---
title: "Osteosarcoma Case Study: Jade"
description: With a combination approach that included FidoCure® therapy, Jade is alive and well 2 years after her initial diagnosis of osteosarcoma.
image: https://blog.fidocure.com/hubfs/Jade.jpg
---
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# Osteosarcoma Case Study: Jade
[Dr. Dorothy Jackson Girimonte](https://blog.fidocure.com/fidocure-blog/author/dr-dorothy-jackson-girimonte)
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#### With a combination approach that included FidoCure® therapy, Jade is alive and well 2 years after her initial diagnosis of osteosarcoma.
#### History and Initial Therapy
Jade Joseph, a 10-year-old female spayed, Doberman Pinscher, developed an acute lameness of her left forelimb in February 2021. Radiographs showed a mixed osseous lesion of the left distal ulna. Cytology of the lesion was diagnostic for a sarcoma with osteosarcoma being the top differential based on the presence of osteoclasts.
Jade’s parents did not want to pursue amputation, so she received radiation therapy to help control her pain. This was followed by a course of 6 doses of Carboplatin. Jade’s family wanted to pursue additional targeted therapy, so they contacted FidoCure®.
#### FidoCure® Analysis
Jade was enrolled as a therapy only case in July 2021. Therapy recommendations were made based on other osteosarcoma cases we have sequenced as well as data available in both the human and veterinary literature. Mutations felt to have therapeutic implications for osteosarcoma include DMD, P53, PTEN, and SETD2.
DMD is a gene that encodes the protein dystrophin which primarily functions in the stability and structure of muscle cells/fibers. Mutations in this gene have been most commonly associated with Duchenne muscular dystrophy in humans. More recent research has identified a potential role for DMD as a tumor suppressor in human malignancies such as rhabdomyosarcoma. Interestingly, recurrent aberrations in the DMD gene have been identified in canine osteosarcoma. The majority were identified as structural variants including copy number loss and translocation while a small number of single nucleotide variants were also identified. The tyrosine kinase inhibitor, dasatinib, has been identified as a potential therapeutic agent in the setting of DMD mutant disease.
TP53 encodes a protein called tumor protein p53 which has become one of the most well published tumor suppressor genes in human and canine cancer. This protein helps to regulate cell growth and damaged cells by controlling signals for pausing the cell cycle and cell death. Phosphatase and tensin homolog (PTEN) is a tumor suppressor frequently altered in various human cancers, and alterations have been identified in canine malignancies. The normal function of PTEN is negative regulation of the AKT/PI3K/mTOR cellular growth pathway. Targeting this mutation using mTOR inhibitors has decreased its effect as a driver of canine cancer.
SETD2 is a gene that encodes a lysine methyltransferase which has been described for tumor suppressor properties in human cancer literature. Mutations in SETD2 contribute to epigenetic regulation and interact with or modify the activity of histone deacetylases (HDAC).
#### FidoCure® Treatment
DMD mutations, found in 50% of cases, are common in canine osteosarcoma. Based on this, it was decided to start Jade on Dasatinib at a 0.5 mg/kg every other day dose in July 2021. She had occasional nausea after starting this new therapy but was otherwise doing well. Her nausea was well controlled with Cerenia. Jade also received monthly Zoledronate infusions to help with pain control.
At her recheck in June 2022, her forelimb pain had worsened. There was no evidence of disease progression or metastasis on repeat imaging, so her pain was thought to be due to microfractures. In addition to her monthly Zoledronate infusions, she received Gabapentin, Tramadol, Tylenol, and Amantadine.
Jade’s left forelimb became more painful and swollen over several days ultimately requiring an amputation in early December 2022. Her local lymph nodes were removed at that time as well. Biopsy did not reveal any evidence of cancer recurrence, and the swelling was considered a delayed side effect of radiation therapy.
Her CT scan at the time of amputation showed a solitary nodule in her right cranial lung lobe. Follow-up PET scan confirmed that to be the only evidence of metastasis. Jade is scheduled to have the lung mass removed in early February. Jade continues to receive Dasatinib, but this may be adjusted pending FidoCure® genomic sequencing of the new lung nodule.
#### Conclusion
On a combined treatment plan that did not include amputation, Jade has done well for 2 years following her initial diagnosis of osteosarcoma. This is double the reported median survival time of 1 year for dogs historically treated with amputation and injectable chemotherapy.
#### Thoughts from Dr. Richard Joseph, a veterinary neurologist in New York, and one of Jade’s pet parents:
> “...really pleased and love the philosophy of the safe drugs they can take for life…it is phenomenal.”
#### Dr. Dorothy Jackson Girimonte
Dr. Dorothy Jackson Girimonte DVM, Diplomate ACVIM (Oncology), CVA Board certified in Medical Oncology 2015
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**FidoCure® is an advanced cancer-care service for dogs, developed by One Health Company**. DISCLAIMER: All patients are enrolled in FidoCure® by a veterinarian with a valid veterinarian-client-patient relationship (VCPR). We use best efforts to inform the veterinarian on available targeted therapy options for patients. FidoCure® does not prescribe therapy. The targeted therapies that veterinarians may prescribe and order from compounding pharmacies, after receiving genetic test results from FidoCure®, may constitute extra-label uses of those drugs. FidoCure® makes no claims that every patient will have genetic test results that lead to targeted therapy options. FidoCure® makes no claims or guarantees about the effectiveness of the diagnostic and targeted therapy selected by the veterinarian for an individual patient. Like most cancer care approaches, the services provided by FidoCure® are not a guarantee of a cure. FidoCure® is not a pharmacy and does not supply drugs directly. By ordering any medication via one of our pharmacy partners, you agree that the pharmacy, not FidoCure®, is solely responsible and liable for any and all issues relating to the preparation, dispensation and fulfillment of the medication. The lifetime offer is subject to the commercially reasonable availability of any medication(s) and/or active pharmaceutical ingredient(s) necessary for the selected therapy.
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