Could Fido lead us to better cancer drugs?

A recent study offers up a trove of data on dog cancer health outcomes from targeted therapies that could help improve care for people.

A company that pairs dogs with cancer care, The One Health Company, has sequenced genetic mutations in more than 1,000 dogs with cancer and then treated them with medicines targeted to specific genes or proteins available to humans. Both the genetic mutations and the doggie patient outcomes were similar to that of humans. Researchers believe this data, which is pulled from veterinary clinics, can help lead research into better treating some canine cancers, which in turn could help pharmaceutical companies develop human drugs for harder-to-treat cancers.

“Some of the most common predictive biomarkers that we’re seeing in the dogs are also some of the most common for human non-small cell lung cancer, breast cancer — some of the big tumor types,” One Health CEO Christina Lopes told Ruth.

Researchers know dogs and humans have a lot of genetic similarities that can be mined to better understand cancer. Dogs and humans share the BRCA1 gene mutation most associated with breast cancer, for example. The National Institutes of Health has run a comparative oncology program with dogs for 20 years.

But studying dog patients is expensive and obtaining large-scale data, particularly genomic data, can be difficult. One Health has been able to get that data by erecting a veterinary business around it. The company charges pet owners for the sequencing and medicine, which they try to keep lower than chemotherapy costs (on average $4,317 in the U.S., according to medical expense credit card company CareCredit).

Why it matters: Instead of forcing researchers to hunt for grant dollars to cover the cost of sequencing and medications for dog clinical trial patients, dog owners pay for it. Pet insurance can cover the cost of One Health’s precision medicine product, the company said. But not all pet owners have pet insurance, which can be expensive compared with typical veterinary treatments.

On the regulatory front: The FDA has pushed for a shift away from using cheaper lab animals. That could make veterinary patients more promising prospects for clinical trials.

The pitch from One Health is that pharmaceutical companies could use its insights to inform future cancer research in humans. Lopes said that pharmaceutical researchers might have a signal in their human data they want to see replicated in One Health’s canine data. Alternatively: “Do we have a signal in our data set that they can then interrogate in their data set?”

For example, dogs suffer from a cancer called hemangiosarcoma, which is associated with the genetic mutation PIK3CA. This mutation correlates to a rare form of cancer in humans known as angiosarcoma. Hemangiosarcoma makes up a significant chunk of dog cancer cases. Lopes wonders whether testing drugs targeted to PIK3CA in dogs might help give researchers some answers on how to treat angiosarcoma.

There’s also an opportunity for research into drug repurposing. In the study, researchers found that dogs with BCRA1 mutations had better outcomes when treated with dasatinib — a drug used to treat certain types of blood cancer in humans, and considered a potential breast cancer treatment.

“Human biopharma companies want to de-risk drugs,” said Lopes. Her platform could help them do that, she added.

This is where we explore the ideas and innovators shaping health care.

Mosquitoes carrying yellow fever first hitched rides on slave ships to the Americas some 500 years ago. A new study also hints at when mosquitoes evolved to transmit the virus: some 5,000 years ago, during a period of natural climate change at the southern border of the Sahara desert.

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Today on our Pulse Check podcast, host Katherine Ellen Foley talks with Alice Miranda Ollstein about internal divisions that are splitting the abortion-rights movement over their efforts to keep abortion legal by putting it to a popular vote.

Walgreens-backed VillageMD is forging a primary and urgent care mashup that may rejigger what care looks like for millions in the Northeast and beyond.

VillageMD wants to expand into rural America and has already acquired one of the biggest urgent care chains in the New York City area, moving closer to that goal.

Last month, VillageMD finalized its $8.9 billion acquisition of Summit Health-CityMD. It also announced a deal with Connecticut-based Starling Physicians, which offers primary, specialty and urgent care.

The acquisitions are an extension of VillageMD’s value-focused health care model, Tim Barry, co-founder and CEO of VillageMD, told Erin. They’re also a counterbalance to the current U.S. health care system, which Barry says is too hospital-centric.

