days to approve). We are excited to be starting this journey to raise awareness and fund research for hemangiosarcoma.

In the meantime, we are currently exploring some research articles and other material that will allow us to build out our "Pet owner portal", which will describe current diagnostic and treatment information for pet owners. The amount of information around hemangiosarcoma available on the web can be overwhelming, and the academic and medical language surrounding this information can sometimes be confusing and repetitive. Our goal is to tailor the available information for pet owners in a dedicated section of our website, so be on the look out for that.

Currently, the best way to follow our progress is to signup for our occasional newsletter here, and to follow us on Facebook.