Dog Cancer Cure: Fidocure by Christina Kelly Lopes
|Dogs have a significantly higher incidence of cancer compared to humans, with six million dogs diagnosed with cancer in the U.S. annually.
|The limited genetic diversity in dogs contributes to their higher cancer rates.
|One Health Company, a startup, offers a dog cancer cure service called FidoCure, which aims to deliver precision cancer treatment for dogs.
|The current standard of care for canine cancer is limited, with few options for treatment and limited access to clinical trials.
|Christina Kelly Lopes recognized the similarities between human & canine cancer, and saw the potential to leverage naturally occurring diseases in dogs for research & treatment.
The Harry Glorikian Show
Harry Glorikian: Hello. I’m Harry Glorikian, and this is The Harry Glorikian Show, where we explore how technology is changing everything we know about healthcare.
If you’re a dog owner, you know how much joy dogs can bring into our lives.
But there’s a sad downside to being a pet parent, which is that dogs have a shockingly high incidence of cancer, compared to humans.
Six million dogs are diagnosed with cancer every year in the U.S., compared to just two million people, or even less.
And that’s in a country where there are a lot fewer dogs than people—90 million dogs, compared to 330 million people.
The basic reason for the difference in cancer rates is that dogs are far more limited in their genetic diversity than humans.
And there’s not much we can do about that.
But we can work harder to make sure that dogs benefit from some of the last two decades’ advances in human cancer treatment.
If your dog gets a cancer diagnosis, it shouldn’t have to be an automatic death sentence. There should be a dog cancer cure.
At least, that’s the argument coming out of a startup called One Health Company, which offers a dog cancer cure service for dogs called FidoCure.
My guest this week is the company’s co-founder and CEO, Christina Lopes.
And she says it’s becoming possible to deliver precision cancer treatment for your dog, by taking what we’ve learned about genomic testing of tumors in humans and using it in veterinary clinics in the form of a dog cancer cure.
In a paper published this January in the Nature journal NPJ Precision Oncology, Lopes and a team of researchers sifted through veterinary records and DNA sequences from more than two thousand dogs.
They showed that they could predict cancer survival rates in dogs by looking at whether the dogs carried key oncogenes like TP53 that are known to be associated with worse cancer outcomes in humans.
They also found that when dogs were given small-molecule drugs designed for humans carrying these same oncogenes, they had a better prognosis.
None of this is all that surprising, since, in a lot of ways, dogs are better model organisms for humans than mice or other mammals.
But what is a surprise—and what Lopes and her company are trying to change—is that it’s taken so long for the notion of precision cancer care to make its way from human medicine back to veterinary medicine in the form of a dog cancer cure.
With FidoCure, a vet can now submit a dog’s tissue sample for DNA sequencing.
The company then supplies a personalized report showing whether the animal has specific mutations that could help determine which dog cancer cure will be most effective.
In our interview, we talked in more detail about how that process works, and where Lopes got the idea for the company.
So let’s listen now.
Harry Glorikian: Christina, welcome to the show.
Christina Kelly Lopes: Thanks, Harry. It’s a pleasure and an honor to be here with you.
Harry Glorikian: Yeah, it. I’m so glad, like, we ran into each other and started talking and me learning about the company. I think what you’re doing is, like, just. Knowing enough about, you know, the whole oncology genomic space and then how you’re applying it, which we’re going to get into here in a second. But it’s truly like it’s one of those things where you’re like, duh, I like, why, why didn’t we think of that before? Right sort of thing. So I’m glad we, you know, you’re here and I’m glad we’re talking, but. Let me step back here. I want to just sort of set the stage right. You and your partner, Ben are coauthors on a recent precision oncology paper that says 1 in 3 dogs will develop cancer in their lifetime. That sounds a little higher than the cancer rate in humans. So let’s start off with, are dogs more cancer-prone than humans are? Are there lots of other common causes of death for humans, so cancer doesn’t rank as high? I mean, how do we think about that and how do we get to a dog cancer cure?
Christina Kelly Lopes: Yeah, no, thank you. That’s a fabulous question because I think we all hear about the vast unmet need, right, of cancer in humans and folks anecdotally learn about it. You might have had a neighbor, you know, like personally, maybe a dog that had cancer, but no one is aggregating and putting this as almost an asset class, a narrative category creation. And we are really the protagonists in that. And let me say why. So dogs. So there are about 90 million dogs in the United States right now. And last year, 6 million were diagnosed with cancer. So you can see the incidence, the prevalence is very high because there are over 300 million people. And, you know, at 1.8 max, maybe 2 million cancer diagnoses in humans. So right there you can already right see, there’s a big, and this is you can imagine the cost also to diagnose a dog with cancer. So there’s probably likely an underrepresentation. Why? Why is this happening? So the number one cause is really from genetics, I think the breeding. So dogs are 10,000 times more homogeneous than we are. And for example, a breed like a golden retriever, some whole litters will have, you know, 1 in 3 to like very high canine lymphoma. Right now, the number one is angiosarcoma for golden retrievers. So it’s really from the genetic landscape. There’s a clustering and that’s a key driver.
