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If Your Dog Has Cancer, This Podcast Can Help
What is FidoCure

What is FidoCure? | Ben Lewis Deep Dive


Summary

For many years, DNA sequencing has been a first line option for diagnosing and treating many human cancers, in a treatment that is often referred to as, targeted therapy. Targeted therapy works by directly inhibiting the growth and replication of the cancer cells in certain types of tumors, and because of its targeted action it has shown high rates of tumor responsiveness in people. So, what happens when you take this science and apply it to dogs? Well, essentially the same thing, which is exciting and is exactly what we are talking about this week with Ben Lewis, the co-founder of FidoCure.


Episode Notes

Ben Lewis, the co-founder of FidoCure gives our listeners a deep lesson about genomic sequencing, as it relates to cancer causing DNA mutations. He shares the science behind FidoCure, the types of dog tumors that they’ve had the most success with, as well as how all this biotechnology and science could really help improve the standard of care and the prognosis of many types of cancers in humans and their dogs.

Links Mentioned in Today’s Show:

The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity by Dr. Demian Dressler and Dr. Susan Ettinger.

https://www.fidocure.com/

https://www.fidocure.com/how-it-works

https://www.fidocure.com/find-a-clinic

https://www.fidocure.com/contact-us

Link to the Hemangiosarcoma paper by Guannan Wang and Nicola Mason: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708669/

Link to the Science Exchange website: https://www.scienceexchange.com/

Related Links:

https://www.dogcancerblog.com/articles/glossary/dna-definition/ by the Dog Cancer Vet Team

https://www.dogcancerblog.com/articles/glossary/genes-definition/ by the Dog Cancer Vet Team

https://www.dogcancerblog.com/articles/glossary/chemotherapy-definition/ by the Dog Cancer Vet Team

https://www.dogcancerblog.com/articles/cancer-causes/is-the-cause-of-cancer-really-not-known/ by Dr. Demian Dressler

https://www.dogcancerblog.com/articles/full-spectrum-cancer-care/conventional/chemotherapy/first-dog-cancer-drug-fda-approved-but-not-great/ by Dr. Demian Dressler

About Today’s Guest, Ben Lewis:

Benjamin Lewis is an animal health visionary, proud pet parent, and former Olympic athlete. As CSO of the One Health Company, Ben is committed to advancing cancer cures for dogs. Formerly, Ben was the co-founder and CEO of 4Vets, the largest B2B distributor of animal health products in Brazil.

Ben also represented the United States in the 2004 Olympics in Athens, Greece, where he served as captain of the K4. Ben studied bioengineering at Dartmouth College where he was inducted in the Dartmouth Hall of Fame (Wearer of the Green). In addition, Ben studied veterinary medicine at the University of Pennsylvania School of Veterinary Medicine, and Health Care Management at the Wharton School of Business.

Connect with Ben by email: Ben@fidocure.com

Connect with Ben Lewis on LinkedIn: https://www.linkedin.com/in/benjamin-lewis-268b246/

FidoCure on Facebook: https://www.facebook.com/FidoCure

FidoCure on Instagram: https://www.instagram.com/fidocure/

FidoCure on Twitter: https://twitter.com/fidocure?lang=en

YouTube: https://www.youtube.com/channel/UCWMWoy41AEZn3_a86dMDSzA

Other Links:

To join the private Facebook group for readers of Dr. Dressler’s book “The Dog Cancer Survival Guide,” go to https://www.facebook.com/groups/dogcancersupport/

Dog Cancer Answers is a Maui Media production in association with Dog Podcast Network

This episode is sponsored by the best-selling animal health book The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity by Dr. Demian Dressler and Dr. Susan Ettinger. Available everywhere fine books are sold.

Listen to podcast episode for a special discount code.

Have a guest you think would be great for our show? Contact our producers at DogCancerAnswers.com

Have an inspiring True Tail about your own dog’s cancer journey you think would help other dog lovers? Share your true tail with our producers.

If you would like to ask a dog cancer related question for one of our expert veterinarians to answer on a future Q&A episode, call our Listener Line at 808-868-3200 www.dogcanceransers.com.

Dog Cancer News is a free weekly newsletter that contains useful information designed to help your dog with cancer. To sign up, please visit: www.dogcancernews.com

Transcript

[00:00:00] >> Ben Lewis: FidoCure is the first precision medicine offering for dogs with cancer. For the last 30 years we’ve known in humans and actually dogs and most animals that cancer is actually a genetic disease. It doesn’t just occur spontaneously like we used to think. It actually occurs because of all these genetic abnormalities in the DNA of an animal. And when they accumulate to the point where the cells start dividing uncontrollably, that’s just what we call cancer. So in humans we’ve actually run sequencing to identify where in their 3.2 billion base pairs of DNA, the mutations are. So what we’ve done as a company, we’ve taken the precision medicine approach that has been successful in the human side and adapted it for veterinary medicine.

[00:00:46] >> Announcer: Welcome to Dog Cancer Answers, where we help you help your dog with cancer. Here’s your host, James Jacobson.

[00:00:55] >> James Jacobson: Hello friend. Thank you for joining me this week on Dog Cancer Answers. This week’s interview is long but, oh, so very fascinating. You know, if you’ve ever Googled dog cancer, which I’m sure you may have at one point or another, otherwise you probably wouldn’t be listening to my voice right now. In those search results, did you happen to notice that something called FidoCure stood out as the top of the search query? It’s an ad, of course, a paid placement on Google. But my guess is that if you’re anything like me with internet searches, you started heading down a rabbit hole, meaning you look, started Googling, what is FidoCure or what does FidoCure do?

[00:01:39] And if you’ve listened to this show, Dog Cancer Answers, before you probably already know that one of our mission is to proactively answer those kinds of dog cancer questions and get answers direct from the source. So sometimes those questions and answers come in the form of actionable veterinary advice or tips, full spectrum treatment options, and one of my favorite topics, which is introducing new and cutting edge cancer therapies. Therapies that will hopefully one day change the grim statistics of how many dogs cross over the rainbow bridge each year due to cancer, which brings me to this week’s guest. CSO of the One Health Company, Ben Lewis.

[00:02:29] Ben is also one of the founders of FidoCure. And between him and his team, they’ve taken a groundbreaking approach to diagnosing and treating cancer in dogs, using DNA sequencing. It’s exciting stuff, right? The whole idea behind taking DNA, scanning it for cancer causing mutations and then creating a targeted therapy for that particular mutation almost sounds like something straight out of a sci-fi film.

[00:02:58] Well, it’s actually pretty common first-line treatment protocol among many human cancers these days. And today we’re going to talk about how it has finally made its debut to the veterinary oncology space. From his Silicon Valley garage in California, literally, let’s get started with this week’s conversation with Ben Lewis.

[00:03:22] >> Ben Lewis: I got kicked out of the main office so I’m out here in the garage, but it works fine. Hopefully.

[00:03:26] >> James Jacobson: I saw that. I was like, you’re in a garage. Is this the legendary Silicon Valley garage?

[00:03:32] >> Ben Lewis: So it’s really funny. When we started out, we were a couple of blocks away from the original HP garage, which was the start of Silicon Valley. But now we’re I guess, four or five blocks away.

[00:03:43] >> James Jacobson: Okay. As we record this, you are literally in a garage. They can see your garage door behind me and you’re on the inside. So that’s great.

[00:03:50] >> Ben Lewis: This is a Silicon Valley garage. Yes.

[00:03:52] >> James Jacobson: I think that’s actually a really good starting point to get into it because we talked to so many different people on Dog Cancer Answers from veterinary oncologists and all sorts of people in the space of taking care of dogs with cancer, but you’re approaching it from a whole different One Health perspective backed by deep pockets of Silicon Valley.

[00:04:15] Right?

[00:04:16] >> Ben Lewis: Uh huh.

[00:04:17] >> James Jacobson: So tell me about that.

[00:04:19] >> Ben Lewis: So, as you said, you you’ve spoken to, you know, some of the great veterinary oncologists out there, and we were really taking a technology and kind of big data approach to cancer, just like, has been done in the human space. So rather than basing decisions off looking at three or four or five dogs in prospective, you know, randomized controlled clinical trials, we’re doing kind of the new way of looking at data called real-world data and real-world evidence, which was really pioneered by people like Dr. Amy Abernathy, who actually used to be on the One Health team and is now the deputy commissioner of the FDA. But it really looks at patients with real clinical problems with naturally occurring cancer that isn’t exceptionally controlled. And it’s more reflective of actual patients with the actual condition.

[00:05:06] You know, if you’re just going to look at cancer patients and you gonna to cherry pick four or five of them, and all of them are young patients without any comorbidities that are otherwise perfectly healthy, that is generally not a reflection of most patients out there that veterinary oncologists are treating with cancer..

[00:05:22] They oftentimes have other things wrong with them. So at One Health Company, we’ve really taken the precision medicine approach that has been successful on the human side and adapted it for veterinary medicine.

[00:05:34] >> James Jacobson: Okay. Why don’t we start off by getting into what does FidoCure do?

[00:05:37] >> Ben Lewis: So FidoCure is the first precision medicine offering for dogs with cancer.

[00:05:42] So, you know, just like people, you diagnose a human being with cancer, but you don’t just look at the type of cancer from a histopathological standpoint. For the last 30 years, we’ve known in humans and actually dogs and most animals, that cancer is actually a genetic disease. It doesn’t just occur spontaneously like we used to think. It actually occurs because of all these genetic abnormalities in the DNA of an animal. And when they accumulate to the point where the cells start dividing uncontrollably, that’s just what we call cancer.

[00:06:14] So in humans, the first step after histopathologic diagnosis, you actually run sequencing to identify where in their 3.2 billion base pairs of DNA, the mutations are.

[00:06:23] >> James Jacobson: That’s not done in all human cases, right?

[00:06:26] >> Ben Lewis: For the most part. I think it’s pretty well accepted.

[00:06:29] >> James Jacobson: Well, when you do genomic sequencing, but not everyone does that.

[00:06:33] >> Ben Lewis: I think it’s becoming pretty standard of care. I mean, for some like few malignancies for example, they might do something like flow cytometry, or they might look at neoantigens or neoepitopes if they’re coming from immunological standpoint.

[00:06:46] But I’d say sequencing is pretty standard for most cancers out there in humans.

[00:06:50] >> James Jacobson: Okay. But this is the first time it’s being done with dogs.

[00:06:52] >> Ben Lewis: This is the first time it’s being done in dogs.

