Palladia, First Dog Cancer Drug FDA Approved But Not Great
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Updated: March 14th, 2019
Palladia, the first drug officially approved for use in treating dog cancer has arrived. This was described in the Dog Cancer Survival Guide by it’s pre-market name, SU11654. Now it’s finally ready for release.
Palladia, made by Pfizer, has been approved by the FDA. It is expected to be available next year. This drug is approved for treating mast cell tumors in the dog.
The fact that this is the first drug approved for dog cancer may be odd for many. What about all those chemotherapy drugs that are used? They are not FDA approved?
Well, the facts are that vets and veterinary oncologists have been using human drugs the whole time. As a matter of fact, many of the drugs we use generally are not FDA-approved for use in the canine.
Why?
It turns out that FDA drug approval is allowed for one species at a time. On top of that, approval is for one disease or problem. In veterinary medicine, we have cats, dogs, birds, rabbits, monkeys, snakes, and so on…many different species, and they all need treatment.
It would take hundred of years and staggering amounts of money to get all our drugs approved for all these different species and diseases.
So vets have “off-label” drug use privileges. Off-label drug use means we can use drugs approved for one species (including humans) freely in other species.
Let’s take a look at some of the facts around Palladia.
Like most of the conventional treatments we use in treating dogs with cancer, the numbers for Palladia are a bit disheartening.
The median duration of objective response (meaning how long the Palladia’s effect lasted on mast cell tumors) was 12 weeks. Yes, 3 months of tumor shrinkage or disappearance is what you can expect. This number is taken from the original study.
After 3 months the cancer came back.
On top of this, not all dogs with mast cell tumors even responded. It turns out that roughly 40% of dog with mast cell tumors will actually respond to the drug, while the majority do not.
This means that while about 40% of the time the cancer either went away or shrank, in the remaining 60% of dogs Palladia had no effect.
Get a copy of the Dog Cancer Survival Guide for more information and tools to help your dog with cancer
Sigh.
If you would like to look at the original data for yourself, here is the link.
This highlights important points.
First, there is a big to do about Palladia. But, the actual statistics are depressing. Interesting contrast between hype and reality.
Second, I think most guardians of dogs afflicted with mast cell tumors would not be jumping for joy at these numbers, in spite of the festivities at Pfizer.
Lastly, this shows how important it is to leap sideways in our efforts to really treat canine cancer.
The more I think about dog cancer, and disease in general, the more I believe early choices are key, long before old age.
I will start addressing how dog cancer does not start in old age, in future posts. Instead, it starts many, many years before hand. We need to start taking steps earlier, much earlier.
Best to all,
Dr D
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Hi again Carolyn,
How long did it take Palladia to make the mass smaller?
Thanks
Eric
Thank you Ryan. I’m so sorry to hear about your girl. We are very skeptical of all recommendations for meds and appreciate your feedback on the Paladia. At the moment we are waiting for second opinion from the specialist in Seattle. Our Bulldog was also very healthy at the start, the Vet could not believe his age, and he had nothing show up on any of the tests. However, his situation is very serious because the tumour is so aggressive. It is very, very frustrating to think that there is nothing we can do. The tumour is so large and wraps from his check half way around his neck. I wish we could have surgery, but have been told it is not an option and even if we do everything he still only has maximum six months, if we are lucky.
Carolyn,
You are awesome for the info you are giving me. The holistic vet I go to is against Palladia because he thinks it is hard on the kidneys but I am scared that I don’t try everything I can. So I think I am going to start up the Palladia this week.
I will post more results….
Thanks so much
Eric
P.S. What side effects did you experience so I can look out for them
Dr. Dressler,
I’m enjoying your books, but I have not seen anything on palladia, and I wanted to know if you ever heard of it being used on Transitional Cell Carcinoma? Just recently my 12 yr old BlueTick Coonhound had an ultrasound after two doses of Mitoxantrone, it showed that the tumor in his bladder and the iliac lymph nodes were unchanged; however, the cancer was now seen in his prostate as well. Is Palladia something you would use for this type of cancer, or would you use something else? Also, do you see anything wrong with give prostate supplements along with the chemo drug?
Thanks so much for what you do, and the information you provide.
Best Regards,
Mark
Eric
It is a SCC tumor, left maxillary. The tumor has not grown, the mass is smaller, however, it is difficult to measure due to the location of the mass. She is considered stable disease, no new growth for months. For us, the use of Palladia has not been without side effects. We had to take a “drug holiday” after 3 months on the drug. We restarted her meds at a lower dose and she is handling the lower dose well. The first two months of treatment we had to take her in weekly for blood work and check-ups, we now take her in monthly. Although Palladia was not initally intended for SCC,it has stablized her disease. I took her to a holistic vet, the holistic vet was unfamiliar with Palladia, and did not feel comfortable prescribing/trying anything until she researched Palladia. On the advise of the holistic vet we did change her diet. She suggested a “cooling food” (fish based) medium to high protien, and no grain.