Christina Kelly Lopes: Um, relatedly and importantly, I work in the cross-species world, right? So I’m looking at comparing species. That’s the main one. Health is actually a movement looking at what can we learn across species about health and disease. We look at cancer, we look at from the genomics precision oncology and AI angle. But there are folks, for example, that study the elephant, just to give you another range. Large animal, under the sun, lives a long life and actually doesn’t spontaneously really develop as much cancer as you would expect. Why? There are more protective copies of Tp53 so they have more than humans. Humans have more than dogs. So that’s kind of the, let’s say, the foundational basis. Then we have a paper actually coming out with the Broad and UG Cancer Center where we’re really looking at the mutational, basically the onco, the oncogenes that are driving cancer in dogs and comparing that to the human at the tumor level (tumor in dogs). And the overlap is significantly more than we thought, in genes of interest. So lots of RAS family. BRCA. So it could be that there’s a lot of rights, like cancer driver mutations but they’re not as actionable or not as from relevancy of cross-species interrogation. So I went to a few places here. Tell me if this makes sense.
Harry Glorikian: Yeah. No, I was going to ask you, like, you know, because one of my questions was like, in what way is, is cancer in dogs similar to cancer in humans? Why? You know, and then, you know, how is it that humans and canine biology are so similar? Right? Because, you know, I know where you’re going with the company, but I just want to sort of get everybody…
Christina Kelly Lopes: Oh, the foundational.
Harry Glorikian: …to the same place. Yes.
Christina Kelly Lopes: So, dogs co-evolved with humans. Right. So that’s a big part. And touch on beyond the evolutionary, the co-evolution, and the genome, the genetic landscape is also the other part of the story, which is dogs share the environment with humans. Secondhand smoke. They sleep in bed. They might eat all the scraps. Do you see what I mean? They’re lower to the ground. So there are actual breeds that have been found to have a higher propensity to bladder cancer who live close to golf courses. There’s a whole other study about dogs near oil wells and certain disease progressions that are observed that might be even a proxy for what happens in humans. But you can see it. You can see it in a more in a tighter timeframe. So there’s so much to do. Let me stop there and make sure that we’re setting the foundation.
Harry Glorikian: No, no. I mean, we’re going to go through lots of stuff. But I’m trying to understand some sort of dog cancer cure, right? Because I will admit, I don’t, I’ve not spent my time trying to, I’ve spent enough time trying to understand cancer care in humans. And I’m still a little befuddled by that every once in a while. But is it correct to assume that the dog cancer cure has got to be behind cancer care in humans? I mean, it’s got I mean, it can’t be the same. It’s so I would guess, I don’t know, 20 years, behind.
Christina Kelly Lopes: Maybe more.
Harry Glorikian: How does that translate into care? I mean, what is the standard of care for canine cancer right now before genetic testing and before…
Christina Kelly Lopes: Before precision medicine.
Harry Glorikian: I mean, in other words, if dog cancer cures of 2023 looks like human cancer care of, say, 2003, you know, can you tell us? What it’s like, what sort of dog cancer treatments could do and where is it right now?
Christina Kelly Lopes: So no, that fantastic question. Um, I would say it’s probably closer to the 90s from the human equivalent. Yeah. No, really very stigmatized. So think, you know, even departing from cancer like a world 40 years ago of organ transplants like, you know, or HIV-AIDS, right, before certain innovation. Really stigmatized. Very few, very few tools to even interrogate and understand the disease or even classify it in an interesting way. Right. Such that we can then guide therapy. Um, predominantly if someone, if someone can even access care and the pet parents really want the care, that’s a very, very big shift culturally where the humanization of pets, consumerization of pets is, is not just for Halloween costumes, it’s actually for care at that most vulnerable portion of perhaps the four-legged family member’s life. So the current care would be very few options for chemo. Some chemo agents that are not even used anymore in humans, very few options, even few, few, few options of radiation, as you can imagine. Right. How many would even invest in a machine? So and then if you, you know, even are aware of the world of clinical trials, very few. And the ones that, you know, folks can access might be in a university in Minnesota, you know, like upstate New York. So Cornell, right. So not everybody can go there. So it ends up being, who might even have a private plane, you know. So it’s really an access issue in a pretty, pretty wild way. Um, and we’re here to change that.
Harry Glorikian: So well, that’s sort of like brings me to the question of so, what have we learned about canine cancer in, say, recent years that make a service like yours feasible and beneficial? And maybe this is just a good time to talk a little bit about your precision oncology article. I don’t know, maybe you can describe the findings in that paper. I mean, I think a short description would be that you took the same kinds of machine learning that that’s been applied to clinical genomic data in human patients and applied it to dogs. But I guess you should tell us. Like, what did you learn? In a nutshell? Yeah. Any big surprises? You know, that sort of thing?
Christina Kelly Lopes: Absolutely. Absolutely. So, um, so we thought, you know, given the very high unmet need of canine cancer, the desire to take care of our, you know, family members, dogs that give us so much love, combined with some of these really interesting aspects of, you know, the genomic overlap right from the cancer lens, um, really made it very interesting to, hey, could we actually help deliver precision medicine to dogs? Today. Translate back what was built for humans. And I say back because we also enable through our pharmacy partner therapies, targeted therapies that were all tested on beagles. So we’re arriving at the scene with lots of data from the safety, right? So the beagles in pre-clinical studies don’t have tumors, spontaneous tumors, right? So here we’re talking how can we reimagine what already exists out there that there’s even evidence in at least from the safety-tox angle? But now the novelty is bringing it to tumor bearing dogs, right, that might just benefit even more from the precision medicine toolbox if we get it right more than humans. Why? Because the genomic landscape clusters, right? So the actionability, there are certain tumor types that 80% of a tumor will have Braf mutation. 80% mean there’s nothing, you know, that’s really hard, right? So that breeding. You can really start getting a certain, you know, just basically from a population point of view, Right. You can really and think now, right, to figure out clinical trials and evidence on the other side of the leash. But back to the dogs.
