Episode 36: Precision Medicine for Pets

[00:00:02] Hello, welcome to TGen Talks, I'm Mark Moran. Comparative oncology, the field of study that in recent years has gained in popularity seeks to integrate information from naturally occurring cancers and pets into what we know about the biology of cancer in humans. At TGen, scientists have studied naturally occurring cancer in canines for over a decade, and this expertise led to the formation of a company aimed specifically at partnering with veterinarians to identify treatment options for our four-legged friends and bring greater peace of mind to pet parents. Vidium Animal Health was launched in September of 2020. It provides genomic based precision medicine to veterinary oncologist through its flagship test Searchlight DNA. It was designed to specifically identify any of the nearly 120 known cancer associated genetic mutations in dogs and to use the molecular profile of misbehaving genes to help guide diagnosis and treatment. Joining us today is veterinarian and video president Dr. David Haworth, who has seen firsthand the pain and concern that veterinarians and pet parents experience when a dog is diagnosed with cancer. Dr. Haworth, welcome. Thanks for being here. Thanks, Mark. Great to be here. What's behind the name Vidium and how is it applying precision medicine and the knowledge that comes with it to help veterinarians and pets?

 

[00:01:29] Vidium came from the Latin vidi, to see, which we think is pretty fitting for a diagnostic company, particularly one that is letting us see into the biology and genetic changes that we find in cancers, in dogs.

 

[00:01:41] Why this company? Why Vidium and why now?

 

[00:01:44] A couple of things that you need to understand about veterinary medicine as it compares to human medicine — three things mainly. The first one is that veterinary medicine, as most of us know, is direct payment. Even veterinary pet insurance is reimbursement based. And so every cost associated with veterinary care for your pet family member is going to be seen by the owner. The second thing is there are very low, essentially no regulatory hurdles to diagnostic tests in pets. And then the third is that veterinarians by law can prescribe any drug that's approved for any species as long as they think it's going to be safe and effective. That includes all human drugs and getting access to those and the cost of that's another story. But essentially a veterinarian who believes that any kind of drug would be a safe and effective for their patients can prescribe that. And so when it comes to why video and why now, we think we're in a pretty sweet spot where the cost of genomic testing has come down to a place where the value that it can provide in terms of diagnostic, prognostic and therapeutic indications is enough to justify the cost of that genomic testing. So it creates enough value to the pet owner and to the pet care team to in order to justify a genomic diagnostic. That's pretty cutting edge.

 

[00:03:01] Did you say that most pet insurance is reimbursed? In other words, you pay upfront and they pay. There's no copay?

 

[00:03:10] It's like a no co-payment insurance, which also has huge ramifications when you think about diagnostic testing and what actually gets paid for. We as a provider to veterinarians never have to deal with third party payment systems or government or insurance companies.

 

[00:03:26] How does Vidium interact specifically with pet practices?

 

[00:03:29] We’re built on the concept that we're part of the veterinary care team. So almost all of our interactions are with veterinarians, specifically veterinary oncologists. And there are about 450 veterinary oncologists, board certified through the American College of Veterinary Internal Medicine. So we primarily direct our messaging towards those oncologists, primarily work with them to order and receive the tests. We do it specifically. We get tumor samples delivered either from the pathology lab where they've already been looked at by history pathologist or directly from the veterinarian. We extract that DNA here in our labs in Phoenix, that DNA then gets sequenced, variants are identified, and then we generate a report,

 

[00:04:15] 450 canine oncologists. Is that nationwide or worldwide?

 

[00:04:21] Worldwide. You might think to yourself, well, that's kind of a small market to build a company around. Yeah, the answer is there's also 26,000 veterinary practices out there that the oncologists are just the tip of our marketing iceberg. And we also believe that if we're going to get feedback and understand what their needs are, those are the people we're going to need to convince first.

 

[00:04:39] So many in the U.S.,

 

[00:04:40] 425 or so, the large majority are in the United States.

 

[00:04:42] What sets Vidium apart from other companies doing the same thing?

 

[00:04:48] Well, there aren't very many companies in this space right now. We do have a there are a couple of them. And I think the thing that separates us apart primarily is that depth of understanding that being aligned with TGen allows us. The research that goes on in this building and by these scientists allow us to have what we like to call unimpeachable science as one of our two cornerstones of our company that sets us apart. And also, we have some pretty deep expertise and understanding of the veterinarian marketplace, as well as the veterinary oncology

 

[00:05:22] You're listening to TGen Talks, I’m Mark Moran. Today, we're talking with Dr. David Howorth, who is president of Vidium Animal Health, which provides genomic based precision medicine to a veterinary oncologist through its flagship test Searchlight DNA. How has the science evolved? What do you think we're learning?

 

[00:05:41] How long do we have to talk? I think without hyperbole, literally every day there is a new deeper understanding of the genomics behind these diseases. By far, the majority of that knowledge is targeting disease in humans. But because of the similarities and the amount of the genomes and the mechanisms of disease that we share between dogs and humans, we can translate a whole lot of that over to help our canine friends.

 

[00:06:06] Speaking of which, you're currently focusing on canine cancer, but are there plans for other animals, other diseases?

 

[00:06:11] Absolutely. What we are starting with canine cancer and I should say all canine cancers, which is a pretty broad spectrum of diseases because that's where the science lives today. Unimpeachable science being our cornerstone as the science expands to other diseases and other species. Of course, we're going to follow it there. Our plan is to develop a catalog of between five and seven diagnostic tests over the next three to five years. Feline lymphoma is something that we feel really strongly. We would love there to be enough science for us to be able to help with early detection, but also treatment options for that disease in particular.

 

[00:06:49] What are the differences between cat and dog owners as it relates to cancer and seeking aggressive treatment for it?

