The Cancer Revolution

A $1.77 Billion Problem and Opportunity:

Cancer is the leading cause of death in dogs over ten years of age. It is not a rare disease. It is not a specialist's curiosity. It is a daily reality in general veterinary practice, and it has been chronically undertreated; not for lack of scientific understanding, but for lack of accessible, practical tools.

The veterinary oncology sector reached $1.77 billion in 2025, growing at a compound annual rate of 12.14 per cent. By 2034, analysts project it will reach $4.86 billion. That growth is not driven by speculation. It is driven by a genuine expansion of what is possible: new drugs, new diagnostics, new understanding of tumour biology, and a growing recognition among pet owners that their animals deserve the same quality of cancer care that human medicine has been developing for decades.

Dogs, it turns out, are not just patients in this story. They are also research partners. Canine tumours share remarkable biological similarities with their human counterparts, similar immune microenvironments, similar genetic drivers, similar responses to treatment. The dog with lymphoma is not just a dog with lymphoma. It is a naturally occurring model for human non-Hodgkin lymphoma, studied in real-world conditions, with real-world immune systems, in a species that shares our environment and our exposures. Veterinary oncology and human oncology are, increasingly, the same science.

The Pill That Changed Everything:

On 16 January 2026, the United States Food and Drug Administration announced the full approval of Laverdia (verdinexor tablets); the first and only FDA-approved oral treatment for canine lymphoma. The announcement was the culmination of a journey that began in 2021 with conditional approval, and that required four annual renewals and a properly controlled clinical trial before the drug earned its full regulatory status.

What makes verdinexor remarkable is not just that it works, but how it works. Most chemotherapy drugs target cells that are dividing rapidly; a blunt instrument that catches cancer cells but also catches healthy ones. Verdinexor takes a different approach entirely. It is an XPO1 inhibitor: it blocks a protein called Exportin-1, which cancer cells use to shuttle tumour suppressor proteins out of the nucleus. When those proteins are expelled from the nucleus, they cannot do their job: they cannot regulate cell growth, cannot trigger apoptosis, cannot keep the cancer in check. Verdinexor blocks the exit route. The tumour suppressors stay where they belong. The cancer cell, deprived of its escape mechanism, is selectively destroyed.

💊 LAVERDIA AT A GLANCE:  Twice-weekly oral tablet · Starting dose 1.25 mg/kg, increased to 1.5 mg/kg after 2 weeks if tolerated · Minimum 72 hours between doses · Must be given with food (3–5× higher absorption) · Prescription only · Chemotherapy handling precautions apply · Distributed by Dechra Veterinary Products.

The drug is administered at home, by the owner, twice a week. That convenience is genuinely significant. For the 80% of lymphoma cases that currently go untreated; often because owners cannot manage the logistics of repeated clinic visits an oral, at-home option removes one of the most significant practical barriers to treatment. As Dr Clifford put it: 'Knowing that 80% of lymphomas are left untreated, this gives the primary care practitioner a game changer — something else that they can utilise, other than just prednisone.'

A note of clinical honesty is warranted here. Laverdia is not a cure. The pivotal trial showed a median time to disease progression of 35 days in treated dogs versus 23 days in controls, a statistically significant improvement (p=0.011), but not a dramatic extension of life. Side effects were common: anorexia in 74% of treated dogs, vomiting in 61%, lethargy in 61%, weight loss in 52%, and diarrhoea in 43%. Only about 30% of dogs in the treatment group completed the 56-day study. This is a drug that buys time and improves access, not one that transforms the prognosis. But in a disease where 80% of patients currently receive nothing, buying time matters.

📊 TRIAL RESULTS:  N=160 dogs · 10 sites · Randomised 4:1 verdinexor:placebo · Median TTP: 37 days (verdinexor) vs 23 days (placebo), p=0.011 · Particularly high response rate in T-cell lymphoma · No cross-resistance to other chemotherapy types.

How Artificial Intelligence Found a Cancer Drug:

The story of verdinexor's journey to veterinary approval is also the story of a new model for drug development, one that uses artificial intelligence to do something that would have taken decades by conventional means.