Christina Kelly Lopes: So the idea is this whole toolbox have been has been developed in this century for humans, it’s quite de-risked. Um, why can’t we bring this to dogs? What do we have to do? So we basically have a genomic test. We research everything under the sun. Foundation Medicine. We spoke to the leadership at Memorial Sloan Kettering. I mean, you know, we went all over to find how can we build the best test right at the, you know, more accessible cost. So we’ve done that for the tumor and we’re building from the liquid biopsy right now. So, okay, that’s step one, however, that’s not sufficient because if you don’t have the therapies, what is the point of information if it’s not actionable? So we come very much from that lens of we want to intervene, we want to intervene at the right time, the right place, and build that machine. So then we help enable about 12 small molecules targeted therapies that, you know, the original molecule has been FDA approved for humans. So again, very well understood. And in this, we are figuring out the dose, the regimen, all sorts of things. And there are some very interesting aspects in this, which one, there is no standard of care for dogs with cancer because the standard of care has an implication, an ethical implication of, you’re not practicing good medicine if you’re not doing that standard. Right. And hey, who can get you know, who can go right for a course of seven weeks of chemo and take all that time off?
Christina Kelly Lopes: And drive potentially very far and pay out of pocket. So there’s a whole paradigm that just from the human does not work. So that’s one. Two, what’s also interesting is that there’s just this vast opportunity to bring, and small molecules for us, particularly interesting because you don’t have to do the species shift where in larger molecules you do have to caninize—and that does not mean a religious connotation. That means a species. So it’s not impossible. We have folks in our lab working on that, even as far as Car-T, but the lowest-hanging fruit is the small molecule world. So we basically have figured out a lot about the dose regimen. A whole world. And help deliver this FidoCure is the name, a toolbox at the point of care. So we’re in over 900 veterinary clinics. So think of turning the veterinary clinic into almost leapfrogging. And it gives you that idea that, wow, if we can leapfrog so quickly for the veterinary space, we may, depending on how we figure things out, be able to even leapfrog the human. Right now we’re taking what’s from the human side right to the dog. But you see the opportunity. Another really important point. So as we’re delivering care, we’re learning what works. We track the data. So we’re a data company at heart from day one. This was not a, you know, something, we then built a data set and now it’s messy and we mine it. No. from day one we had the luck to meet Amy Abernathy at Flatiron very early on. She was fascinated by how there’s no HIPAA in dogs. So if you think about it, if the dog you know, if there’s concordance in the genomic landscape, if the cancer journey recapitulates, and that’s part and I’m getting to the Nature Precision Oncology paper, where this is what we set out, our hypothesis and this is what the paper peer-reviewed. We did a paper with Stanford AI Health Faculty leadership, James Zhou, who is been deep in bringing to the Flatiron data set. So you see how it all comes together at some point, right? So if Amy brought the concept of real-world evidence, we and clinical genomic data sets, we essentially recreated that and we had to actually go from zero to build it, put it together, the clinical and the genomic and the longitudinal data set because of all these folks who had already done it in the human side, we already knew some of the pitfalls to keep the integrity of the data from day one, what we needed to capture. We were. So let me stop there and just make sure. And then I’m going to get into the paper. And so that’s like setting the stage because the essence of the paper is the dataset and the billion data points.
Harry Glorikian: Which is of course my favorite part, I mean, where can we. You know, I’m always looking at companies and people in the space where there’s some canonical data that you can sort of you can see how you’re going to take it forward from where you are, right? Where it’s not just going to sit there and…
Christina Kelly Lopes: Yes.
Harry Glorikian: …not grow and not be reusable in a sense. Right. But. Let’s step back for a minute. I’m sure that there are dog owners that are listening and dog lovers that are listening. Um. What? What’s the actual, say, FidoCure process? I mean, maybe you can just walk us through it step by step. I mean, when does it come into play? You know, what kind of cases warrant DNA sequencing? How does the tissue sample get submitted? What kind of sequencing do you do? Is there a panel that you guys are looking at from a mutation perspective? What does a report look like? And then at some point, do you guys actually help the veterinarian or the dog owner get the dog cancer cures that they actually need? Right. So what does that circle of life look like for this process?
Christina Kelly Lopes: Yeah. No, that’s a, you know, we thought a lot about this. And actually, the tools we chose from, say, you know, oncology toolbox were very, we were very mindful for the setting of the veterinary, the veterinarian number one and pet parent. Right. Obviously, the patient is really at heart. But those who love them and care for them and how could we make it easy? So that’s part of being in Silicon Valley. You know, our, you know, early head of product was from, um, IDEO, human-centered design and really thinking how to make this very, very how could we bring almost a distributed trial, how could we bring this toolbox to where it’s needed. So for this reason, we come in as of right now, once there is a cancer diagnosis. Okay, So that’s we’re working on things ahead of that. But right now it’s, you know, sadly, bad news. Fido, Fluffy has cancer. The good news is that potentially, right, we can sequence the tumor and find out, given the genomic landscape, the phenotypic information, our population health data, and the FidoCore dataset, what might be a really like a really promising path from the precision medicine angle. So how do we work with the clinician? So the veterinarian is the clinician for us at the point of care. And we essentially, um, you know, whether the pet parent comes in asking the clinician or the clinician learned about us at a conference, read the Nature Precision Oncology paper, however, they hear about us.