 

[00:06:56] So let me start by saying there are about 97 million cats in the United States and there are about 86 million dogs, so there are actually more cats than there are dogs. And the nature of the bond for anybody who's owned both knows that the nature of the bond that you have with your cat is different than the nature of the bond that you have with your dog. I think that they are equally as deep when it comes to cancer. However, dogs are used to telling us what they feel, and cats as a species tend to hide disease a lot more. So typically when you figure out that a cat is ill, they're already further down the road. So typically we have fewer treatment options available to us than we do when we have dogs because dogs will show up and you might be able to feel something right away. Also, the nature of the tumors that develop in dogs is a little bit different than the nature of the tumors that develop in cats.

 

[00:07:50] Dogs are better at telling us how they feel. What does that look like?

 

[00:07:54] You know, when I was in practice, it was always amazing to me how deeply attuned pet owners are with their pets. In fact, in veterinary medicine, we have an acronym ADR — “Ain't Doing Right” — and everybody knows it. And so a dog owner will come in and say, jeez, I don't know what's going on. Fluffy was good yesterday and today he's just, he's just off a little bit. Also, since the dog can't tell you where it hurts, that forces us to rely more deeply on our diagnostic tests, both the ones at the ends of our arms, using our hands and our eyes and our noses and our ears, but also looking into how is the blood chemistry look, your analysis, all the other diagnostic tests. And Vidium hopes to be able to contribute more diagnostic tests to that repertoire.

 

[00:08:38] How can a pet parent interact with video? Do they have to contact them directly, go through a vet's office? How does that work?

 

[00:08:44] So that anybody can look at our website now, which gives us more information on search like DNA and more about the company. And that's video Match.com. Typically, we won't provide the test to pet owners. We'd like to be a part of the health care team. And so those pet owners who are interested in genetic genomic profiling of their pets, cancer, clearly that's something you should talk to your veterinarian about. We have to acknowledge that this is also new territory. Human oncologists have been getting used to this over the last decade, whereas veterinarians, this is still pretty new area. And so one of the things that we recognize as a company is that we need to do a lot of guiding and a lot of teaching and a lot of education around the genomics and the basis of cancer and what that means to us and why these diagnostics that we're going to be providing can show so much value to the pet owner, to the veterinary health care team and ultimately to the pet.

 

[00:09:35] Is that where Searchlight comes in?

 

[00:09:37] Searchlight DNA…that's the first of our tests. And it's a tumor only all cancers, DNA panel test looking at 120 of the genes most relevant to canine cancer.

 

[00:09:49] That's the Searchlight report. Searchlight report. Can I get my pets information being that it's my pet or is that only available to a vet?

 

[00:09:56] So technically, all your veterinary records belong to the owners, just sort of like in human medicine. But we provide two reports actually to the veterinarian. The first report intended for the client lists. All the variants that we found in this tumor, in these tumor cells, also talks about those genes, what their role is in health and in disease and the strength that it tells us in terms of diagnosis. Yes, that is the tumor that we thought it was in terms of prognosis. This is a really fine tumor to have. You don't worry about it too much or this is not a really good tumor for your pet to have. And then also treatment options according to these genetic markers, this treatment or that drug might be more appropriate than standard of care treatments. So all of that, the diagnostic and prognostics go into the client report. We give a separate report to the clinician. Then the clinicians report has all that information that's in the client report. It also has treatment options listed out, as well as clinical trials that that pet might be eligible for. That's all contained in our knowledge base, which is kind of the thing we spend most of our time building.

 

[00:11:06] We hear so many stories today about with so much information being available online, how many pet parents do you see coming and going? I think I already know what's wrong with my dog or my cat?

 

[00:11:16] A lot, you know? I mean, and Dr. Google is as real in veterinary medicine as it is in human medicine, and we have to deal with that. But I think one of the things that my profession is doing is becoming more understanding of how our role isn't as much giving information. It's giving perspective. It's giving an understanding, a deeper understanding, because information as you, as you point out, is essentially free. So now we have to put that information into perspective. And that's also why we give clinicians different information or more information than we give the clients. It's not because we're trying to keep information from the clients. It's simply that the best diagnostics in the world don't have very much value if they're taken out of context of that case, something that we were particularly concerned about, which is why we ended up doing these two different cases, because there's no veterinarian, there's no human being in the world who would like to have someone come in with a 25 page report that they've not seen before and have the pet parent say here, you should be giving my dog olaparib because … and the veterinarian is looking at looking at down at the report saying, I don't even know how to spell olaparib, much less prescribe it. I don't know if it's safe. I don't know how comfortable I am giving this. And so what we're trying to do is be the guide that helps lead the veterinarians, give them the information that they don't have while still respecting the fact that it's their case, it's their patient and it's their client.

 

[00:12:35] Talk about the cost associated with Vidium.

 

[00:12:37] The costs for Searchlight DNA is listed on our website as a thousand dollars. And while that sounds like a lot, it's worth noting that most treatment costs in veterinary medicine for cancer are between three and five thousand dollars. And so learning the most that you can about the behavior and the likely activity of a tumor, as well as understanding which treatments may be more effective than others, actually works into it a reasonable amount there. So we think that the value provided is fully justifying of the cost.

 

[00:13:05] Fascinating stuff. Dr. David Haworth, president of Vidium Animal Health, providing genomic based precision medicine to veterinary oncologists through its flagship test known as Searchlight DNA. Thanks for being here.

 

[00:13:18] My pleasure, Mark. Thanks for having us.

 

[00:13:20] Vidium President Dr. David Haworth, who was seen firsthand the pain and concern that veterinarians and parents experience when a dog is diagnosed with cancer.

 

To hear more TGen Talks, visit tgen.org/tgentalks. TGen is an affiliate of City of Hope. Thanks for listening. I'm Mark Moran.