The second platform, AniviveTRIAL, used intelligent patient matching and digital recruitment to identify and enrol dogs for the pivotal clinical study. It contributed approximately 40% of the study's enrolment, a remarkable figure that illustrates how AI can accelerate the clinical development timeline by solving one of its most persistent bottlenecks: finding enough patients.

Laverdia is the first FDA-approved veterinary product to complete the full AI-enabled development cycle, from repurposing through clinical development to approval. Anivive is now investigating verdinexor for other canine and feline cancers, and as a potential antiviral. The company has also developed SearchLight DNA, a next-generation genomic sequencing test for pet cancers that can characterise tumour biology at the molecular level. The pipeline is expanding rapidly, and the model, AI-enabled repurposing of proven human medicines, is one that other companies are watching closely.

The Blood Test That Sees Cancer Coming:

Of all the advances in veterinary oncology in 2025 and 2026, perhaps none is more conceptually exciting than liquid biopsy. The idea is simple: instead of cutting into a tumour to get a tissue sample, you take a blood draw. Cancer cells shed fragments of their DNA into the bloodstream [cell-free DNA, or cfDNA] and those fragments carry the molecular fingerprints of the tumour. Analyse the cfDNA, and you can detect cancer without ever touching the tumour itself.

In human oncology, liquid biopsy is already transforming early cancer detection. In veterinary medicine, it is just beginning. A landmark study published in Frontiers in Veterinary Science in January 2025 by Ko and colleagues at GenesisEgo and Soonchunhyang University in South Korea demonstrated that canine hemangiosarcoma, one of the most aggressive and rapidly fatal cancers in dogs, can be detected from a blood sample using cfDNA analysis and machine learning.

Hemangiosarcoma is a particularly cruel disease. It originates from the endothelial cells lining blood vessels, and it can manifest in the spleen, liver, heart, and skin. By the time clinical signs appear, often a sudden collapse from internal bleeding, the disease is typically advanced. Traditional diagnosis requires tissue biopsy, which is invasive and often performed only after the dog is already in crisis. A blood test that could detect the disease earlier would be transformative.

The study analysed cfDNA fragment sizes and copy number alterations from whole genome sequencing of 21 hemangiosarcoma-affected dogs and 36 healthy controls. The results were striking. Hemangiosarcoma samples showed characteristically shorter cfDNA fragment sizes compared to healthy controls: a leftward shift in the primary peak that mirrors patterns seen in human cancer liquid biopsy research. The team also identified seven novel genomic gains and nine losses specific to canine hemangiosarcoma. Applying machine learning to the cfDNA fragment size distribution, they achieved an average Area Under the Curve of 0.93 in ten-fold cross-validation, a strong performance for a non-invasive diagnostic approach.

🔬 LIQUID BIOPSY RESULTS:  AUC 0.93 in 10-fold cross-validation · 7 novel genomic gains, 9 losses identified · 8 distinct periodic cfDNA patterns unique to canine hemangiosarcoma · Foundation for non-invasive cancer screening and monitoring.

This is early-stage research; 57 samples is a small cohort, and the technology needs validation in larger, more diverse populations before it becomes a clinical tool. But the signal is clear, and the direction of travel is unmistakable. The blood test that detects cancer before it becomes a crisis is coming to veterinary medicine.

Less Is More, The Metronomic Revolution:

Not every advance in veterinary oncology requires a new drug or a new technology. Sometimes, the revolution is in how you use what you already have. Metronomic chemotherapy, the continuous administration of cytotoxic drugs at low doses, well below the maximum tolerated dose, is one of the most practically significant developments in veterinary oncology in recent years, and a 2024 review by Petrucci and colleagues in Frontiers in Veterinary Science has brought its evidence base into sharp focus.