Christina Kelly Lopes: And it’s been remarkable because, with very little, really, effort on the commercial side, we’re right, like, you know, close to 1,000 clinics. The need is very there is what I would say. However, you know we come to play the clinician can set up a time with us and we essentially do a very white glove. We see ourselves as Sherpas in the cancer journey. So we’re there to help the clinician who might have not had even genomics training, even the veterinary oncologist, the most highly trained folks. You’d be surprised, right? Again, that gap. And so we bring all of that to them and make it as easy as possible. So I don’t need a re-biopsy. We use what was already submitted to get the histopathology report, the cancer diagnosis. So that’s you know, we’re trying to be as less and like, no re-poking the dog as much as possible. And so all the clinicians, if that parent and clinician decide it’s a five-minute FidoCure.com sign up. That’s it. And we have a whole team, Harry, that works with all the pathology labs, not mostly in the United States, but even internationally, believe it or not.
Christina Kelly Lopes: And we just handle it all like we figure out and we’ve created partnerships, obviously, to make it easy. So behind the scenes, we pull the tissue and with some labs, we do it super fast because we’re already very integrated. If it’s an academic lab, you know, it might take longer, but we know there’s a cost of waiting with cancer, so we go as quickly as we can. Tissue is just, you know, paraffin-embedded like, you know, just the really basic arrives at Lab. The Lab is a CLIA-certified lab. So it’s the same lab that will be running human, you know, really sophisticated. So that same quality however we use next-gen sequencing. A panel right to keep it focused. We’ve done the whole genome, and we’ve done everything under the sun, but we’ve nailed it, and we keep evolving as we learn. Right? Because remember, there’s not been as much of research dollars into the canine genome as there have been for humans. So that’s why Harry, without having then the dog cancer cures and the outcomes data. You see how that informs what gene? Do you see what I mean? It’s the learning. It’s exactly what you were hitting in that learning database that really is the key. So we keep evolving the panel and adding what we learn as also science evolves.
Christina Kelly Lopes: We partner with a lot of academics, so as the science, basically, we understand more about canine cancer. We also add the gene. So we keep that moving. Obviously, we infer a lot from the human side because we have to start somewhere. And so that’s, you know, the tissue then the report is very modeled very after. So say, you know, a couple of weeks pass. We’re pretty fast because again, of the cost of waiting. We send the report to the clinician, we give a consult to the clinician to help guide. Right. So sorry, Fluffy has cancer, but good news. There are some actionable genes we found. And here’s what that means, right? There are some targeted therapies or some prognostic information in this report that really matters to the treatment. And we guide on a really high touch, individual basis at the clinician level. So what’s more, that’s our interface. And essentially prep the clinicians, so they can deliver that information. And then on our own, in our own platform, they can order the targeted therapies. So we make it real, and we help in side effect management. Like we, you know, like we’re there every step of the way. So let me stop there and make sure that that answered your journey.
Harry Glorikian: That’s great. I mean, you know, I want people to understand what we’re talking about when we’re, you know because they’re listening to this or they’re watching it on YouTube. But they could sort of, you know, get their head around this process. But. I you know, I don’t know the answer. How many good targeted therapies are there for specific kinds of canine cancer? I mean, I’m assuming that you’re generally using human-approved therapies on dogs.
Christina Kelly Lopes: So by and large, if you think even cancer or not cancer or anything, drugs approved are generally approved for humans, period. Right. So if the tiger in the zoo has something in the cardio, they probably using a human drug instead of another cancer cure. So that’s kind of like where we’re coming from. However, FDA does have a center for veterinary medicine and we feel really blessed by they have put out even guidance on real-world evidence. Isn’t that cool? So, you know, we can really play a strong role there because we are very much the leaders in real-world evidence in veterinary medicine, starting with cancer. But, you know, the approach can be used for other disease states. So historically, in terms of what has been actually approved, there are very few dog cancer cures that are actually approved for dogs like really for the species. Okay. But there are a couple. Okay. So but I’m talking a couple, a few. Then when you, when you depart what is approved, it’s, you’re really using in an extra-label, off-label. I forget now, which one. It’s a very specific capacity and there’s a regulatory framework that’s similar to the analogy with the tiger and the zoo. If the animal’s life is at stake and is in danger, the veterinarian in alliance with the pet parent can actually pull really, really anything that’s out there.
Harry Glorikian: Right. Okay.
