The One Health Company
by	Jorge Conde
There are more than 90 million pet dogs in the United States. Every year, approximately six million of them will be diagnosed with some form of cancer and, sadly, many will succumb to the disease. Cancer, at its most basic level, is a disease of DNA. When you think about the fact that dogs share their living environment with humans (including many unhealthy lifestyle and environmental factors) plus the fact that many breeds have been heavily interbred for generations leading to numerous deleterious genetic predispositions, it's probably not surprising that cancer is by far the #1 killer of our most faithful companions. So even though pets bring their families immeasurable love and joy, when you sign up for being a pet parent, a lot of the time you also sign up for helping your dog deal with cancer during their lifetime.
The best dog in the history of the world, according to the author.
Dogs, of course, cannot easily communicate when they're not feeling well. This means most are diagnosed with cancer at a fairly advanced stage of disease — when a pet groomer finds a lump, or an owner notices excessive bleeding or the sudden onset of noticeable behavioral changes. Once diagnosed, veterinary practice today offers limited treatment options. If treated at all, pet owners will spend by some estimates an average of $6,700 — usually out of their own pocket — for their dog to receive a standard chemotherapy regimen that attacks rapidly-dividing cells (e.g., cancer and healthy cells alike) and that may not be particularly effective against certain tumors. As owners come to the painful and too common conclusion that there's little that can be done, many dogs with advanced cancer will simply be euthanized. Either way, a cancer diagnosis is currently more often than not a near-term death sentence for our beloved pets.
And yet our collective understanding of human cancer has advanced dramatically over the last decades. Radiation and chemotherapy remain powerful weapons to rein in out-of-control cancer cells, but they are blunt tools. Genomic analysis has given us the ability to analyze tumor DNA, increasingly shifting the characterization of cancer away from its organ-of-origin (i.e., "it's a lung cancer") to its mutation-of-origin ("it's an EGFR mutation positive cancer"). The genomic era has recently unleashed a wave of innovative precision therapies designed to target specific mutations and other genetic drivers of cancer. Foundation Medicine, recently acquired by Roche for $2.4 billion, helped pioneer the use of unique genetic changes in a patient's own cancer to inform that patient's care and match them with relevant targeted therapies. Advances in immuno-oncology — such as PD-1 and PDL-1 checkpoint inhibitor molecules and engineered CAR-T cells that work to activate and recruit a patient's own immune system to join in on the fight against its oncological invader — have demonstrated astonishing remission rates and, in some cases, cures.
What does this have to do with cancer in dogs? It turns out that there is a striking similarity between certain human and canine cancers. Studies have shown conserved biological pathways and common mutational drivers among the two species. Cancers in dogs also resemble human disease with respect to clinical symptoms, cellular changes, and perhaps most importantly, response and resistance to therapy. In other words, even though we look very different, humans and dogs have co-evolved together, and cancer is created and progresses in very similar ways between us and them. What's more, unlike other experimental animal models (like mice), where the disease often has to be induced or engineered artificially to "replicate" the human version of the disease and can therefore be a very poor predictor of what will actually happen in humans, cancer commonly emerges spontaneously in dogs — just like it does in humans.
Given these similarities, dogs are increasingly used as a preclinical experimental model to help test cancer drug candidates before initiating human clinical trials. But this doesn't have to be a one-way street, the way much pharmaceutical testing on animals is. Odds are that many of the cutting-edge precision medicines used to treat human cancer patients today were already shown to be safe and active against cancer in dogs. Which means that we can potentially take the latest human cancer therapeutics — therapeutics which have recently improved by leaps and bounds — and reimagine how we care for our sick dogs.
I'm thrilled to announce that the a16z bio fund is leading the seed investment in the One Health Company. This is the future of veterinary care and cancer research, where both pets and people will benefit from each other. One Health provides dogs with access to cutting-edge cancer treatments and, in doing so, will generate data and insights to contribute to the future development of better human therapies that are more likely to succeed.
At a16z, we seek founders that have traversed the idea maze and have emerged with an earned secret. One Health co-founder Christina Lopes has financed rapidly growing businesses creating new categories across emerging markets. She has worked to ensure healthcare access to women here in the United States and, after she lost her father to terminal lung cancer, she embarked on a personal mission to ensure broader access for advanced cancer care. Former U.S. Olympian and company co-founder Benjamin Lewis endured multiple human clinical trials himself to help recover from injuries. As a bioengineer-turned-veterinary-school-dropout and pet parent that lost a dog to cancer, Ben was concerned that the state of the science in cancer diverged so dramatically from standard of care in veterinary oncology. A former CEO of one of the largest distributors of pet and veterinary supplies in Brazil, he also recognized the enormous market potential for better pet care. And so this wife-and-husband team together founded the One Health Company, with the vision that cancer-afflicted dogs could be used for better preclinical testing for emerging human therapies — while at the same time providing pets with highly beneficial cutting-edge therapies to improve their wellness.
One Health's flagship offering, FidoCure, allows pet parents to purchase a detailed treatment plan through their veterinarian that includes an in-depth report summarizing genetic testing results of the dog's cancer, along with an individualized treatment recommendation based on the latest cancer research to help inform the veterinarian as to how best to treat that dog's specific cancer. There is already anecdotal evidence that identifying a dog's cancer and matching it to advanced therapeutic approaches can have a very meaningful impact on these dogs and their human families. And the offering will only improve: dogs will benefit as the company generates data and experience from matching targeted therapies with specific genomic drivers.
Many of the most exciting technology companies are based on two-sided marketplaces with mutually-reinforcing network effects. In other words, they have more than one product serving more than one customer base, where each product is improved and each customer segment benefits from the presence of the other. Given the deep connection between cancer in dogs and cancer in humans, the long-term longitudinal data the company generates over time will also benefit human oncology researchers and drug developers. Think Flatiron, but dogs. Flatiron Health — recently acquired by Roche for nearly $2 billion — created a technology platform that enabled researchers to learn directly from the experiences of cancer patients, generating an important source of new knowledge. Amy Abernathy, Flatiron's Chief Medical and Scientific Officer and recently-named FDA deputy commissioner, was a founding advisor to One Health. One Health's longitudinal dataset has the same potential to augment human data, even with some additional advantages (such as the ability to rapidly iterate on novel combination therapies) and without some of the limitations (there's no doggy HIPAA.) And to the extent that this creates new frontiers for cancer research, dogs will in turn benefit from next-generation targeted therapeutics for human cancers.
To the lucky, we say "every dog has its day." One Health is working to ensure that those unlucky enough to be touched by cancer have many more days too.
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