The logic of metronomic dosing is elegant. Conventional chemotherapy works by killing rapidly dividing cells; but it does so in pulses, with recovery periods between doses that allow tumour cells to regroup. Metronomic dosing takes a different approach: instead of hitting hard and then retreating, it applies continuous low-level pressure. This works through two distinct mechanisms. First, antiangiogenic effects: low-dose chemotherapy inhibits the proliferation of endothelial cells that tumours need to build new blood vessels, starving the tumour of its blood supply. Second, immunomodulatory effects: metronomic dosing reduces regulatory T cells (Tregs) that suppress anti-tumour immunity, and restores the function of CD8+ cytotoxic T cells that can attack the cancer directly.

The practical advantages are considerable. Metronomic protocols typically use oral agents: cyclophosphamide, chlorambucil, toceranib;  that can be administered at home. Toxicity is lower than conventional chemotherapy. Cost is significantly reduced. And the approach is suitable for general practice, not just specialist oncology centres. For the many dogs whose owners cannot access or afford specialist care, metronomic chemotherapy offers a meaningful option.Nec

The honest caveat is that the evidence base remains largely retrospective. Well-designed prospective randomised controlled trials are needed to establish which patients benefit most, which protocols are optimal, and how metronomic approaches should be integrated with other treatments. But the mechanistic rationale is sound, the clinical experience is encouraging, and the accessibility advantage is real.

Getting the Margins Right:

In surgical oncology, the margin is everything. When a tumour is excised, the pathologist examines the edges of the removed tissue to determine whether the surgeon got it all; whether the cancer cells stop at the boundary of the specimen, or whether they extend to the cut edge, suggesting that tumour cells remain in the patient. A clean margin means the surgery was curative. A dirty margin means the cancer is still there.

A 2025 study by Vincenti and colleagues in Frontiers in Veterinary Science addressed a question that sounds technical but has profound clinical implications: how should those margins be assessed? The study evaluated combined cross-sectional and tangential surgical margin assessment in dogs and cats with different tumour types, and found that relying on a single trimming approach, the most common practice, significantly underestimates margin involvement. In other words, tumours that appear to have been completely excised by conventional assessment may actually have positive margins that a more thorough evaluation would reveal.

The implications are direct and practical. A dog that appears to have had a successful surgery may actually need adjuvant radiation therapy or re-excision. A cat whose owner is told the tumour is gone may be at higher risk of recurrence than the pathology report suggests. Combined margin assessment, cross-sectional and tangential provides more accurate, standardised, and informative reporting, and should become the standard of care in veterinary surgical oncology.

🔪 CLINICAL LESSON:  Single trimming approach underestimates margin involvement. Combined cross-sectional and tangential assessment provides more accurate pathology reporting, with direct implications for adjuvant therapy decisions and recurrence risk.

Osteosarcoma, Fighting for Every Limb:

Canine osteosarcoma is one of the most devastating diagnoses in veterinary medicine. It is the most common primary bone tumour in dogs, affecting large and giant breeds disproportionately. The standard of care, amputation followed by adjuvant chemotherapy with carboplatin or doxorubicin, achieves a median survival of 10 to 12 months. That is not a cure. It is a reprieve.

Two important studies are advancing the field in different directions. The first, by Norquest and colleagues in 2024, investigated the combination of zoledronate, a bisphosphonate drug that inhibits bone resorption and has direct anti-tumour effects, with radiation therapy in canine osteosarcoma. The study combined in vitro assessment with a prospective clinical cohort, and supports the feasibility and tolerability of the combined approach. Questions about optimal timing and biological variability in response remain open, but the signal is encouraging.

The second study in 2023, by Griffin and colleagues, took a different approach: surgical stabilisation combined with non-stereotactic radiation therapy for dogs with axial and appendicular osteosarcoma, plasma cell tumor and fibrosarcoma. This bi-institutional study demonstrated meaningful functional improvement, acceptable complication rates, and encouraging survival outcomes, even in advanced cases. For dogs whose owners cannot accept amputation, or whose tumour location makes amputation impractical, this combined approach offers a viable limb-sparing and palliative strategy.

A full blog on the novel findings in osteosarcoma is published here: The Bone That Fights Back! Join me and read.☺️

You Are What You Feed (Nutrition in Oncology):

A 2025 review by Amaral and colleagues in Frontiers in Veterinary Science made a case that veterinary oncologists have been making for years, but that general practitioners often overlook: nutrition is not an afterthought in cancer care. It is a core pillar of treatment.

