FDA Approves Tanovea for the Treatment of Lymphoma in Dogs
Key takeaways:
Tanovea (rabacfosadine) was conditionally approved in December 2016 to treat canine lymphoma, so veterinarians (vets) have been using it for that purpose for the last 5 years.
As of July 2021, Tanovea has been fully FDA-approved for canine lymphoma after additional clinical study data established its effectiveness in treating this condition.
Talk to your vet if you’d like to learn more about Tanovea as a potential treatment option for your dog.
In July 2021, the FDA fully approved Tanovea (rabacfosadine) for the treatment of canine lymphoma. This is a type of cancer in dogs that begins in immune system cells found in their lymphatic systems. The medication was conditionally approved in December 2016, and it’s now the first of its kind to gain full FDA approval.
Even though canine lymphoma affects less than 70,000 dogs every year, it makes up about 24% of all canine cancers. For dogs, conditional approval means that medications are made available before their effectiveness has been fully proven. These medications are reserved for the treatment of uncommon conditions (like cancers) to help veterinarians (vets) access new treatment options faster.
As a result of the FDA’s conditional approval, vets were able to offer Tanovea over the last 5 years as a more convenient and potentially less expensive treatment option for canine lymphoma when compared to other treatments.
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Here we’ll cover what you should know about Tanovea — how it works, its potential side effects, and what full FDA approval means for your furry friend.
What is Tanovea?
Tanovea is an injectable chemotherapy medication used to treat lymphoma in dogs. It’s given as an intravenous (IV) infusion by your vet.
The FDA initially gave Tanovea conditional approval in 2016, which means that the medication was considered to be safe and likely to provide a benefit for its intended use but that more effectiveness data was needed for full approval. Between 2016 and 2021, additional clinical study data was collected, analyzed, and used to learn more about medication’s effectiveness.
Those additional study results showed that Tanovea can help dogs live longer. For dogs who completely responded to the medication, it helped keep their lymphoma from getting worse for about 168 days (between 5 and 6 months). It was also found to extend a dog's survival time by about 2 months after cancer was diagnosed.
How does Tanovea treat lymphoma in dogs?
Tanovea is considered to be chemotherapy, a type of treatment that works by killing rapidly growing cancer cells. It’s also a prodrug, which means that it is changed into its active form(s) once inside your dog’s body. The active molecules build up in cancer cells, preventing them from growing and repairing themselves, and causing them to die.
How is Tanovea dosed?
Tanovea is given as an IV infusion by your vet. The infusion process takes about 30 minutes, and you’ll likely need to bring your dog back every 3 weeks for up to 5 infusions total.
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It’s usually dosed as 1 mg per kg of body weight per infusion. But your vet may lower or delay doses to manage possible side effects.
After your dog’s infusion, it’s important to know that you run the risk of being exposed to the medication through your pet’s saliva, stool, or other bodily fluids. For this reason, avoid direct contact with these substances for at least 5 days after each treatment.
A few tips to keep in mind during this time are:
Get a box of chemotherapy-resistant gloves for cleaning up after your furry friend and handling toys, food, water bowls, and other items.
Wash items (like towels, clothing, food, and water bowls) that may have come into contact with your pet’s stool or body fluids separately from other laundry or dishes.
Pay attention to where your dog might be going to the bathroom or licking. Avoid areas or surfaces where people may come into contact with your dog’s stool, urine, or saliva.
If you accidentally come into contact with these substances during this 5-day window, it’s recommended to wash your hands right away with soap and water. Take extra caution if you’re pregnant: Exposure to chemotherapy medications like Tanovea can harm an unborn baby.
What are the known side effects of Tanovea?
As with all medications, Tanovea can cause side effects, some of which may be serious.
The most common side effects of Tanovea include:
Diarrhea
Less appetite than usual
Weight loss
Vomiting
Lacking energy
Low white blood cells (neutropenia)
As listed above, Tanovea can affect your dog’s appetite. But if they refuse food for more than a day, or have repeated diarrhea or vomiting, let your vet know.
Tanovea can also lower the amount of neutrophils, a type of white blood cell involved in fighting infections. In other words, Tanovea can allow infections to occur more easily. Contact your vet if your dog is running a fever (symptoms being red eyes, warm ears, shivering), since these may be signs of an infection.
Additional serious side effects include skin issues (e.g., ulcers and peeling) and pulmonary fibrosis, a lung condition where the lungs become scarred or damaged. Contact your vet if you notice hair loss, sores, or scabs on your dog’s skin, or if they are having trouble breathing.
How does Tanovea compare to other lymphoma medications?
Canine lymphoma treatment is usually built upon a combination of four cancer-related medications, often abbreviated “CHOP.” There are a number of different CHOP protocols (treatment strategies). These protocols may have slightly different doses or administration frequencies.
CHOP consists of three chemotherapy medications and one corticosteroid (prednisone):
Cyclophosphamide (given by IV or orally)
Doxorubicin, also known as hydroxydaunorubicin (Adriamycin) (given by IV)
Vincristine (Oncovin; given by IV)
Prednisone (given orally)
Depending on the protocol, you’ll typically need to take your dog to the vet every week or every other week over the course of several months, and total costs can range from $3,500 to $10,000. Tanovea, on the other hand, may cost around $600 to $700 per treatment (that is, $3,000 to $3,500 for five treatments) and is given every 3 weeks.
There are also other protocols that may be more convenient or less expensive, but they may not work as well. However, your vet will work with you to determine the best option for your pet.
Earlier this year, the FDA also gave conditional approval to the first oral canine lymphoma medication called verdinexor (Laverdia-CA1). Similar to Tanovea’s conditional approval, it’s currently available for use, and the manufacturer has 5 years to complete effectiveness studies to receive the FDA’s full approval.
However, Laverdia-CA1 is available as an oral tablet, which gives you the option to administer the medication yourself at home, unlike the injections.
Which treatment is best for your dog?
There are a number of factors that help your vet determine which treatment protocol is best — and cost and convenience may be factors in making a decision. CHOP or other protocols may not be feasible for all dog owners, so Tanovea gives vets another tool in their treatment arsenal for dogs just getting started on a medication or not responding as well to other options.
How much does Tanovea cost?
Each Tanovea treatment is estimated to cost around $600 to $700, which may add up to $3,500 if five treatments are recommended. And now that the medication has been fully approved, treatment costs may change, so you’ll want to discuss pricing with your vet to get the most recent information.
Your vet may decide to use Tanovea in combination with other medications, which may also change the expected treatment costs.
Talk to your vet if you’re concerned about potential treatment costs or if you’re looking for ways to make treatments more affordable.
When will Tanovea be available?
The good news is that Tanovea is already available. Since its conditional approval in 2016, vets have been able to use Tanovea as an option for treating canine lymphoma. So its availability continues.
Talk to your vet if you’d like to learn more about Tanovea and if it might be a good option for your dog.
The bottom line
Canine lymphoma is typically treated with a combination of medications referred to as CHOP. However, CHOP protocols can be expensive, and they may not be feasible for all dogs. Tanovea gives vets another option for treating this condition, either by itself or in combination with other medications. Talk to your vet if you’d like to learn more about Tanovea and whether it might be a good option for your dog.
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References
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