[00:06:54] >> James Jacobson: So how does it work? I mean, how do you get the sample. How does that work?

[00:06:58] >> Ben Lewis: So we work with the veterinary oncology community and just like they would diagnose a cancer histopathologically, they normally take a lump or a bump off.

[00:07:06] They send it to a veterinary pathologist. From there, the veterinary pathologist will just take a couple of slices, sends it on to us. And usually around three weeks later, we can provide results back where we actually sequence a tumor using our next gen sequencing panel, which is actually run in parallel with human samples.

[00:07:22] So literally it’s the same, like CAP CLIA certified lab that’s running human samples and we’re actually running the doggie samples. And what’s really cool is we actually get our results faster.

[00:07:30] >> James Jacobson: Why is that?

[00:07:31] >> Ben Lewis: Because we do high volume and we have a great analysis pipeline from the bioinformatic standpoint. And we also have a great reporting team as well, that actually generates the reports and sends them back to the veterinary oncologists with treatment recommendations.

[00:07:44] >> James Jacobson: So the actual analysis is done by your team, but it’s actually being processed by the same facility that does human.

[00:07:52] >> Ben Lewis: Correct.

[00:07:53] >> James Jacobson: Okay. That’s pretty cool. But is it your team that’s analyzing it or is it like human doctors who are looking at it?

[00:07:59] >> Ben Lewis: So it’s our team that’s actually analyzing it, but the sequencing is done on sequencers that are also running human samples.

[00:08:05] >> James Jacobson: Got it. Okay.

[00:08:05] >> Ben Lewis: So Illumina HiSeq X Tens, which are basically the most cutting edge gene sequencers out there.

[00:08:11] >> James Jacobson: Okay. And each of those sequencers costs a couple of bucks.

[00:08:14] >> Ben Lewis: A few dollars, yes. It’s a pretty.

[00:08:16] >> James Jacobson: What does a sequencer cost? If one were to go to an eBay and buy, you know, a new one.

[00:08:21] >> Ben Lewis: A couple of million bucks.

[00:08:22] >> James Jacobson: Okay.

[00:08:22] >> Ben Lewis: I think with the service packages, the X Tens around 10 million.

[00:08:26] >> James Jacobson: Okay.

[00:08:26] >> Ben Lewis: Yep. So they’re expensive.

[00:08:27] >> James Jacobson: So that’s why it’s being done on the same systems that are being used for humans.

[00:08:31] >> Ben Lewis: Correct.

[00:08:31] >> James Jacobson: So then it goes to your team.

[00:08:33] >> Ben Lewis: Uh huh.

[00:08:34] >> James Jacobson: And is that composed of veterinarians or researchers or phDs?

[00:08:39] >> Ben Lewis: So our team is composed of PhDs, cancer biologists researchers, bioinformatics, veterinary oncologists, human medical oncologists, pathologists. We have a pretty diverse team and it really has taken a whole village to actually adapt this model from the human space into veterinary oncology and to do it in a way that, you know, makes sense and is actually clinically accessible.

[00:09:04] So one of the big differences between human oncology and veterinary oncology in human oncology, there’s somewhere like a hundred fifty FDA approved drugs for people with cancer. In veterinary oncology, there’s one.

[00:09:17] >> James Jacobson: That is specific to dogs.

[00:09:19] >> Ben Lewis: For dogs. Yeah.

[00:09:20] >> James Jacobson: Yeah. Palladia.

[00:09:21] >> Ben Lewis: Palladia. Yep. And that was developed by Dr. Jerry Post, who’s our chief medical officer and Dr. Cheryl London, who’s on our scientific advisory board and it’s obviously sold and distributed by Zoetis.

[00:09:31] >> James Jacobson: Okay. And then, so for all the people wondering were like, but there’s so many treatments that they have for dogs with cancer, those are all human chemotherapy drugs.

[00:09:42] >> Ben Lewis: Correct.

[00:09:42] >> James Jacobson: And you’re saying that basically what FidoCure enables veterinarians to do is to more precisely use a human chemo drug on a dog. And I’m just trying to make sure that I’m clear on this, but oftentimes use human chemo drugs that most veterinarians would never even consider because it’s not standard of care for veterinary oncologists. True?

[00:10:08] >> Ben Lewis: Yeah. You’re like 60% of the way there.

[00:10:11] >> James Jacobson: Okay.

[00:10:12] >> Ben Lewis: So most of the drugs that veterinary oncologists use today are chemotherapies, you know, cytotoxic chemotherapies, which were kind of the, let’s say the previous generation of cancer therapies in people. The current generation of cancer therapies in people are targeted therapies. So they’re therapies that you use when you know what the underlying mutation is and just try to specifically target just those cells with that mutation. And this is in kind of a juxtaposition to cytotoxic chemotherapy, which kills basically any rapidly dividing cell, whether it’s the bone marrow, whether it’s the cancer, whether it’s the lining of GI tract, you know, that’s what will be targeted by a cytotoxic chemotherapy, whereas a targeted therapy specifically inhibits the growth of ideally just those cells with a given mutation.

[00:10:58] >> James Jacobson: Okay. So let’s unpack that a little bit for people who are just overwhelmed because their dog has cancer.

[00:11:03] >> Ben Lewis: Sorry.

[00:11:03] >> James Jacobson: So cytotoxic means, and we will just break that apart, that’s toxic to cells, and that is the type of chemotherapy that is traditionally used with dog cancer. You’re saying it’s sort of an older type of chemotherapy and in the human world that has evolved so that while they still use some of those cytotoxic chemotherapy agents, there are a whole host of new drugs that are being used because of this genomic testing.

[00:11:34] Am I getting closer?

[00:11:36] >> Ben Lewis: Yes, you’re spot on now. So people have probably heard of BRCA1 mutations, or HER2 mutations in breast cancer, you know, BRAF mutations in melanoma or EGO4 mutations in lung cancer in humans. And it turns out dogs actually have these same mutations and what’s even more fascinating is the drugs that are being used in people today were originally tested in dogs.

[00:12:01] So we actually have a ton of data, particularly around safety and toxicology about these drugs that’s even older than their use in humans.

[00:12:09] >> James Jacobson: Right. Well, am I understanding isn’t like almost on all human drugs, the last species before it gets to human testing are dogs?

[00:12:17] >> Ben Lewis: Yeah. So dogs and non-human primates. They are the last species before you can put something into. They’re usually pre-IND, pre-Investigational New Drug.

[00:12:25] >> James Jacobson: Because human cancer and dog cancer is so similar.

[00:12:28] >> Ben Lewis: Yes. Yeah. I mean, it truly is remarkable. I mean, we see, oftentimes if you look at diffuse large B-cell lymphoma in people and in dogs, it’s almost identical, you know, osteosarcoma. Angiosarcoma in people is the same thing as hemangiosarcoma in dogs.

[00:12:43] So this whole comparative oncology approach is amazing and what we’ve done as a company and as well as the whole ecosystem of academics and the government, you know, NCI, National Cancer Institute, has done an incredible job of demonstrating is that at the genetic level, as well as the histopathologic and likely immunologic levels, canine cancer and human cancer is almost identical, which is really exciting because it does open up a whole toolbox that was previously unavailable.

[00:13:10] You know, there was no reason before One Health Company and FidoCure came along to say, let’s use this EGFR inhibitor in this type of doggy cancer, or let’s use this BRAF inhibitor in this type of dog cancer, because we didn’t know that mutation existed, and in what percentage. So what we’ve done as kind of a company is we’ve really identified a whole variety of mutations. We had a poster at, I believe it was AACR, the American Association of Cancer Researchers, the triple meeting, where we demonstrated 64 mutations that kind of are concomitant between humans as well as canines. And it, a lot of these had never been demonstrated before.

[00:13:46] So it was like a thousand dog dataset, which is huge for the veterinary oncology space or comparative oncology space.

[00:13:53] >> James Jacobson: That’s very large because many drugs are done in like 16 very unfortunate beagles.

[00:13:57] >> Ben Lewis: Yes.

[00:13:58] >> James Jacobson: Okay. So let’s unpack this again. So you got a dog with cancer, they take a biopsy, they send it to your mystery lab somewhere. Where is this?

[00:14:07] >> Ben Lewis: It’s in New Jersey.

[00:14:08] >> James Jacobson: Okay. So send it to New Jersey. It’s sitting next to human. It’s being sampled at the same time, the human and other dogs? Are there other animals that are also processed through this same genetic testing?

[00:14:20] >> Ben Lewis: We’re just doing dogs and maybe a couple of De Novo cat sequences.

[00:14:23] >> James Jacobson: Okay. And then the data after the sequencing goes to your team of scientists, PhD researchers who then do what?

[00:14:35] >> Ben Lewis: Who then apply what are called drug rules to the data. So let’s very simplistically break it down. It’s almost like heuristics. If this, then not that. And people are really good at keeping track of, you know, 1, 2, 3 of these and they’re at the top of their head, but it turns out computers are incredible at actually keeping track of tens of thousands of them and coming up with, you know, rank orders and whatnot. So, you know, a lot of what FidoCure has developed over the past couple of years are these drug rules. It’s kind of a real-time feedback loop. So they get better and better with each additional dog.

[00:15:07] So it’s almost like a Bayesian statistic trial.

[00:15:10] >> James Jacobson: What’s Bayesian statistic trial?

[00:15:12] >> Ben Lewis: So think of it as a, like an adaptive trial, a system that has a feedback loop where each additional case improves the rules dramatically.

[00:15:20] >> James Jacobson: Couldn’t we call that AI.

[00:15:21] >> Ben Lewis: Yeah, you could call it AI, machine learning.

[00:15:24] >> James Jacobson: Machine learning.

[00:15:24] >> Ben Lewis: It’s a similar approach at Ray Dalio in Bridgewater Associates uses for trading stocks and their hedge fund. And it’s the same approach that most other sectors have seen the application of AI except veterinary oncology is still pretty far behind.

[00:15:37] >> James Jacobson: I get that totally. Okay. So are these drug rules that you originally started with all from the human space?

[00:15:45] >> Ben Lewis: So a lot of them came from the human space and then a lot of them were kind of extrapolated based on medical records. So, you know, we have a whole team that all they do is.

[00:15:53] >> James Jacobson: Can you elaborate on that. What do you mean extrapolated based on medical records?