I hope this helps. My heart goes out to you, please let me know how your cat is doing.
Carolyn
Hi there,
Our 10yr old Border Collie/Lab cross was diagnosed with a MCT on his front leg in October. We have tried two different chemotherapy drugs (Loumustine, being the last) which have been uneffective in treatment. Aside from the large tumour on his leg he is in great spirits and in near perfect health.
Our only and last drug option given to us by our oncologist is Palladia. Unfortunately the costs are astronomical and far more than we can afford as we have already spent nearly $10,000.00 on chemo and initial testing.
We may be able to afford one 6 week cycle of the Palladia but wonder if just one round would have any benefit if we cannot afford to continue with the drug. Any thoughts?
I am not ready to give up on my dog yet and would truly break my heart to do nothing for him. Any other suggestions would be greatly appreciated.
Thanks,
Kara
Dear Cara,
I would consider Apocaps and Neoplasene, along with diet, immune supplements and antimetastatics discussed in the Guide. Please make treatment changes under veterinary supervision-
I hope this helps
D
Becky,
My heart goes out to you. I lost a wonderful cat to cancer last year and I cant believe I am going thru it again.
I am trying holistic remedies with modern medicine.
Definitely talk to a holistic vet also adn look up Budwig diet for dogs. It cant hurt.
My little one feels awesome after a week on it.
Take care
Ryan McDonald?
Please tell me the symptoms your dog experienced from Palladia. I am so sorry about your dog.
Hi all interested in Palladia and treatment of mast cell tumor. My 12 year old Weimaraner has struggled most of her life with MCT, grade II, we always had them surgically removed. Last February she got a grade III tumor, miotic index 10, very bad news. We removed it surgically and the lymph node it had matastitized to, and a few other grade II tumors. After she healed we started chemo, Lumostine and Vinblastin. Her white cell count dropped so low we had to discontinue the protocol and wait until it went up, then start again. I think this caused the cancer to become resistent.
Through the wonderful people at WSU Vet Teaching School, I was able to get her in the Palladia program. Her tumors immediately responded to it and shrank to nothing. She tolerated it well and had a great quality of life. She did get sick when we tried to go on a camping trip, but returned to good health when we got home. She did well for 4 months on the Palladia, then new tumors started to grow. We got her into the Masitinib program, which is similar to Palladia. She responded well, needed a some drugs for nausea, but then great quality of life. The Masitinib worked for 6 weeks, then the tumors started to grow. When they got 4 inches across it was decided to let her go, they were starting to bother her. I just put her down two weeks ago and am still crying, she was my AKC certified Tracking Dog Excellent, and mother of her breed champion daughter and son. Going through this was hard and very expensive with all the blood tests, vet checkups, and medicines. But we loved her so much we had to do everying possible until there were no options left. I am glad we went on this journey with her and had almost another year with her. Now I face the same journey with her daugher, she has had a few Grade II’s removed through her life. This is not a journey for everyone, if the medicines even work for your dog. My lessons learned were to catch the disease early in the dog’s life and do everything possible to stop it before it gets Grade III. I will read your other posts to see what advice you have for working on it early. I wish I had found this site earlier.
Dear Becky,
Sounds like you are becoming all to familiar with the number one reason for dog mortality in this country. I am sorry you have to go through all this. I just wanted to refer you to a little explanatory blog on grade versus stage. Recall that mast cell tumors do not typically progress from Grade 1 to 2 or from 2 to 3:
https://www.dogcancerblog.com/blog/dog-cancer-words-you-should-know-grade-and-stage/
Here are some other blog posts you might be interested in:
https://www.dogcancerblog.com/blog/why-benadryl-for-mast-cell-tumors/
https://www.dogcancerblog.com/blog/diet-for-dogs-with-mast-cell-tumors/
https://www.dogcancerblog.com/blog/when-to-avoid-chemo-for-canine-mast-cell-tumors/
https://www.dogcancerblog.com/blog/dog-cancer-decisions-in-the-gray-zone/
There is a plethora of organized information in The Dog Cancer Survival Guide.
Another though for you would be the Compassionate Use Program for masitinib, available through AB Sciences and Dr. Albert Ahn. I have had some good results with this drug. You need to have your veterinarian contact them. AB Sciences is located in New Jersey.
