General practitioners may be hesitant to offer referral for the possibility of enrolling a pet with cancer into a clinical
trial. While they may be aware of the possibilities, they do not wish for the owners to see their pets as experiments rather
than cherished pets. However, clinical trials have several benefits and should be included in the discussion when talking
to owners about treatment options for pets with cancer.
Kim A. Selting, DVM, MS, DACVIM
When general practitioners include this option, they are often viewed as practicing on the cutting edge of veterinary medicine.
Owners feel that they have truly been given all the options and that nothing has been withheld or overlooked in their quest
to consider all of their options for their pets. The reality is that once a pet is diagnosed with cancer, owners want options.
WHY CONSIDER A CLINICAL TRIAL?
Clinical trials can occur as dose-finding or pharmacodynamic studies or later-phase studies that compare a new treatment to
the standard of care, if one exists. Trials involve treatments that have shown promise in preclinical studies. Benefits include
availability of a promising treatment that would not otherwise be obtained, financial subsidy, treatment options when all
others have failed, and the opportunity to contribute to the greater good.
This last point should not be undervalued. Many pet owners realize that the cancer may lead to the death of their pets, but
they enjoy tremendous peace of mind knowing that their pets did not die in vain and that their participation in the trial
will benefit dogs or cats in the future—and possibly people as well—in the fight against cancer.
Some veterinarians may avoid clinical trials. Referring cases elsewhere can lead to a loss of connection with the pet and
owner. The learning curve to become acquainted with the details of trials may be daunting. Also, trials are typically either
partially or fully subsidized, and the attraction of free cancer care may lure a pet owner away from standard therapy for
which the veterinarian may have garnered income. Medically, this can be a concern for fear that owners will forego known effective
therapy for an alternative of unknown benefit.
However, consider the fact that pets undergoing therapy will live longer and have more opportunities for extended care than
those that are euthanized early in the course of disease. Many trials require some follow-up care at the referring clinic.
The teamwork between the referring veterinarian and specialist has tremendous value to the pet owner. Also, when presented
with all options, owners will ultimately choose what is right for them and their pets, and they may feel betrayed if they
find a clinical trial that was not offered by their veterinarian.