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Brian Flesner, DVM, MS, DACVIM

MU Veterinary Oncologist Advancing One Health with Novel Bone Cancer Treatment for Dogs

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Few people realize that what is good for man’s best friend can also be good for mankind. Dr. Brian Flesner, an Assistant Professor of Oncology at the University of Missouri College of Veterinary Medicine, focuses on healing companion animals diagnosed with osteosarcoma. By using immunotherapy instead of chemotherapy, Flesner targets a translational approach and aims to prolong his patients’ lives while also improving their quality of life.

Flesner and his team focus their attention on bone cancer but with a One Health approach. One Health strives to achieve optimal health outcomes by recognizing the interconnection between people, animals, plants, and their shared environment. Because this disease and currently available treatments for dogs are remarkably similar to those in humans and treatments available for people, Flesner has the rare opportunity to improve outcomes for both patient populations.

The most promising research results have come from a collaboration by Flesner and Dr. Jeffrey Bryan at the University of Missouri with Elias Animal Health. Using ELIAS Cancer Immunotherapy (ECI™), a tumor is surgically removed, manipulated outside the body, and returned as an adoptive cellular therapy, like a vaccine. This results in the immune system responding with T-cells to attack the new foreign material. These T-cells can then be combined with a different type of immunotherapy to stimulate a response against bone cancer.

This treatment approach already has exciting results, specifically in dogs. Historically, the success of chemotherapy has plateaued at around a one-year survival rate after treatment. With post-surgical immunotherapy, the dogs treated by Flesner and his team are averaging 415 days, with a third of them surviving more than two years. “We are not saying that immunotherapy is superior to chemotherapy at this point, but it doesn’t look like it’s worse. The promising aspect of it is, that without chemotherapy, we have elongated a lot of dogs’ survival times, which is truly novel. No one else has done that,” Flesner said.

The biggest translational opportunity for people is in the treatment of osteosarcoma, the most common bone cancer in young adults and adolescents. For approximately 30% of patients, the existing treatment options of surgery and chemotherapy do not stop the disease from progressing. “We still have children that are having disease progression and are dying from this cancer, so if successful, we would have the opportunity to give them back full lives,” Flesner said, “We use the same medications often for dogs as we would use for a person, everybody is aligned, and I think that One Health is something that we really need to focus on.”

Flesner grew up on a beef cattle farm in Illinois and had an affinity for livestock and wildlife. “My mother would get on me because I would go fishing and return with salamanders, turtles, and fish. Then, I would put them in my kid pool. I thought for a long time I would be a veterinarian,” Flesner said. He went to Veterinary School at the University of Illinois to focus on bovine health but wasn’t satisfied with herd health as opposed to individual medicine. During his third year of Veterinary School, both of his grandfathers were diagnosed with colon cancer, and a friend was diagnosed with lymphoma. This sparked an interest in cancer similarities between species.

MU has a strong clinical trial footprint with ongoing efforts to work with other regional institutions. “We are really set up to lead the way,” Flesner said. “Our clinical trials draw people from all over the country.” Flesner was recruited to MU by his mentor, Dr. Carolyn Henry, who established the Oncology Service at MU’s Veterinary Health Center. She is now the Dean of Veterinary Medicine, which employs most of the veterinary oncologists in the state. “Dean Henry strongly advocates for One Health research and is the reason I am happily stuck at MU,” Flesner said.

The value of One Health and translational medical treatment cannot be understated. Taking advantage of the disease similarities in humans and animals with bone cancer will improve the quality of life in dogs and their two-legged friends.

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