Christina Kelly Lopes: The issue then becomes dosing excipients that are mixed in that the dog might not really, you know, react well to. You can’t just go to CVS, take, you know, ibrutinib, and chop it up like so. There’s some work that needs to be done there. That’s what we’ve done. And we’re so proud of it, you know because it’s really opening up a whole access. And imagine a world where we’re doing this we’ve deployed over 13,000 targeted therapy orders, you know, partnering with pharmacy. So imagine these are going to the home. Right. I’m a dog lover, obviously. And so even taking my dog for a wellness check is such, they don’t want to go to the vet, right? It’s like a big ordeal. It’s a family affair. So we’re just making it much more, you know, really basically for, for our times, right? Um, so there’s not this, oh, cancer, that stigma, dog cancer, almost think right, like the 1990s, maybe earlier, almost a death sentence. No, no, not a death sentence. Absolutely not. We’re demonstrating that.
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Harry Glorikian: Now as I think a good time because you said I’m a dog owner is like taking a step back from the origin story of the company. What happened? What interest. What event? Something happened that put you on this path to say, I’m going to start a life sciences company and it’s going to be in canine health, and that this is going to be what I’m going to do next.
Christina Kelly Lopes: I know it sounds wild, right? So from a kind of like real impetus, I actually took care of my dad with lung cancer, end of life, the whole journey. So, you know, you just start getting in learning, why can’t I access this drug? What happens here? Like you’re just in it. And we’ve had family dogs that had cancer and you start to think, wow, there’s metastasis, you know, there’s similarities and oh, and similar, you know, there’s some of the drug chemo or at least the category and it’s like, wow, okay, that’s interesting. But in learning about basically how, you know, R&D, right? And there’s a lot that, let’s say is broken or why dog cancer cure prices for oncology drugs are high. But one of the issues, and that I started to learn by being very close to the veterinary community, my husband is a veterinarian and we would chat and say, Hey, that’s cool. You know, we work half of the day or part of the day in lab animal science, right? So working in an R&D setting and the other half you’re at the clinic of the school, the hospital and you have dogs coming in almost with the same disease, you’re inducing in a…So is there a way to leverage spontaneous disease, naturally occurring disease in a way that actually helps the animals? One. That’s number one. And that’s the beauty of our almost circular, circular economy, a very impact side of the company, which is we’re looking in a very progressive way of how can we help, on one side of the leash, the dogs, and then generate data to help the other side of the leash.
Christina Kelly Lopes: So it’s not the either or. So I’m very fascinated personally with a mission. I’m a big mission person myself. Um, coming from Brazil, I’ve worked really in getting the resources, capital, people, and technology to what I felt were very big unmet needs. So all my career for the last 20 years, I’ve been for sure doing that, whether it was infrastructure, water, and you end up going into health care. So I’ve worked in emerging markets. Brazil, Turkey, Vietnam, all sorts of countries and trying to bridge what is the highest need and then figuring out how to capitalize it, how to bring the decision-makers, government, financiers, you know, the whole architecture. So I’ve been very much in that mission. You start getting into health, right? You start working. And I started to get involved in global health. So that’s my other, from a professional lens, this is how it kind of came together for me, which is I joined the advisory board of Planned Parenthood for the whole Western Hemisphere. With Margaret Sanger’s grandson. Imagine. And 30 million health services are delivered a year. And the entire mindset is how can we deliver that last mile of care with all things that already exist and do it economically?
Christina Kelly Lopes: So an example, right? Bolivia has one of the highest cervical cancer rates in the world. Cervical cancer is preventable. You know that, right? So guess what? That hustle of, you know, how can we negotiate vaccines and the right to get HPV vaccines to get to that delivery of care? So that actually inspired me to have that mindset of how can we use what’s already been built in a totally novel way. I’d think a lot about this. I would talk a lot, a lot about serving those that are voiceless and marginalized. I didn’t mean dogs at the moment. So watch what you say. So I said voiceless. And so dogs are, you know, so I just didn’t think the species, that came came as a surprise in a sense of my own self. But I’ve always liked wedges. I’ve always liked not obvious asset classes. You know, from a more financial point of view, I’ve always liked creating, you know, again. So I’ve worked on helping develop the Brazilian protein sector as an asset class, you know, IPO, the whole thing. I was a managing director at Cerberus Capital, you know, one of the largest PE firms in the world. So I saw a lot of how capital, how people, how power moves. And coming from a mission point of view, you know, what is really underserved but high potential. Right? So that you can see how that then leads me to, wow, this is an unmet need for dogs, an unmet need for humans. There is evidence we can generate. So that for me is like a dream.
Harry Glorikian: Yeah. So so I mean, let’s go there now. So. So okay. You’re doing the work on the dog. I mean, I’m not sure that people totally appreciate the HIPAA advantage, I’ll call it. Right. The other fact is that you’re centralizing all this data and we all know that centralized data seems to give you nuggets or insights that, you know, when everything is scattered all over the place, it’s a little it’s a little harder to get to those same insights. But you actually want to take, and I think your term is, both sides of the leash. You want to take what you’re learning with the dogs and the therapies you’re using and translate that into what might be used in humans. Now, I’m going to assume is it a lot of the same therapies, but just understanding how to use them better. Or is it also working with pharmaceutical companies on the development of new therapies because of the data that you have?
