Learn all about promising advances with early cancer detection in dogs on Tripawd Talk Radio Episode #115.
What is the OncoK9 Early Detection Cancer Test? What cancers does it screen for? And what can be done when results reveal a positive Cancer Signal Detected? Learn all about early cancer detection in dogs out on this episode of Tripawd Talk Radio…
This is Tripawd Talk Radio episode number 115, and we’re going to be discussing promising advancements in the detection of canine cancer.
Learn About PetDX OncoK9 Early Cancer Detection Test For Dogs
Nearly half of all dogs get diagnosed with some form of cancer. Wouldn’t it be great to have an accurate early cancer detection test for early cancer detection in dogs? And what can you do if a cancer signal is detected? Well, we’re about to find out.
Keep listening as Tripawds’ Rene talks with Board-Certified Veterinary Oncologist Doctor Andi Flory – Chief Medical Officer. She’s Co-Founder at PetDx, creators of the OncoK9 test for Early Cancer Detection.
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PetDx Early Cancer Detection Test for Dogs Resources
Learn more about OncoK9
When to start Cancer Screening?
OncoK9 Cancer SAFE™ (Screening Age For Early detection) tool
Test failures and false positive or false negative results may occur. To review OncoK9 disclosures, please visit the OncoK9 Test Limitations & Risks web page.
Prefer to read about the PetDX test? All the details follow in our transcript of the interview with Dr. Andi Flori!
Tell us how and why you got involved with OncoK9.
DR. FLORY: I am a veterinarian. I’m a medical oncologist so I treat cancer in dogs and cats and I have practiced in the San Diego area which is where I live for a little over a decade. And in 2019, I was practicing here. I was working at both of our hospitals that are in this area and I kind of think of it a little bit as fate kind of made this all happened because I was really interested in early cancer detection and what pet parents could do to try to find cancer early. It’s one of the most common questions that I get is:
What could have I done? What can I do for my next dog to try if they are going to develop cancer to try to find it early?
I was already thinking a lot about early cancer detection and I happen to have a little patient by the name of Poppy.
Poppy came to me and like most dogs that I see in clinical practice, unfortunately, her cancer was detected only after it had spread, and that happens unfortunately not infrequently because the way that we usually find cancer in dogs is that they start to show clinical signs or symptoms is what they would be called. In people and dogs, we call them clinical signs because they can’t voice them, they can’t tell us that they are nauseous but we can see that they are nauseous because of the signs that they are showing. Because her cancer was detected because of clinical signs, her cancer was already advanced and it meant that it already spread.
As a veterinarian having to tell a family, “I’m sorry that you are going through this diagnosis,” and there are definitely things that I can offer.
I can do things to help Poppy feel as comfortable as possible for as long as possible, and here are the options that we have. But in terms of a cure, the chance of that unfortunately is low. It’s kind of a devastating feeling.
As we were going through Poppy’s treatment, I got to know her family pretty well and it turned out that Poppy’s owner, her dad, is an MD by training but his background expertise is in something called genomics, which is basically the study of the entire genome or the set of instructions in the DNA and also something called liquid biopsy which is cancer detection with just the blood test.
He said to me sort of as we are going through her treatment, “This is my background and my expertise and going through this with Poppy has really made me realized that if we only could have found it sooner, we would have more options. Do you think that cancer detection with the blood test is something that veterinarians could use in the management of their patients?” And I think my jaw just dropped. It’s like, “Wow! Imagine all of the uses that we could apply if we had a blood-based non-invasive test like that?”
And so, it was a resounding yes for me and so we co-founded the company in 2019 and with a small team of us. We are super proud to have developed a really fantastic test for OncoK9.
When did the test become available?
DR. FLORY: We started that in 2019 and we realized that really the first step was that we needed to develop – obviously develop the test for dogs and then also demonstrate how well it works in dogs with and without cancer. We actually started our trials later that same year in the fall of 2019.
We were able to enroll so many dogs because I think that veterinarians have heard for so long, isn’t there a blood test for cancer?