[00:15:57] >> Ben Lewis: So it turns out taking the real world evidence approach where you actually structure data that was previously unstructured and take a look back. Okay. You know, here’s 500 dogs with hemangiosarcoma. They’re all the same breed. These ones were treated with this. These ones are treated with this. Oh, the ones treated with drug X seemed to live 40% longer than the ones treated with drug Y. But you can then forward test that hypothesis and either prove it or disprove it.

[00:16:21] So there’s just a lot of data that has always existed in veterinary medicine, but it hasn’t really been mined very much. So that’s one of the things we’re kind of doing in the backend of FidoCure is trying to identify these kind of latent data trends and drug rules that just, you know, pop out when you actually start looking at the data and organizing it and analyzing it in large numbers.

[00:16:41] >> James Jacobson: Where are you getting the data?

[00:16:43] >> Ben Lewis: So the data comes from a whole bunch of agreements and a lot of it is actually coming from our FidoCure patients.

[00:16:48] >> James Jacobson: Obviously you can do it now with your FidoCure patients, but before you were getting the data that you were combining with the human rules. And so I’m just wondering how much data were you, how many years, or like how many dogs?

[00:17:00] >> Ben Lewis: So a lot of that actually came from papers originally. So a lot of it was coming from like the publications, because that was kind of the strongest level of evidence that we could start with. And then as we’ve gathered more and more data from more and more patients, we’ve been able to refine those rules.

[00:17:14] >> James Jacobson: Was there enough because I would imagine those older papers were basically talking about the traditional cytotoxic chemotherapy agents.

[00:17:23] >> Ben Lewis: Right?

[00:17:24] >> James Jacobson: So how did you extrapolate that to these more new, modern class of drugs?

[00:17:29] >> Ben Lewis: So not all patients actually have what are called actionable mutations. So in dogs we see somewhere on 65, maybe 67% of patients have what’s called an actionable mutation, which means they have a DNA mutation that is actually druggable.

[00:17:44] I mean, there’s the patient has a mutation that’s targetable with a drug that we have access to.

[00:17:48] >> James Jacobson: So that means about 30, 40% do not.

[00:17:51] >> Ben Lewis: Correct. And in those cases, we can work with the oncologist to help identify what is a potential next step for that patient. Now, a lot of these patients are also treatment refractory, which complicates things.

[00:18:04] >> James Jacobson: Okay, cool. Well, let’s again, break down all these words for our non-medical listeners. What is non refractory?

[00:18:09] >> Ben Lewis: So there’s treatment naive, which means a patient that’s never seen a drug or radiation or any other, let’s say therapy, and then there’s treatment refractory, which means they’re a second line patient or a third line patient, which means they’ve already seen it a round of therapy or several rounds of therapy and have failed.

[00:18:27] So that’s kind of treating in a salvage in a different rule base. Then these patients that have never seen any drugs.

[00:18:33] >> James Jacobson: Okay. So going back to the 60 something percent that could benefit from this. I’m assuming just to pull that out, that means that about 60% of dog cancers might be appropriate for this type of treatment regimen, but you don’t know until you do the testing.

[00:18:51] >> Ben Lewis: Correct. So there was a great paper by Guannan Wang and Nicky Mason over at University of Pennsylvania, looking at hemangiosarcoma, which is a very common cancer of the lining of the blood vessels. And it’s commonly seen on an emergent basis where the dog comes to the emergency room with a ruptured spleen.

[00:19:08] So there’s four or five different subtypes of hemangiosarcoma, it turns out. And some of those subtypes, we theoretically have drugs that can slow the growth or the progression of that disease. And then there’s other subtypes where there’s no known drugs. So an example might be, let’s say, if you have the p53 mutant version, there’s no therapies that can, you know, inhibit the growth of p53 mutant cells because p53 is what’s called a tumor suppressor gene.

[00:19:38] Most of these actionable mutations are what we call proto-oncogenes. I can get into it, or I can just punt the topic.

[00:19:44] >> James Jacobson: I think if our listeners are this far, they are, we call them dog health geeks.

[00:19:48] >> Ben Lewis: So the oncogene is basically the gene that when it’s normal or what we call wild type, that gene basically is functioning normal. But when it’s mutated, it then can lead to cancer, which is uncontrolled cell division. So if you have a mutation it’s like putting the gas on, that’s an oncogene. The opposite of that is like the break and that’s what we call a tumor suppressor gene. So p53, when it’s working, it puts the break on cell division.

[00:20:15] But when it’s mutated, it’s like the brakes come off. So for those tumor suppressor genes are oftentimes more difficult to drug at this point. Although there are some really cool things. If you really want to nerd out, I could go way, way, way deeper into this.

[00:20:29] >> James Jacobson: Give me an example of something nerdy and geeky that would be fun.

[00:20:32] >> Ben Lewis: Okay. So in human medicine, I’d say in the last couple of years there’s been a huge breakthrough and it’s something called synthetic lethality.

[00:20:39] >> James Jacobson: I love the name.

[00:20:40] >> Ben Lewis: It sounds like a good movie, right?

[00:20:41] >> James Jacobson: Yeah. It does sound like Arnold Schwartzenegger.

[00:20:44] >> Ben Lewis: Yep. So a lot of his work I believe was to, um, actually one of our advisors, Dr. Elizabeth Iorns she’s the CEO of a company called the scientist. Um, I’m blanking on the name, but she’s an incredible PhD cancer biologist.

[00:20:56] >> James Jacobson: We’ll put a link in the show notes.

[00:20:57] >> Ben Lewis: Yes. Science Exchange. But she was part of the team that helped develop a drug called Olaparib. Olaparib is a PARP inhibitor. So BRCA1 and BRCA2 are two common mutations seen in women with breast cancer.

[00:21:12] And previously those mutations were untreatable because if you had, you know, a bad copy or two bad copies of that gene, I think in the tumor suppressor gene category, where there was nothing you could do really to specifically inhibit BRCA, but they realized that if you have one bad gene, the cells can continue dividing.

[00:21:29] But for some reason, when you have two bad tumor suppressor genes, for some reason, it kicks the cells into realizing that there’s some mutations and they should stop dividing. And they kind of puts them on the path of a programmed cell death. So what it does is it almost like fakes like a second genetic mutation so that the cell stops dividing because it thinks it’s damaged, which it is damaged because it obviously is cancer, but it’s a really fascinating new approach. And hopefully we’ll see a lot more drugs kind of taking advantage of this synthetic lethality pathway.

[00:21:59] >> James Jacobson: Cool. Okay. So you got the test, you got the results, you have matched it with some drugs that you think will work. Those are almost all oral agents. They’re not injected or is it a combination?

[00:22:15] >> Ben Lewis: No. So that’s one of the big things that we’ve kind of worked around. Most of the therapies we’re using are what are called small molecule tyrosine kinase inhibitors, which are all oral capsules and they’re all human FDA approved cancer therapies that we’ve brought back into the veterinary space via one of our partners that’s a compounding pharmacy. So we’ll work with a vet, they’ll get the report that says, you know, try drug X, Y, or Z they’ll then contact the pharmacy. And then based on either a mgs per kilogram or milligrams per meter squared basis, we’ll actually prescribe their patients a therapy. And you know, all the therapies within the formulary are oral capsules.

[00:22:56] >> James Jacobson: Westwood compounding.

[00:22:57] >> Ben Lewis: Uh, Wedgewood.

[00:22:58] >> James Jacobson: Wedgewood. Wedgewood, sorry.

[00:22:59] >> Ben Lewis: Yup. We work with Wedgewood Compounding Pharmacy.

[00:23:01] >> James Jacobson: Okay. And so that’s again, sort of a differentiator because so many traditional chemotherapies are done via IV, which obviously during COVID is even more problematic.

[00:23:12] >> Ben Lewis: Yes. So there’s a reason why we’re really leaning towards the oral therapies. One is during COVID, they’re a lot easier to administer, you know, they’re administered at home by the pet parent. Two, their kind of duration of action, if you will, is a lot shorter. So with an IV chemotherapy, once it’s in the vein, you can’t take it out again and then you have to wait 14 or sometimes even longer for the effects of that drug to run their course.

[00:23:39] The nice thing about these small molecules is they often have half lives like 12, 24 hours. So God forbid, there even was a side effect, which, you know, when you’re dealing with cancer drugs, there are side effects. Thankfully yet, this class of drugs is safer than instead of toxic chemotherapy, at least based on our early data.

[00:23:55] And there’s a poster where Dr. Jerry Post presented these data. I believe it was at the Veterinary Cancer Society meeting or the American College of Veterinary Internal Medicine meeting a couple of months ago. It was a online meeting. And because they have such short half lives, if you just stopped giving the drug, theoretically, the side effect should just go away.

[00:24:13] So that’s one of the other beautiful aspects of these small molecule inhibitors. They’re oral. They’re given at home. They have short duration, which, you know, God forbid there was a side effect that would go away rather quickly, hopefully. And it’s just ease of administration. You don’t have to bring your dog in, you know, every two weeks or every other week, one week for blood work one week for administration of chemo one week for blood work or whatever schedule you and your veterinary oncologists have.

[00:24:37] So it’s a lot less intensive, especially during COVID, which is important.

[00:24:41] >> James Jacobson: Let’s talk a little bit about safety and efficacy in general, as compared to a more traditional way of approaching this if you go the oncology route in the first place. So how would you gauge the safety and then let’s do efficacy.

[00:24:56] >> Ben Lewis: So from the safety standpoint, veterinary drugs, there’s a whole veterinary oncology creating scale. I can send it to you if that’s interesting to anybody. And we keep pretty copious records on the patients. And we collect adverse event forms for basically every patient that has an adverse event. We have a whole committee that adjudicates adverse events, you know, did the dog die because it was run over by the car? Did the dog die because it was on a cancer therapy? Or did the dog have, you know, elevation of liver enzymes because of the cancer, because of the therapy?

[00:25:28] And we have a whole team that, you know, adjudicates this stuff. We’re very, I guess conservative when it comes to classifying adverse events. So we probably have a lot of AEs in there that probably don’t belong, but just for statistics and whatnot, we do keep them in. And from an adverse event standpoint, the drugs that we work with are all safer, less toxicity than we’ve seen with let’s say Palladia as an example, I think that was the benchmark. And I don’t want to make any label claims or drug claims here, just to be clear. This is just observational data from, I think the poster had 722 patients in it. So it’s a very large dataset. Thankfully, in this day of digital records, we can actually gather the records fairly simply.

[00:26:13] And it turns out veterinarians, as well as pet parents are very eager to report adverse events, you know, side effects as they happen, when they happen, and for as long as they happen.