Christina Kelly Lopes: Yeah, absolutely. So to backtrack. You know what the Nature Precision Oncology paper, you know, peer reviews and validates, is, one, that this whole, you know, this initial set of targeted therapies designed for humans are working in dogs. So we’re showing in some contexts 3x the control improvement, right? We have another paper coming in, the canine equivalent of Angiosarcoma, Hemangiosarcoma. And it’s astounding what we’re doing, really, if I may say so, really turning and not adding a month. No. Adding like, you know, a year, which in the dog world is a big deal. So the paper demonstrates that. The paper demonstrates that not just, you know, we have this other work I mentioned before about the genomic landscape of the tumors being very right. There’s high concordance. The paper takes one next level which shows the journey. So what a biomarker, the predictive aspect of, and that’s where the AI, the tools really mine the data. When we see a certain mutation, does it mean good news, or bad news for canine cancer, and is that recapitulated in the human world? So when you see that mutation in the human world, does that have a similar prognostic? Right, like predictive power. So so we’re very much that’s what the paper really shows. And the answer is yes, We’re seeing concordance on the journey.
Christina Kelly Lopes: We’re seeing the dog cancer cures applied to one species, to the other works. And so what helps us really solidify is not only precision medicine as a toolbox is really beneficial for dogs and that’s amazing, but also the learnings. Now this opens up the door really wide for us to think about this as a very, very large in vivo almost data set. Okay, so how do we work with that specifically? So we do partner with biopharma. We actually have a lot more inbound from the animal health, which is very exciting because I think we’re part of actually getting them excited about, hey, you know, we can do this so and can do it in a right accessible way, meaning evolve the toolbox for dogs. But from the human side, we already have a proof point. So we partnered with ACI and that’s public. We presented the results at ACR and the American Association of Cancer Research, and we interrogated a drug. In this case, it was a drug that had already been FDA approved for one tumor type breast cancer, and they were looking to interrogate in a sarcoma that we see often in dogs. So we generated the data. It helped me make the decision to go to the clinic. The drug is at the clinic, Mass General, and a few other trial sites.
Christina Kelly Lopes: And what we saw in the dog this is really important was predictive of what they’re seeing in the human clinic. It also helped generate evidence in that setting where the traditional preclinical models and I mean that really clearly. Right, like models didn’t they’re there. They just didn’t they weren’t convincing enough or sufficient enough quality-wise for a company to make the decision to go to the clinic. Because we, you, and I know. Right. Going to the clinic is like, you know, just recruiting patients right there is super hard. Right? So so we’re part of that engine and we’re so proud to already be playing a part in that one. So you can imagine how we are partnering with other biopharma and I really love one of your podcasts, Harry, about the Insilico world, right, in drug discovery. Because think about this world where you have now an engine of discovery, right? An industrial type, not that artisanal, right? Shot in the dark. One target, one drug, takes ten years. Oops, it didn’t work. You now have this potential world of molecules coming through. Right. And how are you going to figure out that? In silico, in vitro, maybe traditional animal model world to the clinic? How?
Harry Glorikian: But it’s interesting, right? Because I don’t think most people understand or realize. That the dog model is actually a better model. Right, because. Like if I had a nickel for every mouse that we’ve been, we’ve cured cancer in mice. I mean, let’s face it.
Christina Kelly Lopes: Alzheimer’s, you name it.
Harry Glorikian: Yeah. We’ve done everything. That mouse, that. That should be a superhuman, ever-living mouse, right?
Christina Kelly Lopes: They should be pets now.
Harry Glorikian: I mean, if I could get rich off of every mouse that someone has come and we fix this problem, right? But translating from a mouse to a human is not you know, it just doesn’t happen. And the second thing is, is. We genetically manipulate that mouse to do what we want it to do. Right. So. What you guys are looking at in dogs that dog. Spontaneously, right? Or maybe I should say naturally because of genetics.
Christina Kelly Lopes: Spontaneous. Spontaneous or natural disease.
Harry Glorikian: And so it’s a more real-world process as well as biology. And you’re going to have to correct me because, again, I’m not the canine expert, it’s more analogous. Human, then the mouse would be.
Christina Kelly Lopes: Oh, yes, absolutely. And actually, we talk about that in the Nature Precision Oncology paper. And because of the co-evolution, right? And all of those aspects, the shared environment. Right. And you know, really importantly, this idea that. Yeah. So basically, like all of the aspects we’ve been talking about really put the dog in a really prime, prime location. And the interesting thing is as we see signals, right, of what works in the dog, fantastic, we’re going to help accelerate the human, but we can also then, hey, let’s bring this to the dog market. Right? So so that’s interesting. And one other example just for you to know. So well, we’re really making this category like creating this category right in the world. Ibrutinib, for example, Imbruvica, which is a cancer drug I think now owned by Janssen, was a very big deal, was one of the first sold, I think, you know, twenty billion. It was gigantic when there was a transaction. But what you may not know is that that drug really came to market because of pet dogs, so it was applicable as a dog cancer cure. They did not see a signal in the traditional preclinical models. And someone had the idea, hey, don’t dogs get lymphoma, and what does caring for a dog with lymphoma look like? And they went to a vet school and they recruited and they saw a signal. This started the conversation about lymphoma in dog treatment.
Christina Kelly Lopes: It wasn’t even precisely, but it was from no signal to signal. Right. And so and, you know, in the cancer world, that’s a big deal. And that then led to the so that’s um. That was an important um, and there’s been a few other drugs and often the biopharma’s don’t talk about it very much but it’s it’s been used more than you imagine because I’m quite close to all these, especially at the research side on academics I really know. So it’s used more. What we’re doing though is doing it at scale, right? Because when you also do this kind of clinical trial, if the school is very far right, you’re going to have the same recruitment, the same issues you have. You know, maybe not the same, but with the human setting. I mean, this is where Flatiron is, right? Like we’re very inspired by how can we learn and take real-world evidence at the point of care at the everyday clinic and understand more. And then and then we take it to the next level to bring the actual intervention to that clinic. But the. So let me stop there and make sure we’re tracking.