And we’ve always had to say no. The response is kind of like, “No, that’s not possible or that doesn’t exist yet,” or the thought of this actually becoming a possibility was exciting I think to veterinarians and veterinary teams, but also to pet parents.
There are so many pet parents out there that have had a personal connection with cancer. They’ve had a pet with cancer. Or, they’ve had a loved one with cancer. They’ve had cancer themselves that they know that this is a big problem and they wanted to kind of pay it forward for future dogs with cancer.
There was so much enthusiasm that we actually enrolled well over a thousand dogs into the studies at 41 clinical sites around the world, and so we were able to perform a very large clinical validation studies using 1,100 dogs with and without cancer, which is just phenomenal in terms of those numbers, those aren’t numbers that we typically see in veterinary studies. And so, the test actually then became available in the spring of 2021.
OncoK9 is a liquid biopsy. What is that?
DR. FLORY: Liquid biopsy is basically the sampling and analysis of biomarkers in a fluid in the body. A biomarker is essentially something that we can find that indicates the presence of disease, and in this case, we are talking about cancer. Then fluids that are normally present in the body, the one that we most often think about as blood but there are other fluids in the body like urine, there is fluid around your central nervous system so that’s called your cerebrospinal fluid or CSF. Sometimes in disease, there are fluids in the chest cavity or in the abdominal cavity if there is a disease going on.
But the most prevalent and the fluid that is really the most reliable in terms of looking for a biomarker is really the blood. When we talk about liquid biopsy for cancer, we are generally talking about using a blood sample which is easy to get. It’s straightforward. It’s something that your pet probably has once or twice a year already especially as they get older is typically have a blood sample drawn. This is a test that’s essentially done using a pretty standard routine that’ performed in the veterinary practice, which is a blood draw.
Regular veterinarians can do this? They don’t have to be a specialist?
DR. FLORY: That’s right, yeah. Because it’s a blood draw, which is something that any veterinarian does, this is a test that can be performed at any veterinary clinic. They do need to have a special kit to be able to do the test because it requires some fancy blood collection tubes that stabilize the DNA because really what we are looking for is these tiny, tiny little fragments or bits of DNA that come from cancer cells. These tubes stabilize the little fragments of DNA that are in the blood and then they basically pull the sample using that kit and then send the sample back to our lab.
What cancers does the test screen for?
DR. FLORY: The test is a multi cancer early detection or MCED test. This is a multi cancer test. It can detect 30 types of cancer including the most common cancers that we see in clinical practice. If we think about those most common cancers, there are about 8 of those that veterinarians see the most frequently in terms of what they are seeing their patients be diagnosed with or that they are managing. In those top 8, the detection rate of the test is 62%. Of the big 3 I like to call, which are the most aggressive cancers that we see in dogs which are lymphoma, hemangiosarcoma, and osteosarcoma, the detection rate is 85%. So really, really phenomenal in these really aggressive types of cancer.
This test could detect osteosarcoma even before the limping, and the obvious outward signs?
DR. FLORY: That’s exactly right. That’s really the hope is that this is a test that can detect more cases of cancer even prior to the onset of those clinical signs really because that means that if we can detect it earlier, we generally are going to have more options for treatment.
Our dogs are starting from a place where they feel better so they are usually going to be kind of more resilient for any of those treatment options that we decide we want to choose from. Most of the time, they are going to have better outcomes in terms of if we are starting from a place before they have clinical signs and symptoms and they are usually going to have better outcomes in response to treatment.
I wanted to just address one other thing that you kind of mentioned, which is could this – in a situation like unfortunately, I’m so sorry that you went through with your dog which is where we have this long period of time where we don’t really know what’s going on until we get that diagnosis, this is a test that can help in a couple of ways.
One is that it can be used in dogs that don’t have clinical signs yet.
It can be used as a screening test to look for cancer in an asymptomatic individual but an individual that’s at higher risk because of their age or because of their breed.