Barry’s vision is to offer 24-hours-a-day, seven-days-a-week accessibility for patients — no ER visits, no hospitalizations. “We want to make sure you get access wherever you need it, whenever you need it – period,” Barry said.

What that looks like: In New York City, a VillageMD patient who lives in New Jersey and commutes into Manhattan could stop at a CityMD clinic near their office to get treatment for a sinus infection.

“That doctor is gonna have access to their medical record and know their whole health history,” Barry said.

The strategy works in reverse, too. If a new patient who has a chronic disease visits a CityMD, the team can connect them with one of its primary care doctors in the broader New York area. “We know that the best thing for that patient would be to have a relationship with a primary care doc,” Barry said.

RuralMD: True to its name, CityMD operates primarily in the greater New York City metro area.

But that’s slated to change, Barry says. Post-merger, the organization has its sights set on moving CityMD into dense metro areas VillageMD already operates in, like Houston, Phoenix and Atlanta.

Then it will turn its sights on the last frontier: rural America.

While health care in rural areas is known for being expensive and difficult to access, Barry, who grew up in Sturgeon Bay, Wis., noted that people who live in rural America are used to driving farther to get care, especially if there’s a dearth of options. “You either have the doctor’s office open or the hospital’s open, and there’s nothing really in between,” he said.

VillageMD could create an in-between option for those communities, Barry added.

Barry’s bottom line: More in-person health care touches, fewer ER visits, lower costs.

“We’re bankrupting more and more people every year because of medical debt,” he said. “People aren’t getting bankrupted in the health care system because they had a $60 PCP visit. They get bankrupted because they had a $30,000 hospital bill that they didn’t expect.”

Expanding a popular decades-old program into rural America could improve access for older adults, says a new report from a Health Resources and Services Administration advisory committee.

To be eligible for Medicaid and Medicare’s Programs of All-Inclusive Care for the Elderly, individuals must be 55 or older, need nursing home–level care and be capable of living safely in their community with assistance.

Almost 90 percent of participants are dual eligibles, who qualify for both Medicare and Medicaid by virtue of their age or disability and low incomes.

The committee found that PACE programs met five key criteria: improved patient experience, better outcomes, lower costs, clinician well-being and health equity.

“Healthy aging that includes aging in place is not currently a feasible option in many rural communities,” the report concluded. “PACE is uniquely situated to adapt and meet the complex needs of rural older adults.”

But the program faces some challenges before states and CMS can implement it rural areas:

— PACE can’t charge co-pays or deductibles, and PACE participants can’t enroll in other Medicare prescription drug plans, meaning higher costs for patients.

— Rural areas tend to have small populations so it’s harder to spread costs across the group if there are fewer patients.

— Patients in rural areas have less access to broadband than those in more populated areas.

— More than 140 rural hospitals closed between 2010 and 2023, and others are financially distressed, putting them at risk of closing, which could lead to a shortage of facilities where PACE can be implemented.

— Medicare and Medicaid patients in rural areas have limited awareness of PACE.

Why it matters: In the U.S., 1 in 5 adults older than 65 lives in a rural area, according to the Kaiser Family Foundation. Rural Americans are more likely to be elderly, have a disability and live in poverty. At the same time, they typically travel farther for health services, receive lower quality services than their urban counterparts and pay more for the services they get.

PACE programs, which include doctors, nurses, physical therapists, social workers, dietitians and transportation drivers, aim to improve health care access for older adults and maintain low costs by keeping participants out of hospitals and nursing facilities as long as possible.

What’s next: There are 149 PACE programs operating in 32 states, according to the report, with a number of program applications under consideration.

The committee offered a series of policy recommendations to the FCC, Congress and the White House to overcome rural-specific challenges to starting PACE programs, including making PACE sites eligible for broadband funding resources, providing start-up grants to new rural PACE sites, considering public-private partnerships and encouraging state Medicaid directors to send letters to long-term care providers to increase awareness of the program.