Harry Glorikian: No, no. Yeah. I mean, I just wanted people to sort of understand that in their minds, right? Because, you know, they don’t necessarily most people don’t follow all the pieces of the puzzle that we’re always dealing with in drug development. Right. And again, like, you know. Nobody ever calls me with dog results, right? Everybody always calls me with their mice results that, you know, they got from Charles River and Charles River makes a business out of genetically manipulating that mouse to give you that expression that you’re looking for. Right. So it’s. I mean, it works. We use it, but it is unnatural, if you think about it, in how things are evolving. Um. So I don’t always expect that one result is going to translate into the other. But what’s your vision for the company overall? Like? Where do you see it? I mean, obviously conquering the dog market would be the first step. But where do you see things going as the company grows?
Christina Kelly Lopes: So, yeah, thank you for asking. We’ve been really lucky to have fantastic capital partners. Um, so A16Z Bio, Polaris in Boston, we did Y Combinator. That was really important for me as a first-time founder. So we feel really, you know, we’re realizing our promise of what we said we would do, which is to build this very deep and large dataset that’s a learning and breathing dataset. The AI community is really rallying around us and what they’re so excited about, and that’s in in the Nature Precision Oncology paper is that when we see a signal, right, we see it right, like a phenotypical interpretation, you know, like so dog tumor, genomic drug (dog cancer cure) that then we see an interesting result. We can then take that signal and further validate and we can do it from an unbiased data first point of view, right? So we let the like, the AI tells us what matters, okay? And that’s magical. That’s like magic in the world. Because think about it, in the human world, right? Even to build those data sets. Right? Think Flatiron Foundation robot. Right. Takes a lot, you know, billion dollars. Right. And then okay, great. You have this data set. Fabulous. Let’s see what signals we’re seeing. You know what that means. If you now want to really take it and validate a signal at the clinic, I mean, we’re talking a very long time, a lot of resources.
Christina Kelly Lopes: So that dynamism of a signal to then putting it back into the algo’s right of, oh, we’re seeing a better interrelation between this drug and this BRCA gene, you know, like that. So it’s amazing. Gives me the goose pimples like it’s real and the community is like, wow. And that’s James Xu at Stanford. He’s, you know, really rising publishing prolifically a lot on the Flatiron data set. Um, and so for him to see our correlate data set and be able to, you know, it’s, you know, to do so much really guide right like intervention, it’s a really big deal. So that’s generating that evidence. The AI capabilities are extremely top of my mind, extremely like this is it. How do we do that? Right. We need a footprint at the veterinary clinic. So and the beauty is that we only care about what’s working really like. Like meaning it has to be we’re looking for the signals of what we’re seeing that are positively impacting the pet’s life. So again, that very virtuous cycle. So we keep refining things for that. And in that, then looking at the other side of the leash. So footprint of the clinic is a big deal. Um, and then as we get more data, we’re now since we published the Nature Precision Oncology paper, we already doubled the data set.
Christina Kelly Lopes: So we now have a whole other world to mine and we’re already doing it where we can interrelate more, we can get more insights. So the data flywheel is really it’s a movement and you know, that is how we think of it. I would love at some point to bring in the pet parents more from a data angle. So we’re very close at the Broad with Count Me In. So learning from them how they brought the patient and the patient data in this case pet parents. From a data side. It’s very it’s very interesting. I’m interested and I’ve been learning myself, how could we and we’re partnering with some folks, how could we use histology, digital histology to interrelate and back into. So that’s the world I’m into. And our pipeline right now from the biopharma side, we have, as I mentioned, the animal health side wanting to really dig in, and okay, what can we figure out? Better diagnostics, better drugs. Right. And that’s fabulous. That’s really exciting. And then on the other side, from the human biopharma, here’s what folks are interested in. They want to see a combination of their drug with another drug that’s really hard to figure out in humans. They want to see just their dog cancer cure in dogs and guess what? They want to use it to help recruit humans.
Harry Glorikian: Yea. I can see that.
Christina Kelly Lopes: Right. They want to learn as we’re developing liquid biopsy and minimal residual disease tests, how could we track right the disease progression and intervene better and quicker. Right as cancer. Right. Like so. So those are all the things that I’m really interested in. And then I think later we will be getting more into the immuno-oncology world because remember, the dog has an intact immune system. Yes. Has micro tumor microenvironment. I mean, there’s so much already happening there. It’s just again, from a feasibility and, you know, impact. We’re very we live in that quadrant, right? Like high impact, high.
Harry Glorikian: Numbers and one step at a time. Right. Being somebody who funds startups one step at a time. We want to make sure you got successful in the first few things we’re doing.
Christina Kelly Lopes: Exactly. And as we see signals, you know, I would love at some point again I’m giving you the roadmap. Right. And partnering with brilliant folks like yourself. And in your world of, you know, what are we seeing that’s unique and novel that, you know, might be very valuable? And who knows from both sides of the leash? Right, Right. There might be a configuration of here’s a combination of drugs that we’re seeing really, or triple combination. We see that. That’s interesting in this context of cancer. Does that can we do something right from a, from a, can we do that? Can we actually can we partner with someone to really bring that to market for dogs? And does it recapitulate a setting in humans that we feel strong enough that maybe we could, you know, with the right partners, like move it to the clinic and see?