But it also can be used as an aid in diagnosis. When we start to have that limping that’s not responding to treatment or seems unusual, this can sort of help to say, well, cancer is the differential list for a lot of dogs that have limping unfortunately, is can cancer maybe the cause. This is a non-evasive test that could tell us whether what we are looking for is a cancer signal which is basically those DNA abnormalities and – then could be an indication that cancer is present and then we kind of maybe shortened the path to diagnosis because now we are more aware of it and we are kind of looking a little more closely.
What is the ballpark price range for the test?
DR. FLORY: It’s going to vary depending on probably what part of the country or it’s available in the US and Canada. So it’s going to vary a little bit depending on where you are. But the average price that we are seeing is around $500.
TRIPAWDS: That’s not bad when you consider what people spend on diagnostics.
DR. FLORY: Yeah. Exactly! Adding it into the diagnostic workup if cancer is suspected. Or, adding it in as for example, a yearly screening test. Once dogs are sorted, considered a higher risk, this is sort of – the recommendation is to do that annual screening.
Do you have any plans to take it over to Europe or Australia?
DR. FLORY: It’s exciting news that it’s available now in Asia. I would say stay tuned. It’s certainly our – it’s my hope that we get as many dogs tested at possible. As many dogs as possible get access to the power of this type of technology. So that’s the hope.
If somebody does get a positive test result, then what happens?
DR. FLORY: What the test is looking for is it’s looking for basically the abnormalities in the DNA that comes from the cancer cells. You could kind of think of those like spelling mistakes in the DNA. We are looking for the presence of those and we kind of do that by multiple methods. But if we find that, then that’s called a cancer signal. The types of results that a pet would get on this test are either a cancer signal detected or a cancer signal not detected.
If a cancer signal detected, a couple of important things that it’s important to note about that result which is that just like any screening test that you or I would have as a person to look for cancer when we are asymptomatic. If you get a positive screening test, it’s important to do follow-up testing to find out and confirm what’s going on.
Similar idea here. If you have a positive result then the next step is to do diagnostic test to confirm what the diagnosis is.
To basically find out where is this cancer signal coming from. The way that the veterinarian would do that is to basically look into places that cancer could most commonly be hiding. If you’re starting from a patient that’s limping, that becomes a fairly more obvious. If where you start, you look in the location where the limp is coming from or the lameness is coming from.
But if you’re starting from a patient that is asymptomatic, this is a dog that doesn’t have a clinical science then we kind of want to do a combination of tests to look for where could this cancer signal be coming from. That includes a thorough sort of interview with you as the pet parent to find out what’s going on at home. Is there anything that’s changing? Or, is there anything new? Is there anything that you’re noticing in terms of water intake, food intake? Energy levels? That sort of thing. Any limping, lameness? Anything that could kind of clue us in where to look?
If not, then we do a thorough physical exam. It’s to kind of look in all of the places including looking in the mouth. And, looking at the lymph nodes and all the little kind of nooks and crannies from nose to tail.
And then doing some testing that includes some lab testing.
Like doing general blood work, general urine testing to kind of see if there’s any clue that any of the organs are not kind of functioning normally. That would kind of hone us in where to look.
Imaging test, so looking in the most common places that cancer could be hiding inside of the thorax or the chest cavity. So that means looking at the heart and lungs. Typically with x-rays, looking in the abdomen or belly, looking at all of those organs in the abdominal cavity usually with an ultrasound but maybe starting with x-rays.
Then if there’s any limping or lameness or any areas of kind of swelling, taking x-rays of those areas. And then if we find anything on any of those tests, taking a sample. Performing usually what’s called a fine needle aspirate. Where we are just taking some cells out and trying to find out. Could this be where the cancer is coming from? Then that let us kind of put a name on it. And then that’s how we get to the next step. Which is, identifying what’s the diagnosis. Then helping the family decide on the treatment options.
A pet parent should expect that if they get a positive result. But there’s going to be a little bit more testing involved after that?
DR. FLORY: That’s absolutely right. Yeah. We don’t ever. Just like with any screening test, we don’t make major decisions based on the result of this test alone. We always take that next step to confirm what the diagnosis is to actually then be able to make those decisions.
How are we as pet parents supposed to detect cancer in our pets? Aside from this test?
