You read that right – Laverdia for dogs is a PILL that can help treat lymphoma!
While lymphoma is one of the more treatable dog cancers, we are still always on the lookout for treatments that can help the unlucky dogs that either don’t respond to current options or don’t have access to them.
Laverdia is a new treatment, so we don’t have all the answers about when it works best yet.
Let’s learn more about this pill and how it may fit into dog cancer care.
A Pill for Lymphoma
Laverdia Ca-1 (verdinexor) was originally developed by a company working on human cancer treatments. When it turned out that this drug works better in dogs, the company Anivive Lifesciences picked it up and started working toward full FDA approval.
This chemotherapy drug is a coated tablet. Owners can give it at home twice a week with three days in between each dose.
Because it is chemo, you do need to handle the tablets with care. Do not break, crush, or dissolve the tablets, and if one gets wet, put on chemo-resistant gloves before touching. Wear gloves when handling the treated dog’s urine, vomit, or feces too.
Conditional Approval for Laverdia CA-1
As of 2021, Laverdia is conditionally approved by the FDA. This means that it is proven to be safe for dogs and has a “reasonable expectation” of efficacy (working).
It is now entering the clinical trial phase where doctors can prove that it is consistently effective against lymphoma in real dog patients.
If you have a dog with lymphoma or another disease and are interested in participating in clinical trials, check out the clinical trials page on the Anivive website. The next study for Laverdia will be starting in approximately spring 2022.
Right now, Laverdia can only be used in dogs with lymphoma while it is still in clinical trials. If it attains FDA approval, veterinarians will be able to use it off-label for other canine cancers. The company also intends to do studies using it for other cancers.
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Laverdia Ca-1 Mechanism of Action
Laverdia is a “targeted therapy,” meaning that it specifically targets cancer cells and is unlikely to harm normal cells.
The cells in your dog’s body naturally contain tumor suppressor proteins, which do exactly what you would expect: stop tumors. These proteins trigger apoptosis, natural cell death, if a cell’s DNA becomes damaged.
To keep things in balance, the transport protein XPO1 binds tumor suppressor proteins and removes them from the nucleus of the cell.
Cancer hijacks this system. Cancer cells produce tons of extra XPO1, which then binds to and removes the tumor suppressor proteins so that they can’t stop the cancer by triggering apoptosis genes.
What Laverdia (verdinexor) does is it binds to the XPO1s. If the XPO1 binds to Laverdia, it can’t bind to tumor suppressor proteins!
This allows the tumor suppressor proteins to stay in the nucleus and do their job: triggering apoptosis to destroy the cancerous cell.
Gained Survival Time
Here are some numbers from North Carolina State University:
- 12 months: median survival time for a dog with B-cell lymphoma who receives traditional chemotherapy
- 1 to 2 months: median survival time if only treated with oral steroids (usually prednisone)
Dogs who do not receive treatment typically only live a short time, as little as a few weeks.
Dr. David Bruyette, DVM, DACVIM, Chief Medical Officer of Anivive Lifesciences, says that they have been seeing survival times 50% longer for dogs treated with Laverdia in addition to low-dose prednisone compared to just getting high doses of pred.
In addition, a third of the treated dogs in the initial studies had survival times of 9 to 10 months when treated with Laverdia! They are not yet sure why some dogs do so much better, but further studies will hopefully help to answer this question and others.
Laverdia for Dogs Side Effects
Like any drug or supplement, Laverdia can have side effects.
According to Dr. Bruyette, side effects are typically very mild. The most common side effects are decreased appetite, vomiting, diarrhea, and lethargy.
Does Laverdia Replace CHOP?
“CHOP” is the acronym for the chemotherapy protocol developed at the University of Wisconsin to treat canine lymphoma. CHOP is the gold standard lymphoma treatment option, and 70-95% of dogs respond when it is used
In a conversation for Dog Cancer Answers, Dr. Bruyette says, “We’re not looking to replace CHOP.” Instead, Laverdia was designed to be an extra (and hopefully soon FDA-approved) treatment option.
The goal for Laverdia was to help three sets of patients:
- Dogs who don’t respond to the CHOP protocol
- Dogs who come out of remission after initial treatment with the CHOP protocol
- Families who can’t afford traditional chemotherapy
Another possibility that researchers will explore in further research is working Laverdia into various CHOP protocols as an extra rotation.
Laverdia for Dogs as a Bridge
Since the onset of the COVID pandemic, it can be difficult to get in to see an oncologist.
With the clock ticking after getting a lymphoma diagnosis, having to wait to see an oncologist is extremely stressful…
… and could be fatal for your dog, because lymphoma left untreated takes a life in a matter of weeks.
Veterinarians often want to start prednisone right away, but oncologists wish they wouldn’t, because if chemo is started later, the pred makes CHOP less effective.
The good news is that, unlike pred, starting Laverdia ahead of time does NOT make chemotherapy less effective!
This means that if you want to pursue chemo but are unable to get an oncology consult right away, your regular vet could prescribe Laverdia to start treating your dog and tide him over until you can start chemo. Your dog will still get the full benefit of CHOP when he starts.
Laverdia also works as a bridge if you are trying to decide if you want to do chemo or not.
The makers of Laverdia wanted to make it more affordable than traditional chemotherapy so that it can be more accessible.
As of the end of 2021, treatment with Laverdia costs approximately $200 per month.
Dog Cancer Answers did an episode on Laverdia at the end of 2021 and spoke to Dr. Bruyette as well as oncologists Dr. Megan Duffy DVM, MS, DACVIM, and Dr. Craig Clifford DVM, MS, DACVIM.
We wanted to know how Laverdia has been performing in the field.
So far, Dr. Duffy has primarily used Laverdia in patients who have failed other treatments. These dogs have not responded to Laverdia either.
Dr. Clifford has used Laverdia in a couple different scenarios and is seeing favorable results. The best response was in a dog with cutaneous lymphoma whose sores completely healed and went away.
Both oncologists pointed out that we are still learning where Laverdia best fits into lymphoma treatment. We will learn more as oncologists and general practice vets continue to use it in their patients, and as clinical trials evaluate how it works in different situations.
You can listen to the episode below:
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Paws and wags,
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