Spring 2018

Catching Every Cancer Cell

A veterinary surgeon tests an experimental imaging technology with help from Tufts at Tech.

By Genevieve Rajewski

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Canine mammary carcinoma cells lit up in red during surgery. Photo: Courtesy of Lumicell, Inc.

In October 2017, Lisa Correa was shocked when a wellness exam at Tufts at Tech Community Veterinary Clinic in Worcester turned up a sign of a serious problem in Dutchess, her eight-year-old rescue dog. “They told me they found a lump on her left mammary gland,” said Correa. “And my world pretty much came crashing down.”

After discussing with Correa options for treating the mammary carcinoma, a hormone-driven malignancy that behaves like breast cancer in women, fourth-year veterinary student Megan Gibeley reached out to the Clinical Trials Office at the Henry and Lois Foster Hospital for Small Animals. Dutchess qualified for a trial led by surgeon John Berg that’s testing a new imaging tool developed by researchers at MIT and Lumicell, Inc. of Wellesley, Massachusetts.

Whenever a tumor is surgically removed, there’s always a chance malignant cells are left behind. A minuscule number can provide a foothold for the cancer to recur. “The problem in both human and veterinary medicine is that we can’t tell if we’ve gotten all microscopic bits of tumor out,” Berg said. The Lumicell technology has promise for letting surgeons check for malignant cells and remove them before the patient even leaves the operating room.

Two hours before Dutchess’s surgery, Berg’s team injected her with an experimental drug containing a fluorescent molecule that causes malignant cells to light up when exposed to infrared light. Then, Berg removed the cancer, and looked through a special camera. “If I see fluorescence, I know I may have left tumor cells behind,” Berg said. Dutchess appeared clear.

Berg has been working with a team from Lumicell for about five years—recently including Edward Nobrega, V94, a medical affairs education specialist. For his first study, Berg tested the technology in 19 pet dogs being treated for soft-tissue sarcomas and mast cell tumors. The results, published in Veterinary Surgery in February 2016, found “that the technology distinguishes cancer from normal tissue with 95 percent accuracy,” he said.

The results helped move the imaging technology into human trials, and multicenter studies in the U.S. are now evaluating the surgical tool in people undergoing treatment for breast and gastrointestinal cancers. Although Berg appreciates the opportunity to make a contribution to human health, he hopes his current study—enrolling dogs with mammary, anal sac, liver, thyroid, or lung carcinomas—will hasten a surgical revolution for treating cancer in dogs and cats. Berg said that an important remaining step will be to confirm that the technology can identify even microscopic quantities of residual cancer that the surgeon would not otherwise be able to see. That question wasn’t answered in the initial trial because the tumors could be removed with wide margins of normal tissue.

Tufts at Tech is playing a pivotal role in testing the approach in dogs with mammary carcinomas, which occur largely in unspayed dogs and those spayed later in life. “When I worked in a veterinary practice in Westborough, I might see one or two cases a year,” said assistant professor Gregory Wolfus, V98, director of the clinic. “But at Tufts at Tech we see mammary cancer every week.”

The owners of pets in Berg’s study gain access to the kind of cutting-edge care generally found only at teaching hospitals, and Dutchess’s owner couldn’t be more grateful. “I love this dog like she’s my child,” Correa said. “Dutchess has healed so perfectly. She’s 100 percent her old self.”

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