DR. FLORY: Well, I think that probably a lot of pet owners do this naturally. What I would say the first thing to do is pet your pets. That’s how we find a lot of things. You’re constantly petting them and you know the second they get a little lump or bump. And that’s really important. That’s actually a really important step in cancer detection. You just sort of paying attention to what’s happening. Changes that they have that you can see and feel, The changes that you notice in their habits. How much they are eating and drinking and sleeping. And, activity level and that sort of thing.
Certainly, if you are noticing any problems, getting your veterinarian to take a look right away. But it’s also remembering to do that preventive care.
The guidelines that we have as dogs age are really important to detect disease early.
They include at least once a year but typically twice a year. As our pets are getting older to go in for that physical exam, that routine lab work, which looks for so many things. It’s really looking to try to find disease early when it’s going to be the most manageable. It’s really, really important to continue those things.
Adding into kind of those wellness visits is now this opportunity to add in liquid biopsy to that annual blood work to add on this blood draw for an OncoK9 test.
By detecting cancer early, we can make an improvement in terms of the ability of families to treat cancer. They are going to have more options to choose from that they are going to really have time to do that to kind of make those decisions. And that ultimately are the patients, the pets themselves will have better outcomes. We can start from either an earlier stage detection. Or an earlier clinical detection before they are sick. Both of those can result in improved outcomes.
What you’re saying is that we could even catch things before they progress to lung metastasis?
DR. FLORY: Yeah. I mean it’s possible. So the test can detect as early as stage 1. But it’s that it improves our ability to detect cancer before clinical signs and/or earlier stage. So both of those can result in improved outcomes. We have to know that it’s there to be able to make the recommendation to find it. To do the work-up to find it. So this is sort of a way to add into what our current paradigm is really. Our current kind of set of recommendations so that we can detect more cancer earlier. So that’s the hope.
Who needs to be screened? How should we start looking at this in terms of making it a part of our pet’s regular health screenings?
DR. FLORY: We know that the risk of cancer increases for a few reasons. One of the most obvious is age, the same as it is in people. As we get older, we have a higher risk for cancer. But it’s also breed. In terms of making a recommendation about who should be screened, we wanted to really perform a study to look at what should the recommendation be.
We took a very large population of dogs. Over 3,400 dogs with cancer to understand at what age do certain breeds develop cancer? And we use that to make a recommendation. What we found is that the average age of cancer diagnosis for all dogs was around 9 years old. Because we don’t want to start screening right when most dogs get cancer. We want to start screening sooner than that. So we made a recommendation to start screening two years before that sort of peak incident. That was starting at the age of 7.
If we think about the recommendation for all dogs, it’s really starting that annual screening at the age of 7.
However, we know that there are certain breeds of dogs that tend to get cancer at a younger age. Like if you think of some of these giant breed dogs, they certainly can develop cancer younger.
We found that Boxers actually develop cancer typically from a younger age. To make a breed-specific recommendation, we performed a study. We looked at the ages at which different breeds develop cancer. It was as early as 6 on average. If we kind of use that same idea of starting screening sooner than the peal incidents of when they develop cancer, we want to start as early as the age of 4, depending on the breed.
We turn all of this into an online tool that you can use. You can input your pet’s age, breed, and weight. That will return to you based on your dog’s individual characteristics when should this individual start cancer screening. Some dogs are like I said, from as young as 4 and some are older like start at the age of 7.
What if you have a mixed breed dog? How does the test account or the tool account for that?
DR. FLORY: Great question. So we took that same group of dogs. Then we said, OK, so for dogs where there either wasn’t enough of that breed or was a mixed breed dog. Then we developed a formula that was based on weight. If you have a mixed breed dog or if you have a breed that wasn’t as common in that collection of dogs then the recommendation will be returned based on when dogs of a similar weight are tend to be diagnosed with cancer because there is a correlation.
Thank you, Dr. Flory!
DR. FLORY: Oh, thank you so much. It has been great being here. I love that your community, I’ve always said that I’ve always send pet owners to your community. They get so much information! So it’s really lovely to be part of it.
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