[00:26:23] >> James Jacobson: Yeah, people are oftentimes more willing to share that about their dog than about human beings.

[00:26:28] >> Ben Lewis: Absolutely. And we very much welcome it because this is how we learn. And the sooner we know, you know, and the more details that the veterinarians, the veterinary technicians and the pet parents can provide us the better.

[00:26:40] >> James Jacobson: Okay. So that’s the safety. What about efficacy?

[00:26:42] >> Ben Lewis: So, Christina, one of the things she said is I can’t make any efficacy claims because they have not been reviewed by the FDA.

[00:26:48] We have had, let’s say based on real-world evidence and early data, very actually, I’m just going to say, we have statistical significance on several cancer types that patients who undergo the FidoCure therapy are living longer. And let’s say in hemangiosarcoma, it’s like 150% longer. So it’s considerably longer, which is exciting.

[00:27:09] And we have data even based on the next level. So it turns out hemangiosarcoma is kind of a catch all term. There’s probably four, as you know, alluded to the Guannan Wang paper on hemangio, there’s four or five different types of hemangio. So it’s basically four or five separate diseases that we just kind of grouped together as one, based on what it looks like under a microscope, when we should be characterizing these things based on the mutation that causes them.

[00:27:32] So we have data down to the specific mutation. So, if I started saying, you know, which mutations have better and worse prognosis, I’m sure my team would kill me.

[00:27:40] >> James Jacobson: That’s when the lawyers call you.

[00:27:41] >> Ben Lewis: Yeah.

[00:27:42] >> James Jacobson: Yeah.

[00:27:42] >> Ben Lewis: That’s when Christina comes downstairs and tries yelling me.

[00:27:46] >> James Jacobson: That’s your wife, your co-founder.

[00:27:47] >> Ben Lewis: My wife and my co-founder.

[00:27:49] >> James Jacobson: And your boss. She’s the CEO.

[00:27:50] >> Ben Lewis: My boss.

[00:27:51] >> James Jacobson: What’s your title?

[00:27:52] >> Ben Lewis: I’m the CSO. The Chief Strategy Officer.

[00:27:55] >> James Jacobson: Uh, and not to be confused with the Chief Scientific Officer. Okay. So she’s the boss. And so she wouldn’t have you giving them the micro details of the efficacy. Okay. How many dogs have gone through FidoCure at this point?

[00:28:06] >> Ben Lewis: At this point, I think we’re on 1,200, which is by far the biggest veterinary oncology data set in existence by at least an order of magnitude, which is exciting.

[00:28:17] >> James Jacobson: Okay. So when Dr. Post did Palladia, how many dogs did he work with?

[00:28:22] >> Ben Lewis: I don’t have the data, but if I recall correctly, it was on ninety four, ninety six dogs, but I haven’t read the FDA submission lately.

[00:28:30] >> James Jacobson: The reason we’re talking about Palladia is, as we said earlier, that was the first and only, actually there were two, but it was the only one that’s currently in existence today that is specifically designed for veterinary use.

[00:28:42] >> Ben Lewis: I was reading a paper from basically the top veterinary oncologists and all these academic institutions looking at the efficacy of another veterinary oncology vaccine and they had eight patients. Another therapy, you know, was put forward with nine patients. So, you know, at 1,200 we’re kind of hitting new limits here. And it’s really exciting because we’re not just using novel therapies, but we’re also looking at cancer in a whole new way based on the underlying mutation that’s causing it.

[00:29:09] >> James Jacobson: Can you elaborate on that? What do you mean looking at cancer in a whole new way?

[00:29:12] >> Ben Lewis: So based on the work of Dr. Bishop up at UCSF in like the late nineties, we realized that for the last a hundred plus years, we’ve categorized cancer based on what it looks like under a microscope, because that’s what we’ve had, you know, what the cancer looks like and where it comes from.

[00:29:28] But Dr. Bishop, won the Nobel prize in like the late nineties for demonstrating that cancer is a genetic disease. So once you realize that cancer is a genetic disease, you realize, okay, so the cause of cancer are these genetic mutations. And if you can identify what the mutations are you can theoretically extend life.

[00:29:44] And in humans that’s been proven and that’s what we’re demonstrating in dogs as well. So we no longer look at, you know, breast cancer as just some type of lump in the breast. Is it BRCA1 positive? BRCA2 positive? HER2 positive? You know, let’s say melanoma, is it V600 BRAF positive, or is it EGFR positive and KRAS positive colon cancer.

[00:30:06] And there’s two kind of components of that. One is a histopathologic diagnosis, which is what it looks like under a microscope, kind of the tissue of origin and where it is. And the equally important part is what’s actually causing it. So think of cells like little computers, but instead of zeros and ones, computers are binary code.

[00:30:21] >> James Jacobson: Right.

[00:30:21] >> Ben Lewis: Cells are quaternary code. So A’s C’s T’s and G’s. Like GATTACA. And the cellular programming is all contained in the DNA. So when you have a bug somewhere in the DNA or a mutation of DNA, sometimes that puts the individual cells on these programs that just tells them to divide and divide and divide. And that’s what we call cancer.

[00:30:39] So if you look at, you know, doggie bladder cancer, transitional cell carcinoma, acquainted the work of Dr. Breen at North Carolina State University. So somewhere around 85% of them are V5E that’s amino acid change BRAF, which is the gene, positive, which means 85% of dogs have the same mutation for their bladder cancer.

[00:31:00] And why that’s interesting is basically the vast majority of bladder cancers fit into this one 85% bucket and then a 15% fit in the other bucket. But those are basically two separate diseases despite occurring in the same place. I guess a good analogy would be like, if you went to the doctor right now with a cough, a cough is a cough, right?

[00:31:17] Your doctor would say that you’ve got a cough, but you probably wouldn’t be satisfied with you got a cough. And this is what it sounds like, you know, it’s a loud cough, it’s a quiet cough. It’s a dry cough. It’s a wet cough, but you probably want to know what’s causing that cough. Right? Like, do you have COVID? Do you have asthma? Or did you swallow, I don’t know. Did you aspirate a piece of pasta? You know, very different causes to the same physical manifestation of a symptom. And cancer is very much the same way. You know, understanding what the underlying mutation is actually gets to the actual cause of the cancer a lot better than just looking at the cells under a microscope and describing what they look like and where they come from.

[00:31:56] >> James Jacobson: Let’s take a break right now, but when we get back, I’d like you to discuss the types of dog cancer that FidoCure works best with. We’ll be right back after this important message.

[00:32:09] Welcome back. We are speaking with Ben Lewis, co-founder of FidoCure. So what kinds of cancer does this work best with?

[00:32:19] >> Ben Lewis: So for the most part, I think the approach works really well with most types of cancer, because as you know, cancer is cancer and somewhere in their 3.2 billion base pairs of DNA are the mutations.

[00:32:29] That being said from the formulary we have access to currently at FidoCure, we’re really focusing on solid tumors. So we think lymphoma is interesting and leukemia is interesting, but you know, I think that’s kind of a place we’ve shied away from because the current standards of care are quite effective, particularly for like B-cell lymphoma.

[00:32:49] >> James Jacobson: Right. I mean, there’s the CHOP protocol, which is probably one of the few things that pretty much makes a lot of sense. If you have a dog with that, it was like, let’s use the Wisconsin CHOP protocol.

[00:32:59] >> Ben Lewis: Yep, exactly.

[00:33:00] >> James Jacobson: But some of these other ones that you’re talking about, like TCC, transitional cell carcinoma and all these sarcomas, normally not so good. And that’s what this is for.

[00:33:08] >> Ben Lewis: Correct. So that’s what we’re really focusing on is, you know, the hemangiosarcomas, the transitional cell carcinomas. Lung cancer is actually a great one. You know, primary pulmonary adenocarcinoma. It turns out to be very similar to what we see in humans. And melanoma, the list goes on and on, but basically solid tumors.

[00:33:26] And for us to sequence, we really do require a biopsy. Sometimes veterinarians will do, what’s called a fine needle aspirate, which is just taking a needle and kind of taking a small sample and squirting the cells onto a slide. But for sequencing, we really do require a chunk of the actual piece of the tumor.

[00:33:41] So either, you know, a punch biopsy, a true cut biopsy, or just a, you know, an excisional biopsy via surgery. So it’s really important that we actually have some tissue. So that’s another reason why we’re focusing on the solid tumors.

[00:33:54] >> James Jacobson: Got it. Okay. Again, let’s go back to the beginning. So you’ve heard about this, you Googled dog cancer and you’ve seen one of FidoCure’s, millions of ads.

[00:34:04] And people are like, what is FidoCure? What is FidoCure? Which is partly why we’re doing this conversation because people are like, what is this? What is the process that you would go through, you’d go to the website. And then what happens next? How do you bring your vet into the picture?

[00:34:18] >> Ben Lewis: The good news is we’re working with a fair number of the veterinary oncologists in the United States already. I think the number is north of 30%.

[00:34:26] >> James Jacobson: So you have to work with an oncologist, not just a vet, but an oncologist.

[00:34:30] >> Ben Lewis: So we very much prefer working with veterinary oncologists, you know, there are case to case exceptions, just to be honest, you know?

[00:34:37] >> James Jacobson: ‘Cause not every place, like I’m in Hawaii where there are no veterinary oncologists.

[00:34:41] >> Ben Lewis: There’s one veterinary oncologist, right, in all of Hawaii. Uh, who is it? Is it Dr. McMillan?

[00:34:45] >> James Jacobson: On Honolulu, but not on Maui. I’ll tell you. So, yeah.

[00:34:48] >> Ben Lewis: Okay. So, you know, if there’s some reason why, you know, a veterinary oncologist is completely out of the picture, there are possibilities for kind of exceptions. Let’s say you are on Hawaii and you don’t want to take your sick dog on an airplane to go receive chemotherapy. We really do want to help clients.

[00:35:04] >> James Jacobson: Right.

[00:35:04] >> Ben Lewis: And that’s our number one prerogative. So similarly, if you’re in the middle of Montana or something, and there’s literally not a veterinary oncologist in the entire state, we’re very much, you know, willing to work with on kind of a select basis, you know, exceptional DVMs and VMDs who do like to treat cancer and are willing to kind of learn a bit. But we very much prefer veterinary oncologists. I’ll double that one down.

[00:35:26] >> James Jacobson: And it requires someone at the beginning of the process who’s a surgeon because you really are going to need it. Someone who can do the surgery part to make sure that you can actually get a sample.