Harry Glorikian: Yeah. I mean, if you think about HIV, it’s a combination of drugs, right?
Christina Kelly Lopes: Exactly.
Harry Glorikian: So it’s a combination of the mean. And let’s face it, biology is only going to have so many moves. So if you can actually block off a few of them, you might be able to, you know, have more of an effect, but. You see, it’s funny. I almost feel like you’re going to move faster in dogs than I’m seeing. We, you know, everybody else moves in humans and for. All sorts of stupid reasons. It’s not moving forward faster, but you know, it is what it is, right? The healthcare system is a little broken.
Christina Kelly Lopes: It’s very dysfunctional. So here’s yeah, here’s how I see it. Like the cover of Cell I believe this month, right, is a lot about cancer and the heterogeneity of cancer and it’s really many diseases. And so if we can develop tools so like great that’s all being learned at the human level, right? And we know that so much of it is recapitulated in the dog so we can without investing all that right to get to that we can take the same approach and learnings. And you’re very right, Harry, and this is where I want to rally the animal health community and really rally because this is a movement too. And that’s where the pet parent is like a patient advocate, if you think about it that way, where we could go be moving faster, we could really be optimizing, right? Whether it’s genomics, small molecules, combinations of dog cancer cures, methylation, or all sorts of tools that are already we’re already understanding the lowering the prices in genomics. Right? So figuring all that out and bringing the tools right so we can really create this very intelligent system and actually leapfrog. You’re right, the dog has the potential for us to do things much faster. It’s much, you know, there’s let’s call it a more elegant regulatory framework compared to humans and beautifully…
Harry Glorikian: And much broader flexibility in you know. I think that there’s an open field here to sort of…
Christina Kelly Lopes: There absolutely is. And I’m also thrilled to see some very big players coming in from the insurance side, pet insurance, because that’s still pretty low penetration in the United States, maybe three, 5%. In England, it’s like 50%. So and so, you know, I just thought of like the dog and the queen, you know, the past. So like, actually the dog really matters. So, um, I’m a little bit joking, but you can see the potential and I’m excited about some big backers coming in for pet insurance because that would be one of the mechanisms to make this accessible. Being from a country like Brazil, having worked in, you know, helping deliver care, and Haiti in the middle of like a natural disaster, I’m very, very obsessed. And then obviously, we all got sensitized around Covid right about that last mile of care. And how that really closes the loop, including who pays for it. Right. So so we’re hoping we’re excited to also partner with some of these insurance companies to help them understand that, you know, you can actually improve results. You can do you can underwrite and cancer, you can do it and you can do it in a way that doesn’t, you know, break the piggy bank. And so we see ourselves in a very data set as the core, right? How do we get the data set we need for the patients and the pet parents and the clinicians? But as we build from thousands of dogs into millions of dogs, there are a lot of use cases, including how to use the data to help predict insurance, but also for predictive health. So that’s kind of in a nutshell how we see it.
Harry Glorikian: Well, you know, I wish you incredible success because I can see how the data that you’re generating is going to have applicability to humans, for sure. Um, but, but. Even how some of the papers that you might write on the process may influence changes on the human side because you can actually point to something that’s working. And so, I mean, I almost want to say like if they got this process working in dogs, like. Can we get it to work in humans? Right? So it’s you know, it would be an interesting case study to see how elegantly it might be implemented in the dog side where. We’re still, you know, stumbling in the dark on the human side, which is beyond my understanding.
Christina Kelly Lopes: Absolutely. And that’s why it’s imperative. In our company, we really have representation of we love clinician-scientists. So I say this also as a call to action. So we have from the veterinary side, we have from the human side, we find it very important that they’re both at the table. Maybe phase one is from the human clinician-scientists that are helping to nudge the veterinary world. Right. Hey, there’s you know, this has been well, well understood. We can go that way. We can improve, actually, because. Exactly the thing precision medicine, right? Our actionability is much higher. We have a lot of flexibility not having the guidelines. You can go right with the vision of insurance coming in. I mean, you can see how this is an ecosystem that’s just beginning and it’s so powerful. Um, and so yeah, so basically we could see there’s an opportunity here to really redesign and then the learnings and that’s a lot about the paper and, you know, nature, precision oncology, we’re talking about a lot here, which is right what we see, we can then start learning for the human side. The learnings can be applied and maybe break some of the paradigms or can just be from when I think of someone like, you know, like Amy, right? Abernathy, She’s preoccupied with evidence first and foremost, you know, high-quality evidence generation. So if you think about it that way, right, if we can create right, like really bring this at a certain level and that’s going to be an exciting also chapter as we, um, you know, understand more the FDA in real-world evidence in the veterinary context like how could we really solidify the level of evidence such that we can move the needle again, both sides of the leash.
Harry Glorikian: Well, I wish you great success.
Christina Kelly Lopes: Thank you, Harry. Oh, so much fun. We could do this another hour easily.
Harry Glorikian: Excellent. All right. We’ll talk soon.
Christina Kelly Lopes: Thank you.