Figure 1. The CIVO microinjection device is inserted into the tumor through the skin to quickly and precisely deliver drug micro-doses.

Figure 2. Delivery of 8 unique drugs is visualized with a special light source. 

Figure 3. A thin sarcoma tumor slice is stained with a marker to show dying cancer cells. Eight drugs were injected. Injection sites 2, 4, and 6 induced the greatest tumor cell death, as shown by the red cellular staining. 

WOOF for the Cure™

Cancers in dogs and humans have many similarities.  As a result, medical advancements in the human clinic can often be applied in the veterinary clinic. Similarly, canine clinical studies have the potential to help bring important new technologies and therapies to the human clinic. 

With this idea in mind, Presage Biosciences partnered with veterinarians in the Seattle area to form the WOOF for the Cure consortium in 2013. Through this collaboration, clinicians and scientists are working together to optimize and apply Presage’s CIVO™ technology with the common goal of filling the unmet clinical needs of better cancer drug development and personalized cancer care. 

The CIVO™ Technology

CIVO was conceptualized at the Fred Hutchinson Cancer Research Center in the laboratory of Dr. Jim Olson. Presage Biosciences has been developing and commercializing CIVO since the company's inception in 2008. The Presage team successfully advanced the CIVO technology into preliminary canine studies in 2009 and human clinical trials in 2012. In both settings, CIVO is currently being optimized to evaluate the efficacy of multiple anti-cancer drugs in the context that matters most: a patient’s living tumor.

During a brief outpatient procedure under sedation, the CIVO device is used to inject minute amounts of multiple anti-cancer drugs through the skin, directly into the patient’s tumor (Figure 1).

Since the injected doses are small, the likelihood of drug-related side effects is very low. This ‘multiplexed micro-dose’ technique is the foundation of the CIVO platform. It allows a simultaneous comparative evaluation of how a patient’s tumor responds to multiple drugs or drug combinations. A special fluorescent marker is co-injected to help visualize the location of each injected drug (Figure 2).

Typically, 24-48 hours after injection, the veterinary surgeon removes the patient’s tumor and transfers it to Presage. Presage then processes the tumor and evaluates the response to the multiple anti-cancer agents (Figure 3).

The Relevance of CIVO™ to Oncology

By directly injecting minute amounts of each drug into a patient’s tumor, CIVO presents little-to-no risk of drug-associated toxicities yet allows for a direct comparison of each drug’s ability to kill tumor cells in an individual patient’s tumor. By applying and optimizing this technology, WOOF for the Cure aims to help fulfill two unmet needs: personalized cancer care and improved cancer drug development. 

A major challenge of personalized cancer care is that each cancer is as unique as the individual it affects. It is therefore critical to understand which drugs are most effective in each patient’s tumor. CIVO may be able to offer invaluable insight into this complex problem. In developing CIVO, Presage intends for this ‘multiplexed micro-dose’ approach to ultimately aid a clinician in selecting drugs that will successfully kill the patient’s cancer while rejecting drugs that cause bad side effects (without killing the cancer).

CIVO may also provide important clinical insight into the development of future cancer therapies. By directly injecting investigational agents into tumors, CIVO seeks to identify which drugs are worthy of clinical pursuit and, equally important, which ones are not.

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