[00:35:35] >> Ben Lewis: Yeah. And for most of the tumor types that we’re looking at, that’s usually kind of the first step anyways, getting the histopathological diagnosis off of a piece of the tumor. So usually, you know, dog has a lump or bump, they go to their veterinarian. Vet says, uh, it’s looking suspicious, let’s take it out. Or the spleen has ruptured, let’s take it out in the middle of the night in the emergency room.

[00:35:55] >> James Jacobson: Right.

[00:35:56] >> Ben Lewis: And then they’ll send it to their reference pathology lab. Antech and IDEXX are the two largest ones. And, you know, if the veterinary oncologists would like to proceed at that point, they’ll just have a piece of that tissue sent to us and we’ll do the sequencing.

[00:36:08] >> James Jacobson: Okay. So that has to be done pretty much at the same time as it is sent to Antech or no.

[00:36:15] >> Ben Lewis: No. So actually veterinary pathology labs have to keep a tissue for like three years.

[00:36:20] >> James Jacobson: Ah.

[00:36:21] >> Ben Lewis: Depending on their state.

[00:36:22] >> James Jacobson: Okay.

[00:36:22] >> Ben Lewis: So they actually save it and re-sequence off what’s called formalin-fixed paraffin-embedded tissue. So FFPE tissue. So it could be six months later. You know, a patient could have failed one round of chemotherapy and they’re like, oh, that first-line therapy didn’t work. Then the veterinary oncologist may recommend something like FidoCure, or they might recommend it as a first-line. And while they’re waiting for the sequencing results, they might start something else.

[00:36:44] >> James Jacobson: So that’s good to know. So that sample is still at the pathology lab for three years. So later on, they come back and they say, oh, it is transitional cell carcinoma, and this is the protocol. And then you say, Hey, I want to try this FidoCure then your vet would, or something that would basically get a sample from the Antech Laboratory to your facility in New Jersey?

[00:37:06] >> Ben Lewis: That’s correct. Yep.

[00:37:07] >> James Jacobson: Okay.

[00:37:08] >> Ben Lewis: And the client, the pet parent doesn’t have to worry about this stuff. This is all kind of done behind the scenes and actually quite straight.

[00:37:13] >> James Jacobson: Right. Okay. So this is all electronic I imagined. And then you guys at FidoCure don’t liaise at all with the dog owner or the dog lover, the dog parent, you are talking to primarily vet oncologists.

[00:37:26] >> Ben Lewis: Correct. For the most part, I mean, plenty of pet parents do call us and we have some incredible veterinary technicians and, you know, I pick up the phone sometimes, Christina, so you never know who you’re actually going to get.

[00:37:36] >> James Jacobson: Right.

[00:37:37] >> Ben Lewis: And we love what we do. So that’s why we still do it. But for the most part, we work behind the scenes with your veterinary oncologist.

[00:37:43] >> James Jacobson: Okay, cool. And so you’re seeing good results at this point that are more promising than what you would see with traditional methodologies. Is that what you’re saying?

[00:37:53] >> Ben Lewis: Based off early data, the types of cancer that we’re focusing on, I can preliminarily say yes.

[00:37:59] >> James Jacobson: Okay.

[00:37:59] >> Ben Lewis: Hopefully that’s like squishy enough that I don’t get in trouble.

[00:38:01] >> James Jacobson: Okay. So what’s the next step for you guys? Because I think what is interesting where I want to go, because again, we’re going to go back to the fact that you are sitting in a garage here in Silicon Valley, blocks away from where HP started and you’ve raised what, $16 million so far?

[00:38:17] >> Ben Lewis: Sounds about right.

[00:38:18] >> James Jacobson: Okay. So where is this going? I mean, I like how it, when you changed your name from FidoCure Ethical Pet Research, which I think is really interesting, right, to One Health Company and One Health means something. What does it mean?

[00:38:33] >> Ben Lewis: So One Health is kind of the commonality of diseases between people and animals. So, you know, the most recent, let’s say a SARS CoVariant 2, Coronavirus, you know, likely emanated from bats or something, or, you know, some animal in some wet market somewhere. And that jumped the species barrier. So just from the disease standpoint, 75% of diseases that affect people are what we call zoonotic, which means they come from animals.

[00:38:59] So that’s kind of a One Health interest, but what One Health is really looking at the similarities between health and sickness, between animals and people and it turns out people and their pets are getting the same types of cancers, literally down to the genetic defect. So it’s crazy. I mean, that’s happened a few times where we’ve had a pet parent and their pet with the same type of cancer and a couple of times even have the same mutation. Maybe there’s some environmental component, who knows?

[00:39:25] >> James Jacobson: You think? We had the same front lawn chemicals or whatever. Wow. So again, help me understand where One Health fits into this, because again, that’s a lot of money in the veterinary field. I’m sure. You know, I don’t have to tell you that. Clearly there’s something beyond just helping Fido. Right?

[00:39:45] >> Ben Lewis: Right. So what’s really amazing is, you know, because people and their pets are having the same cancer types with the same mutations. What we’re learning from the dogs actually is going back and helping people too. So we worked with a large biopharma company on a study, looking at human angiosarcoma and based on actual dog data, they were able to see a signal for a label extension for one of the therapies in people. So that’s really exciting. It’s actually in, I think, phase three trials at Dana Farber right now. So it’s really cool to see kind of this full circle of, you know, it started in the dogs for testing. Then it went to people and then went back to dogs and now it’s going back into people.

[00:40:25] >> James Jacobson: That’s so cool. I remember reading a quote years ago from the, I think the director of the Dana Farber Institute, who said that, like, if we can do it in dogs, we can do it in people because they’re so similar, these cancers.

[00:40:36] >> Ben Lewis: And we’ve cured cancer many, many times over in rats, in rodent species. So it’s not like curing cancer in a rat or a mouse where we’ve done it many, many times. If you can do it in a dog, I think that’s a much stronger signal.

[00:40:49] >> James Jacobson: Am I right presuming that is why these large Silicon Valley venture firms have been interested in what you guys are doing?

[00:40:57] >> Ben Lewis: So that it’s part of it. You know, this kind of comparative oncology aspect, but it turns out there’s a lot of animal lovers out here in Silicon Valley.

[00:41:05] Believe it or not, you know, who have dogs who have suffered from cancer and they themselves are cancer biologists. And when they go to their veterinary oncology clinic and they’re offered a therapy from like the 1950s, their response is, hell no. I know there’s something better. Like I want it. Please give it to me.

[00:41:22] I will pay anything. And so realizing that didn’t exist and we were kind of in their backyard here in Silicon Valley, they decided to help us kind of redefined veterinary oncology in an evidence-based way, as well as, you know, expanding the reclassification of a veterinary cancer and expanding the veterinary oncology toolbox with access to new therapies.

[00:41:44] So this was kind of a great merging. They love the veterinary aspect of actually helping dogs because they themselves are animal lovers. And if we can also help people, that’s just kind of icing on the cake.

[00:41:54] >> James Jacobson: Well, what do you see as the future for the company as the Chief Strategy Officer?

[00:41:59] >> Ben Lewis: So the future of the company, I think in 10 years from now, FidoCure, or at least the FidoCure platform will be the standard treatment methodology for most dogs with cancer.

[00:42:09] You know, if you see a dog with cancer, but your vet is just going to do FidoCure to kind of identify the right treatment, identify what’s next and go from there. So I think that’s kind of the future, you know, there’s 6 million dogs diagnosed with cancer every year, unfortunately. And that’s compared to about 1.6 million people.

[00:42:25] >> James Jacobson: And I think that’s 6 million dogs in North America.

[00:42:28] >> Ben Lewis: In North America. Yes.

[00:42:29] >> James Jacobson: Yeah. You’re not even touching the whole world. There are lots of more dogs. So what does FidoCure cost?

[00:42:35] >> Ben Lewis: So we leave the pricing up to the veterinary oncologists and, um.

[00:42:38] >> James Jacobson: Give me a range though, because we know that like a veterinarian in New York is going to charge more than a veterinarian in Ohio probably.

[00:42:45] >> Ben Lewis: Right.

[00:42:45] >> James Jacobson: So what’s the range?

[00:42:47] >> Ben Lewis: So I think that the most recent care credit data is the average cost of veterinary oncology care is $6,700 per dog. Like, you know, per incident. We aim to be considerably less than that. So one of the nice things about having these awesome Silicon Valley backers is they actually subsidize the cost considerably for pet parents.

[00:43:08] >> James Jacobson: That’s an interesting angle.

[00:43:10] >> Ben Lewis: Yeah. So, you know, it turns out drugs from this century, as opposed to drugs from like the mid 1950s, 1960s are a lot more expensive and it turns out when you actually have to compound them on a main patient basis for each patient that also adds costs instead of just doing a round of a million pills in a given size.

[00:43:28] So what we do is expensive and genetic sequencing is also really expensive. I just got a quote from a friend today. It was like $47,000 for whole genome sequencing in Italy and with RNA-Seq as well. So most people love their pets, but they’re not going to pay 47,000. Thankfully the cost of this is nowhere near that, just because we run a lot of volume.

[00:43:49] >> James Jacobson: Because of the same type of test that you’re saying, if you were to get the same test in Italy, it’d be 47,000?

[00:43:55] >> Ben Lewis: Potentially. It seemed really high to me. So I’m going to back away from that number, but in terms of sequencing in and of itself is expensive. And when we started the, the cost of the test, plus the lifetime of therapy literally was more than we paid for the cost of the test.

[00:44:09] And we were subsidizing it just because the data itself is interesting. And we really are a mission-based company that wants to help animals. So we’ve found other people that actually back this and support us helping animals, even if it means we lose money on every case.

[00:44:23] >> James Jacobson: Okay. So that’s another value of the way you’ve structured your business is that effectively because there’s a bigger focus and a larger focus beyond dogs moving into the human space. The treatments are effectively being subsidized in order to get this data, which I mentioned is something that people have to agree to as part of the process, that this is going to be data that’s going to be shared and used in perpetuity. Now on your website, it says there are 14 FDA human approved drugs that you guys sort of use. Is that right?

[00:44:56] >> Ben Lewis: Yeah. So that’s kind of the initial traunch of therapies that we gained access to is 14 drugs, but going from one to 14 is pretty big. 14 compared to 150 is not that big, but, you know, going from one targeted therapy in veterinary oncology and adding another 14, that, that is a significant increase.