Best of luck,
Dr D
So it looks like we exhausted the Palladia option; the mast cell tumor on our 12 year old boxer stopped responding and he had a few scary incidents involving blood in his stool and coming out of his nose/mouth, so we stopped Palladia. In a way, we are much happier – his personality is back to normal, he seems happy and alive, he eats well and drinks water now instead of licking snow for hours at a time…Palladia definitely had a very negative impact on his personality and the quality of his life and we only realize now how bad it was. But the tumor has grown so much – it is located on his front paw and looks grotesque as if it is about to burst; the vet told us we soon will be facing either an amputation or having to put him down…The sad thing is, this is the only tumor that he has on his body, and it has been the case for the full year (even after radiation failed), so I keep on hoping that we can eradicate it somehow. Out vet did not mention anything about Kinavet, so I am grasping a straw of hope that maybe it will help before he goes under knife. Do I understand it correctly – the only thing we have to do to get my boxer on it is to ask my oncologist to have it shipped from AB Sciences on a compassionate use program? Is there anyone else on the site besides Donna who has used it and can comment on its efficacy? Thank you so much in advance..
Elena, the answer to your question is yes. Kinavet (masitinib) is available through Dr. Albert Ahn and AB Sciences in New Jersey. Have your oncologist request it for you.
Best ,
Dr D
Elena,
If Kinavet is also called Masitinib, which I got through AB Science on a compassionate use program, it is very similar to Palladia and I’m afraid you will have the same side effects. It worked for a short while to decrease the tumor. Unfortunately sounds like surgery is the only option to save his life. Maybe try the other remedies in the Cancer Care Guide, but you might not have enough time.
Hi, we have a ten month old male, choc, labrador. He has been diagnosed with mct. So far he has had stage one and two diagnosed, with the stage two lumps being removed. New lumps keep appearing. Our vet has mentioned palladia, at 40% success rate, is it recommended for such a young dog. Thanks
HI Carolyn
Is it a SCC tumor and has it increased in size at all? Are you doing anything holistically too?
Thanks
Eric
My 13 year old lab has squamous cell carcinoma and has been treated with Palladia since Sept 2009.
Anyone have any luck with treating Squamous Cell Carcinoma? My cat has it.
Thanks
Hi my virtual vet,
As I’ve said before, I just went through a bad year with my older Weimaraner with Grade III Mast Cell tumors, I learned a lot trying to deal with the advanced cancer. I have finished reading your book and am right now ordering Apocaps for the 9 year old daughter of this dog. She has also had a life time of mast cell tumors, having 8-10 tumors removed every 1 to 2 years. She had 8 Grade I and Grade II tumors surgically removed only a year ago. She has been vomiting occasionally the last couple of months which I thought was stress of her mom being sick and dying, now I think it is the cancer and histimine. She’s getting more lumps, they appear one day and by the next are gone, which makes it very difficult to get a needle aspirate as they usually appear when the vet is closed for the night or weekend. I will get these aspirated as soon as I can, but I’ve recently mapped out 10 lumps which I’m pretty sure some are cancerous. I’d like to start her on Apocaps and see if this helps. I know surgery cures the cancer, but if she is growing 10 new lumps every year, it seems the cancer is systemic and is surgery helping? She hates it and has become fearful of people after so many surgeries.
She seems healthy otherwise, but when I have my vet aspirate the lumps, I’ll have her do a all over health exam to make sure it hasn’t spread internally. I’ve changed her diet to what you recommend, given her Tagamet which has helped with her stomach upset. I’m wondering if I were lucky enough to bring her to you, what would you recommend doing now? Do you recommend the Apocaps every day for the rest of her life? Your book mentions rotating between the selection of treatments, do you do this with the Apocaps? It seems a bit overwhelming that she would need 9 capsules of Apocaps every day for the rest of her life, that would be a bottle every 10 days, rather expensive, but not as expensive as trying to save her life later with chemo and Palladia. If this was your dog what would you do next?
Thank you all for sharing prices – it really helped. Apparently, our facility is very expensive – claim they are a specialty clinic and have a 24 hour service, but we don’t need all that since Palladia is a chronic medication… So I checked with a regular vet in the area, they have to do a special order with Pfizer but the price was less – about $16 per a 50ml pill. Still more than MSU is charging, so I will keep on shopping around. It’s sad to think that some people who get a $25 quote can’t afford it, and let their dog deteriorate, yet there are cheaper options but they are not aware of it…
By the way, the blood tests, etc are a separate charge and have been costing us between $300-450 each time, so any little bit of help is important. Thank you all again!
Hello everyone. We had to say goodbye to our boy yesterday. Never had the chance to try any of the new medications. Everything happened in about two months time. It is hard to say whether or not things would have been different if we had a second opinion earlier on. We never administered chemo, radiation, or anything harsh, just appreciated each moment with him. In the end, he let us know it was time. Thank you Dr. Dressler for having this place for people to discuss and for provinding alternatives. Nothing is worse then the feeling that you have no options.
Dr. D,
First and foremost, “Thanks” for all the time you take to help all of us out here. I spoke with my vet because we may be going away from Palladia (given that she doesn’t have the “mutation” and may be getting some side effects). The vet at MSU was very familiar with the masitinib and have pills via the compasionate use program. We may be looking to go this route soon.
Dear Julian
I hope it helps
Best,
Dr D