Cancer-associated cachexia, the progressive muscle wasting and metabolic dysfunction that accompanies advanced cancer, affects up to 80% of advanced cancer patients, in both human and veterinary medicine. It reduces treatment tolerance, impairs immune function, and significantly worsens quality of life. Addressing it is not optional.

The nutritional framework for canine oncology rests on several evidence-based principles. First, carbohydrate restriction: cancer cells preferentially metabolise glucose through aerobic glycolysis, the Warburg effect, and low-carbohydrate diets may reduce the fuel available to tumours while sparing normal tissues that can use fat and protein as energy sources. Second, omega-3 fatty acids: EPA and DHA have anti-inflammatory and anti-cachectic properties, and may enhance the efficacy of chemotherapy by sensitising tumour cells to cytotoxic agents. Third, protein adequacy: maintaining muscle mass during treatment requires adequate dietary protein, and restriction is counterproductive. Fourth, obesity management: adipose tissue secretes pro-inflammatory adipokines that may accelerate tumour progression, and overweight patients have worse outcomes across multiple cancer types.

These are not exotic interventions. They are practical, accessible, and evidence-based. Every veterinarian treating a dog with cancer should be having a nutritional conversation with the owner, not as a supplement to treatment, but as part of it.

The Precision Medicine Vision:

Step back from the individual advances and a coherent picture emerges. Veterinary oncology in 2026 is not just accumulating new drugs and new techniques. It is converging on a precision medicine framework, one that treats each patient as the individual they are, rather than applying the same protocol to every dog with the same diagnosis.

That framework rests on six pillars. Molecular diagnostics: liquid biopsy, genomic sequencing, immunohistochemistry, that characterise tumours at the molecular level and identify the specific drivers of each patient's disease). AI-enabled drug development platforms like AniviveSELECT that identify proven human medicines for veterinary repurposing, dramatically accelerating the path from discovery to approval. Targeted therapy, drugs like verdinexor and toceranib that act on specific molecular targets rather than bluntly attacking all dividing cells. Multimodal treatment, integrating surgery, radiation, chemotherapy, immunotherapy, and nutrition into coherent, patient-centred protocols. Standardised reporting, consistent pathology and staging protocols that enable meaningful multicentre evidence and evidence-based guidelines. And comparative oncology, the recognition that dogs and humans share tumour biology, and that advances in one species can accelerate progress in the other.

The Frontiers in Veterinary Science editorial by Queiroga and colleagues, published in February 2026, captured the moment well: "veterinary oncology is advancing through multiple, interconnected fronts: refinement of local and systemic therapies, consensus building and clinical standardisation, development of enabling diagnostic tools, and the steady expansion of minimally invasive diagnostics and biomarker research. The challenges remain, biological heterogeneity, limited high-level evidence for some interventions, the need for robust clinical strategies. But the direction of travel is clear.

The Dog That Came Home:

Return, for a moment, to that dog with lymphoma. The one whose owner sat in the consulting room, absorbing a diagnosis, wondering whether treatment was even possible. In 2026, that owner has options that did not exist five years ago. An oral tablet, administered at home, twice a week. A drug identified by artificial intelligence, approved by the FDA, that works through a mechanism that is genuinely novel in veterinary medicine. A veterinarian who can discuss not just chemotherapy, but metronomic protocols, nutritional support, and in the not-too-distant future, a blood test that might have caught the cancer earlier.

None of this is a cure. Canine lymphoma remains a serious disease with a guarded prognosis. But the gap between what veterinary oncology can offer and what human oncology can offer is narrowing, and in some areas, the dog is leading the way. The liquid biopsy research in hemangiosarcoma is informing human angiosarcoma research. The XPO1 inhibitor mechanism validated in dogs is being studied in human haematological cancers. The comparative oncology model is not just good for dogs. It is good for all of us.

The cancer revolution in veterinary medicine is not coming. It is here. And for the dogs, and the owners, who need it most, it cannot come soon enough.