[00:45:14] >> James Jacobson: Are the side effects that you’re seeing from those 14, almost exactly the same as the side effects that you might see in human oncology with those 14 drugs?

[00:45:24] >> Ben Lewis: Interestingly, no. So people and dogs can behave differently, or our shock organs are different and organs of toxicity can be different. And, you know, if you talk to someone who focuses on allometric scaling or a pharmacologist.

[00:45:37] Sometimes we see similar side effects and sometimes we see different side effects or lack of side effects. So it has been a learning curve, but at this point where each drug that we use has been dosed in hundreds of patients, we do feel pretty comfortable with the doses and the regiments that these patients are using.

[00:45:56] >> James Jacobson: Okay. But you’re obviously, I mean, part of this whole discovery process, because this is still very much in its infancy and research is to figure out a term often used in oncology is maximum tolerated dose. Do you guys focus on that at all with this or no?

[00:46:10] >> Ben Lewis: So the whole MTD concept is really for cytotoxic chemotherapies.

[00:46:14] >> James Jacobson: Okay.

[00:46:14] >> Ben Lewis: We were trying to kill the log maximum of cells, you know, because just killing any cells that comes in contact with.

[00:46:20] >> James Jacobson: Right.

[00:46:21] >> Ben Lewis: Whereas the targeted inhibitors, it’s all about kind of area under the curve and making sure that you’re actually inhibiting the inhibitory concentration, you know, the right amount of cells for the right amount of time, based on how often you’re giving a drug, whether it’s daily or whether it’s every other day, making sure that you’re inhibiting the growth of those cells, with that mutation at that dose, and that regimen.

[00:46:43] >> James Jacobson: Cool.

[00:46:43] >> Ben Lewis: And that’s completely different than gene therapy. And that’s completely different than CAR T you know, Chimeric Antigen Receptor T-cell therapy, or other cellular based therapies, and completely different than things like let’s say, listeria monocytogenes and other immuno-oncology vaccines. So we’ve seen it all because we do work with large human biopharma companies, and that there’s a lot of really cool stuff on the horizon that we’re excited about. But today we’re focusing on these 14 oral targeted therapies that have common mutations in dogs and we feel comfortable with.

[00:47:15] >> James Jacobson: Got it. And then in terms of the side effects, sometimes you see different side effects than you would see in a human, are they sometimes worse or better, or how are they different?

[00:47:24] >> Ben Lewis: So here’s a good example. There’s a drug, we don’t use it, but it is a therapy called dabrafenib in humans. It’s a BRAF inhibitor as part of a doublet therapy for V600E BRAF positive melanoma in people. It turns out is completely intolerable in dogs. So we never put it in a single dog because while being tolerable in people, it’s completely intolerable dogs. The corollary of that is, I probably shouldn’t name drugs that we actually do use, but, you know, let’s say another drug that is totally tolerable in dogs might be less tolerable in people for some reason, and, you know, might be because sometimes it’s just idiosyncratic. We don’t quite know every difference between humans and dogs, as much as we wish we could.

[00:48:06] But at this point we have a pretty well curated set of drugs that we do work with, that we feel comfortable with. And I think we’ve demonstrated pretty well in these 700 something dogs are better tolerated than the therapies out there.

[00:48:19] >> James Jacobson: That is pretty cool. So I mentioned earlier that I want to learn a little bit more about you. You called it ethical animal research because?

[00:48:28] >> Ben Lewis: So this is a definitely a hot button. So the name was very, very unpopular despite my initial insistence around the name, because I guess it implied that all other types of research that didn’t use naturally occurring disease in pets was unethical.

[00:48:45] >> James Jacobson: Those poor beagles that I mentioned earlier.

[00:48:47] >> Ben Lewis: Right. So, you know, I have to keep my mouth shut on this one, but I have the utmost respect for our lab animal colleagues. And actually one of our co-founders is the former president of the American College of Lab Animal Medicine, Dr. Ravi Tolwani is amazing. He’s one of the leaders in laboratory animal medicine. And, you know, the approach of rather than taking a healthy animal, inducing disease, and then run a test on it, you know, of actually using animals that have naturally occurring diseases that are likely closer to the disease you’re trying to make artificially in an otherwise healthy animal probably is a much better animal model. So that’s kind of the model we’re promoting from a kind of a ethical standpoint. That being said, I don’t want to cast stones.

[00:49:31] >> James Jacobson: Got it. Okay. There’s an interesting story of how you and your wife met and how you started in all of this, because I’m very impressed at your ability to rattle off these scientific terms. So how did you get started?

[00:49:42] >> Ben Lewis: Oh, so I was like a bioengineer undergrad. I went to vet school at Penn for three and a half years, although I’m not a veterinarian.

[00:49:49] >> James Jacobson: Three and a half. Okay. So you almost had the, VMD.

[00:49:52] >> Ben Lewis: Almost had the VMD. I was very close and I hope to have it, you know, someday soon. I haven’t given up on it, but this, you know, One Health Company has kind of taken me away. So I was a dual degree student at Penn. I was in the VMD MBA program. So it’s the veterinary program and then MBA in healthcare management with Wharton.

[00:50:11] >> James Jacobson: So they combined that together or was that of your own choosing?

[00:50:15] >> Ben Lewis: A little bit of both.

[00:50:17] >> James Jacobson: Okay. So you helped to create that program, I guess. Sounds like you were an early student.

[00:50:21] >> Ben Lewis: Yeah. We kind of worked on the curriculum and inked quite a bit around that. One of my classmates, Dr. Molly Dominguez as well.

[00:50:27] >> James Jacobson: So what year was this?

[00:50:28] >> Ben Lewis: This was 2008.

[00:50:30] >> James Jacobson: Okay.

[00:50:30] >> Ben Lewis: So 12 years ago. And so what started as ethical animal research was actually a class project for healthcare entrepreneurship, which is HCMG867, which is taught by Dr. Kurtzman and Jeff Libson. And a lot of great companies have actually spun out of that class. So companies like Warby Parker, Velano Vascular, MedCrypt, I want to say Grand Rounds, but I could be wrong.

[00:50:57] So a lot of the really cool companies have come out of this one class in Wharton. And this company started as a class project. And within a few weeks, we ended up with some pretty awesome biopharma contracts that ended up taking me out of school. So I didn’t go back and finish the last couple months of clinical rotations at Penn Vet.

[00:51:16] So unfortunately I’m not a veterinarian yet. Someday, hopefully.

[00:51:20] >> James Jacobson: Okay. So how did you and your wife meet and how did you guys start building this company?

[00:51:25] >> Ben Lewis: So I was in Brazil for spring break, I guess I’m very fond of taking sabbaticals from school and doing really cool things. So the first time I took a sabbatical from school was an undergrad at Dartmouth.

[00:51:36] So I realized I wanted to train for the Olympics and my mom.

[00:51:40] >> James Jacobson: In what sport?

[00:51:41] >> Ben Lewis: So I love kayaking. I’m from Miami, Florida. I’ve always grown up on the water and love to paddle. And Dartmouth was a great school for that. I guess it would be in 2002, I wanted to train for the 2004 Olympics and decided to take a leave of absence.

[00:51:56] My mother said oy vey, you know, my stupid son, what’s wrong with him? And there’s actually a really funny story. Why would he leave Dartmouth and go to train for the Olympics? You know, I should have raised him better. And this is actually at a second night Seder and another one of the parents, they were in like Westchester, New York.

[00:52:14] Another one of the parents says oy, my stupid son just dropped out of Harvard and he moved to California with his friends and he’s starting some type of Bookface company and it was Mark Zuckerberg. So totally two bad Jewish sons here.

[00:52:27] >> James Jacobson: My goodness. Must’ve been a very interesting Seder.

[00:52:29] >> Ben Lewis: Very interesting Seder, but long story short. So first time that I took a leave of absence from school ended up making the Olympic team represented the United States in the 2004 Olympics in Athens, Greece. Made it to the semi-finals really cool experience. And did, did go back and finish then from vet school I took a leave of absence to go to do the MBA.

[00:52:49] Once I was in the MBA. I took a leave of absence when I went down to Brazil on spring break, it supposed to be a two week spring break trip and ended up turning into a four year spring break.

[00:52:57] >> James Jacobson: Got to go out of Philadelphia for four weeks. Okay.

[00:53:00] >> Ben Lewis: Yeah. So I ended up in Sao Paulo for about four years where one of my learning teammate Bernardo Erspide and I started up a company called For Vets down in Brazil, which is, you know, I guess one of the big animal health supply distribution companies in South America. And we were acquired by a private equity fund, came back, you know, went back to Wharton, took this class. I was supposed to go back after One Health Company, but One Health Company is still going.

[00:53:23] So hopefully soon I’ll go back and finish whether it’s at Penn or somewhere else and, you know, complete my VMD or DVM. But I met Christina in Brazil, so she was down there. She was managing director of Cerberus Capital, which is a large private equity firm. One day, one of our mutual friends from Germany brought her into, we kind of shared an office.

[00:53:45] He was with like a driven private equity fund, brought her into the office. I spoke to Christina for about five minutes. I said, oh my God, let me know for my business partner. Oh my God, this girl is amazing. I’m going to marry her. And six months later, we were married and after our second child was born and Christina was ready to kind of get back into the business world.

[00:54:02] And she saw what I was doing and she saw all the mistakes I was making. And she said, let me help you. You stick to the science, I’ll stick to the business. And I think we can build something pretty amazing. And that was almost four years ago.

[00:54:14] >> James Jacobson: Wow. And then did you start in California or did you start somewhere else?

[00:54:18] >> Ben Lewis: So we actually started in Philadelphia. So our original office was in the Science Center I think of University of Pennsylvania. It’s kind of like tech offices, right next door to Penn and Drexel. So we started in Philly and we originally moved to California for Y Combinator, which is an amazing accelerator program.

[00:54:36] >> James Jacobson: And for people who don’t know what that is, what is Y Combinator?

[00:54:39] >> Ben Lewis: So Y Combinator is this just awesome accelerator program started by Paul Graham. It’s based here in California. And you probably know a lot of the companies that have come out of this accelerator program. Things like Dropbox, Airbnb, Instacart, Science Exchange, which I mentioned earlier, Dr. Elizabeth Iorns and you know, just a whole laundry list. So we came out to Silicon Valley for Y Combinator and have basically been here ever since. So we’re still here in basically downtown Palo Alto. The weather’s amazing, although you’re in Hawaii. So I think it might be a little nicer there.

[00:55:14] >> James Jacobson: You have a heavy coat on, but of course you’re in the garage.

[00:55:16] >> Ben Lewis: Right. I’m relegated to the garage, but yeah, California’s been amazing. But if you are looking to start a business, there are definitely some strategic reasons to be located here, even with COVID. And a large exodus of some big companies from California. This really is a center of talent as well as capital in the United States.

[00:55:37] And it’s just exciting living here because everyone around you is doing something cool.

[00:55:41] >> James Jacobson: So do you basically have a distributed team? How are you guys coping with COVID?

[00:55:46] >> Ben Lewis: So we were distributed to begin with long before COVID, you know, one of the things Christina really focused on as a company is company culture.

[00:55:54] And, you know, she wanted to build a, a very equitable company across kind of all lines, you know, gender, cultural background, and, you know, one of the things that can make it difficult to recruit highly competent, and talented women is forcing them to move from one location to another as well as sometimes the burdens of childcare whatnot.

[00:56:14] So like Christina’s supposed to be on this, but our nanny had to leave early and, you know, couldn’t make it. So one of the ways Christina really wanted to attract like top talent is with this flexibility and this is before COVID. So it would have been unheard of to let someone work from Nebraska. You know, if they’re a great bioinformatics person and they want to work from New Jersey, that would have been a anathema to a Silicon Valley company, but we really have had this distributed culture.

[00:56:40] We communicate via Slack and the whole G Suite and we’ve been using Zoom long before Zoom became a COVID necessity.

[00:56:47] >> James Jacobson: Right.

[00:56:48] >> Ben Lewis: So it’s always been our company culture that people can work from wherever.

[00:56:52] >> James Jacobson: It’s definitely the future way to build companies and it’s smart in so many ways.

[00:56:58] >> Ben Lewis: And you’re distributed as well. Right? Fully distributed.

[00:57:00] >> James Jacobson: I’ve been distributed for many, many years, like 20 years.

[00:57:04] >> Ben Lewis: That’s amazing.

[00:57:04] >> James Jacobson: Yeah, because I really like Hawaii. And this is not a great place to be hiring a lot of people who want to work crazy hours. But what you guys are doing is really pretty cool. And I imagine as you look to the future five years from now, what do you see?

[00:57:20] >> Ben Lewis: Five years from now hopefully we’ll be like the Uber or the Lyft of a veterinary cancer. Like if a dog has cancer you just automatically, you know, you go through the FidoCure platform, basically synonymous with excellent veterinary care. And hopefully we expect this all will remain, you know, affordable in the veterinary oncology realm for hopefully forever and hopefully will drive the price down even further.

[00:57:42] You know, one of the things, when we took money from Andreessen Horowitz, one of the conditions was this can’t be a product just for the wealthiest 1% of Americans. This has to be something that’s affordable. And you know, you have to do whatever to make it so that you actually address the needs of pet parents, whose dogs have cancer.

[00:57:59] So hopefully we can continue driving down the cost to the point where people don’t have to crack open their piggy bank too much to help their loved ones with cancer.

[00:58:06] >> James Jacobson: And I’m assuming the enabler behind all that is this data, which big pharma is going to use to help human cancer. We haven’t said this explicitly, but imagine that’s your business plan. I imagined that’s what they’re interested in. So yeah, the dogs are great and we’ll subsidize that. But what we’re really after is this data so that we can get more information for human cancer.

[00:58:30] >> Ben Lewis: Absolutely. And that’s how we close the loop financially.

[00:58:33] >> James Jacobson: Well, Ben Lewis, thank you so much for being with us. We went way over, but, uh, I think this is really interesting and we’ll make sure to share it with as many people as possible.

[00:58:42] >> Ben Lewis: Awesome. Well, thank you so much.

[00:58:46] >> James Jacobson: Pretty fascinating stuff, huh. But what do real world veterinarians think about FidoCure? Well, we asked two veterinarians who appear regularly on Dog Cancer Answers.

[00:58:57] The first is Dr. Nancy Reese.

[00:59:00] >> Dr. Nancy Reese: So first I have to say upfront that I have not actually used FidoCure in any of my cancer patients. So all of my impressions are from researching the concepts behind the treatment. The idea behind FidoCure is that not all cancerous tumors, even tumors that have the same kind of cancer, not all those tumors will have the exact same genetic features.

[00:59:18] So for FidoCure a biopsy of the tumor, either a piece of the tumor or the whole thing can be sent in and the tumors then tested to find which genetic markers are on that particular individual’s tumor. This genetic markers, then help determine which treatments are more likely to have an effect on the tumor.

[00:59:36] We know, especially from a lot of studies in humans, that certain drugs will work better or worse depending on those genetic markers. And this makes sense, in that we all know individuals who seem to react differently to medications than ourselves. That’s likely due to difference in how the body processes the drugs or how the drug affects someone because they have overall different genetics. For the tumors, we’re looking not at the overall genetics of the dog, but of the genetics of that particular tumor. And this is such a great concept because it is an example of precision or personalized medicine. We are targeting that individual and tailoring treatments to that individual dog or human. And this is a different approach to treatment than just basing the treatment on the tissue of origin of the cancer.

[01:00:21] So theoretically, then we would give medications that have a higher chance of having an effect on the cancer versus a blanket at treatment, based on just the type of cancer. This would certainly be less wasteful in terms of not giving drugs that could have some toxic side effects, but we wouldn’t be giving drugs that we know won’t work on that particular dog’s cancer.

[01:00:41] I think the company mentions 14 FDA human approved drugs that they use. All, I imagine that number would go up with time. And these medications could be given at home. And this is an obviously huge benefit if effective for the dog to be treated at home versus having to come into a clinic frequently. But for the less good side, this type of approach is still relatively new in dogs.

[01:01:02] So we don’t have good studies that show the positive or the negative effects. We have some good anecdotal reports, but we really need some large, well done studies to understand if this is an improvement of care. Another issue is that while this approach has long been done in humans, or at least longer than in dogs, the results are not as good as hoped.

[01:01:21] Well, there are, I think something like 50 drugs used in humans to target the different genetic variations in the tumors, the cancers do not always respond to the targeted treatments. And when the cancer does respond, the response doesn’t often last, as long as we had hoped. These are not proven to cure to cancer, which would obviously be the best outcome.

[01:01:40] And while that can be said of conventional therapy, we are looking at things that are an improvement on conventional care. The other thing we really don’t know is how this translates to the duration of effect in dogs. A lot needs to still be studied there. I think the potential for this approach is great.

[01:01:56] Precision medicine is certainly the wave of the future, but I think right now we’re still in information gathering phase. So I don’t want to add any quote, false hope for guardians. If conventional therapies are more effective, then I wouldn’t want someone to skip a more effective treatment by going this route.

[01:02:12] But treating at home is a huge bonus. And again, the idea of treating an individual versus everyone the same is a great concept. I hope to someday say that this option is better approach than the current therapies, as we are all really hoping to improve the outcome for treating dogs with cancer. Thank you very much.

[01:02:30] >> James Jacobson: And here is Dr. Trina Hazzah, a veterinary oncologist.

[01:02:35] >> Dr. Trina Hazzah: I love it. I love the idea of it. The difference, you know, when you think of how it can be implemented, right? FidoCure is essentially a company that uses genomic markers and genetic markers to target specific mutations in cancer. So when you think of how we treat most animals that have cancer for quite a long time, I’ve been doing this for over 10 years.

[01:02:58] We use majority chemotherapy, which essentially is what we call cytotoxic therapy. It targets the cancer cells themselves, and it creates death on the cancer cells through a variety of different mechanisms. But it also targets, when we think of cancer cells, we think that they divide very quickly. And so when you think of how high dose chemotherapy works, it actually targets rapidly dividing cells.

[01:03:22] The problem with that is that unfortunately you get side effects with chemotherapy in about up to 30%, sometimes even more depending on the chemotherapeutic you use. And that’s because it doesn’t just target the rapidly dividing cells, only that the cancer cells, it also targets rapidly dividing cells that are throughout the body.

[01:03:41] And those are going to be cells of your GI tract or your bone marrow. And that’s why when pets get chemotherapy, just like people, they can develop GI upset, like vomiting and diarrhea or suppression of their bone marrow, where with what they call targeted therapy, which is what FidoCure really supports, and that’s really where their focus is, is is they take the tumor, that’s sitting in the laboratory, your pet’s tumor. They then evaluate it through a variety of different tests and they look at the entire genome and they compare it to that and figure out where the mutation exists in your dog’s tumor. Right. Not just in your dog, ’cause it’s a whole different type of test in your dog’s tumor. So for.

[01:04:22] >> James Jacobson: Just in this specific tumor.

[01:04:24] >> Dr. Trina Hazzah: Yeah. You know, I think a lot of times people say so if my dog has thyroid carcinoma, can’t I just use this one therapy and I’d say, yeah. And probably it would work. However, it’s not your dog’s specific thyroid tumor. And that’s what FidoCure does. It actually takes your dog’s thyroid tumor, not just any dog’s thyroid tumor.

[01:04:42] We’ll take your dog’s thyroid tumor, evaluate that specific tumor for genetic alterations and based off of that, they implement what they call a targeted therapy. And so again, different than chemo that is more cytotoxic kills the cancer cells, targeted therapies, considered what they call cytostatic. So it blocks the proliferation or the growth of the cancer.

[01:05:05] And so it looks at the specific molecular targets that are involved in the growth of the cancer, the progression, the spread of the cancer, and it actually blocks it. So what I tell owners, when I try to explain the difference between targeted and chemotherapy is I say targeted therapy is almost like a light switch on, and that light switch is turning on the lights and the lights are actually the cancer growing, right?

[01:05:30] It’s like the electricity that tell the cancer to grow. If I have a drug that can go over to your light switch and turn it off, guess what happens? No more electricity to the lights or to the cancer. And it stops growing. That is the goal of targeted therapy.

[01:05:45] >> James Jacobson: So doesn’t kill it, but it stops it from growing and spreading and metastasizing.

[01:05:49] >> Dr. Trina Hazzah: And eventually it can start to die off. We have tumors that are on targeted therapy that literally disappear. Right, but it works differently than chemo that targets the cancer directly. This targets more say the growth factors and other things that are telling the cancer to grow and spread and so forth.

[01:06:07] So that’s really kind of the philosophy behind FidoCure and they believe in what they call personalized medicine. And that very much up my alley, because as an integrative oncologist, you have to practice personalized medicine. Every single dog that walks in again with thyroid cancer, let’s say isn’t going to be the same dog and may not need the same type of alternative medication options or chemotherapy or targeted therapy.

[01:06:31] You have to look at the patient as a whole and decide what works best for that patient. Not just what works best for that patient’s cancer.

[01:06:39] >> James Jacobson: You’ve used FidoCure right?

[01:06:42] >> Dr. Trina Hazzah: I have.

[01:06:43] >> James Jacobson: And you’ve had successes, failures, a little bit of both?

[01:06:46] >> Dr. Trina Hazzah: You know, I, I would say I have absolutely had a little bit of both just like with any modality, right?

[01:06:51] Any time you’re treating cancer, it’s a difficult journey, right? I mean, there are certain tumors that respond and there’s certain tumors that don’t, I always think of this one case that I had with a very small little dog named Duchess that ended up having squamous cell carcinoma of the tonsil that had already spread to the regional lymph nodes.

[01:07:13] This is a very aggressive cancer. If you look at the numbers, the chance of a dog with tonsillar squamous cell carcinoma living one year is 0%. I mean, that’s how aggressive this is. And I’ve been treating these tumors for again over 10 years being an oncologist. And I have never found a therapy that can work well enough.

[01:07:32] I can get a few months. I can try to get some pain-free time, but I have tried chemo. I’ve tried other modalities. I just cannot find the perfect combination of therapies or singular therapies that really work well. So I spoke to this particular owner. She was not interested in chemotherapy whatsoever.

[01:07:48] And said, look, I would be interested in targeted therapy. That seems like the newer way to go. And I think it’s absolutely true. This would be certainly a, kind of a new wave of therapy in veterinary medicine and veterinary oncology. It’s been around for a lot longer in human medicine, over 125 different targeted therapies in human medicine compared to the one that is FDA approved in veterinary medicine which is insane. And so this owner said, look, FidoCure has, I think it’s about 14 different therapeutic options that are FDA approved and people that they found can target some of the veterinary oncologic cancers and have been proven to be safe in non tumor bearing dogs. And so we thought, well, what they did was they looked at what would be safety profile and said, why don’t we try these doses and see, and they had been using it for a few years.

[01:08:35] And so I felt very comfortable having this conversation with the owner. She wanted to move forward in that direction. And we of course did some herbs and cannabinoid therapy along with FidoCure. The dog started to get very sensitive stomach. So ended up stopping the herbs, continued with the cannabis and the FidoCure and Duchess must’ve lived for God, over nine months and had a wonderful quality of life, got to be home, getting the pills at home because these are pills. So I’ll make that very clear. Targeted therapy comes in a pill form in veterinary medicine. Right now, what we have available all is in a pill form. So you get to give it at home for your pet, and you’re not having to bring them in and get IV chemo and so forth.

[01:09:19] This does not mean that there are no side effects. And I think a lot of times people think, oh, it’s easy. There are no side effects. It only targets the mutation that’s causing the cancer to grow or spread. No, it also can have side effects.

[01:09:30] >> James Jacobson: So with this dog that lived nine months when normally 12 months is 0%, the high-quality of life.

[01:09:36] >> Dr. Trina Hazzah: Great quality life. And I have no doubt that the FidoCure played a major role. You know, I think a lot of times people say, well, how do you know it wasn’t the cannabis? Or how do you know it was, well, I can tell you the dog stopped its herbs. I would say within a few months, because it was getting some upset stomach.

[01:09:50] And so we had to weigh which ones we wanted to continue. And so if you ask like my inner gut feeling as a doctor, I would say, I think it was probably some type of additive or synergistic effect that occurred between the cannabis and the targeted therapy. I see that in practice a reasonable amount of times actually, and we have that one FDA approved, targeted therapy called Palladia.

[01:10:14] And so I’ve been using that now, since it’s come out for 12 years, 15 years, however long it’s been out. And oftentimes, at least this is my experience. I have not published anything to confirm this. I am sure I have enough cases, to be honest, I just need to take the time to put it together and actually see the dogs that are on a combination of cannabis and targeted therapy.

[01:10:34] I seem to see really good responses. And I wonder if there is that synergistic action that’s occurring. So that would be my gut feeling, but who knows? I can tell you that there was something that was different with this particular dog and any dog that I’ve treated with this disease ever in the past.

[01:10:53] And this is the only dog with this disease that I’ve seen that I put on FidoCure.

[01:10:58] >> James Jacobson: So do you basically recommend FidoCure for all of your cancer patients?

[01:11:02] >> Dr. Trina Hazzah: It depends on the cancer, right? So a dog that has this tonsillar squamous cell carcinoma that I know standard of care doesn’t work well, why not give them a chance and say, I’ve tried it a ton of times with standard of care. It doesn’t work. So let’s try it.

[01:11:15] >> James Jacobson: But something like lymphoma that you would normally use the CHOP protocol, you wouldn’t do that with.

[01:11:19] >> Dr. Trina Hazzah: No, absolutely not. I would use standard of care ’cause I know that works better. So understanding which tumors tend to respond really well to standard of care, which ones don’t and then having a conversation with the owner, understanding it’s not an FDA approved drug, right?

[01:11:33] And so you have to understand that we’re using it off label and let’s go through the potential toxicities, which usually are GI. There’s very few other ones, but there could be, and we just need to make, be a team right, in this type of journey together and make sure that we’re talking and making sure the pet is feeling good and things are going well, but really picking and choosing which cancers and which cases also might be a good fit, right?

[01:11:58] There’s some cases where coming in and getting IV chemotherapy might be best for the cancer, but might not be best for the dog. And there are some dogs that are just so anxious and do not want to come into the hospital are very aggressive and can’t come in and get sedated every time for chemo. Those are the dogs that I think targeted therapy if it’s going to be FidoCure or Palladia that already exists, even chemo in a pill form could be a reasonable option. I think that’s where personalized medicine is so important and FidoCure is clearly looking at the genomics of the dog’s tumor, not just the pet itself. And that’s where I think when we combined genetic evaluation of the patient and genetic evaluation of the actual cancer, that’s where I think magic will really, really happen.

[01:12:47] >> James Jacobson: Is this the future of veterinary and maybe human medicine?

[01:12:51] >> Dr. Trina Hazzah: Totally. Absolutely. And I think the combination, like once you can figure out the makeup, like if you think of almost like a map of you as an individual and a map of your actual tumor, you put that together. You almost like overlied on top of each other and you say, well, what should I use?

[01:13:09] And then of course, as an integrative oncologist, I say, why am I only looking at Western options, right? Or pharmaceutical options? Why can’t I use things like turmeric or use Chinese herbs or cannabinoid therapy or something that also may be able to help. Once I get that map, I can find different ways of targeting things, right?

[01:13:28] It doesn’t have to just be pharmaceutical.

[01:13:32] >> James Jacobson: Wow. I think we can all agree that this week’s episode was jam packed with great stuff about DNA, cancer causing genetic mutations and the science behind targeted cancer therapies. Ben Lewis gave us so much more than I was expecting from our interview. Bur I’m so glad he did, because it helps to have a deeper understanding about the different treatment options available for our dogs, especially when those options are as revolutionary as this one.

[01:14:03] If you need more info about FidoCure, check out this week’s show notes and the verbatim transcript on our website, DogCancerAnswers.com where we will share the links mentioned in this week’s show, as well as provide Ben’s contact information so that you can reach out to him directly to share your thoughts questions, concerns, comments about Fido care.

[01:14:27] If you like our show, please show us your support by liking us on Facebook and by subscribing to Dog Cancer Answers on YouTube or Spotify or Apple Podcast or through your favorite podcast app. And if you want to become one of our ultimate channel supporters, make sure that you tell your friends, your family, and most of all, perhaps your veterinarian and their staff about Dog Cancer Answers. Doing this will not only help our podcast continue to grow and reach more people, but it will help us to connect to other dog lovers and dog guardians, just like you. Up next, we have a quick message from this week’s sponsor because, well, that’s how we paid the bills around here.

[01:15:13] Stay tuned though. After the sponsor break, I’ll be back to tell you how you can call us with your own dog cancer question and how that question could even turn up on a future episode of Dog Cancer Answers. We’ll be right back.

[01:15:33] Did you hear those delightful touchstones? Well, Dog Cancer Answers has a 24 hour a day, seven day a week recorded listener line, especially for you. If you have a dog cancer question or a idea for a future show, just call us and tell us about it. We check our messages often and we’ll make sure that your question is addressed by one of our veterinary experts. And it might even appear on a future episode of Dog Cancer Answers. The number to call is (808) 868-3200. That is (808) 868-3200. Remember it is available all hours of the day so you can call us anytime and leave your question on our recorded listener line. And if you’re not ready to call, but you still have a question about dog cancer or a potential show topic, you can share that with us. Connect with us in writing, by going to our website, DogCancerAnswers.com and clicking on that link that says, ask us a question. We read all of our messages and we look forward to hearing from you.

[01:16:38] Well, that does it for today. Again, thank you for tuning in. Until next time. I’m James Jacobson. And from all of us here at Dog Cancer Answers and Dog Podcast Network, we wish you and your dog, a very warm Aloha.

[01:16:56] >> Announcer: Thank you for listening to Dog Cancer Answers. If you’d like to connect, please visit our website at DogCancerAnswers.com or call our listener line at (808) 868-3200. And here’s a friendly reminder that you probably already know. This podcast is provided for informational and educational purposes only.

[01:17:15] It’s not meant to take the place of the advice you receive from your dog’s veterinarian. Only veterinarians who examine your dog can give you veterinary advice or diagnose your dog’s medical condition. Your reliance on the information you hear on this podcast is solely at your own risk. If your dog has a specific health problem, contact your veterinarian.

[01:17:33] Also, please keep in mind that veterinary information can change rapidly. Therefore, some information may be out of date. Dog Cancer Answers is a presentation of Maui Media in association with Dog Podcast Network.


Benjamin Lewis

Chief Strategy Officer, FidoCure

Palo Alto, CA, USA

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Benjamin Lewis is an experienced executive with a demonstrated history of building leading companies in the (animal) health space. Former Olympic athlete with an MBA in Healthcare Management from Wharton who completed 3.5/4 years of veterinary school at University of Pennsylvania School of Veterinary Medicine. Skilled in Veterinary Medicine, Human Healthcare, Entrepreneurship, Venture Capital, Animal Welfare, and Mergers & Acquisitions.