Any vet with experience with canine cancers knows that they can be very difficult to treat. Not only are there a wide range of different possible cancers, but even the same cancer across different dogs of different breeds – or even the same breed – can respond differently to the same treatments. This complexity is part of why so many treatments end up being ways to throw pred at the problem and hope.
Fortunately, veterinary care in the last ten years has been advancing quite rapidly, and a variety of novel treatment options are hitting the market. Moreover, better diagnostic and predictive tools are also being developed, with promising results.
This brings us to ImpriMed. What is it, how does it work, and how can you fit it into your veterinary care plans? Read on for our analysis.
Disclaimer: We're not affiliated with ImpriMed, and we don't benefit from you using their service. We're just vets who want to help you provide the best possible care for your patients, and that means evaluating and discussing any and every option on the market.
What is ImpriMed?
ImpriMed is a company that provides tumor cell testing and evaluation to help develop a customized, ideally much more effective, targeted treatment for canine lymphoma/leukemia.
If you're a veterinary oncologist and you're already familiar with this, feel free to skip ahead.
With traditional canine cancer treatment, the first step is diagnosis. Identifying the kind of cancer – Sarcoma, Mast Cell Carcinoma, Melanoma, Lymphoma, etc. – is critically important. Tumors of all types can appear on a dog, and identifying what they are and whether or not they're malignant guides the treatment plan.
At this point, traditionally, the vet will assess what kind of treatments are available. The location, size, staging, and other attributes of the tumor are assessed. Sometimes, surgery is viable. Other times, treatments like radiation, chemotherapy, and multi-agent therapies like CHOP are used.
Unfortunately, not all dogs respond the same way to treatment, even if they're the same breed as another dog with the same cancer. The same is true of people and other animals as well, of course, but there are many more treatment options available for people than there are for dogs.
Variations in genetics, immune response, overall health and complicating factors, and more can all impact how well a cancer treatment can work. Many of these variables cannot be controlled.
Therefore, traditional veterinary cancer treatments involve a lot of trial and error. Years of study and aggregate data have developed things like the CHOP protocol as a mixture of drugs and treatments that have the greatest baseline chance of working. But this is a lot like the classic "if all you have is a hammer, every problem looks like a nail" scenario. All too often, vets have to rely on these generic protocols, as a lack of information, experience, or details means nothing more tailored can be used.
This is where ImpriMed comes into play. What is ImpriMed?
ImpriMed is a company that provides tumor cell testing and evaluation to help develop a customized, ideally much more effective, targeted treatment for canine cancer. They help you skip the trial and error and present you with a treatment option that might be more likely to be effective out of the gate to address cancer faster and more effectively than the usual trial and error process.
How Does ImpriMed Work?
ImpriMed is actually a fairly simple process, at least as far as you are concerned as the vet in question.
When you have a patient come in with a tumor, you will take steps to identify what the tumor is. If the tumor is suspicious for cancer – that is, not obviously something benign like a cyst – you take samples via fine needle aspiration and biopsy. These samples are sent off to pathology for evaluation. Various processes are used to then identify what kind of tumor and cancer is involved.
Under normal circumstances, once you know the type of cancer, you then pursue the standard treatment option recommended for that cancer and that breed of dog. You try it, you see how the dog responds, you adjust based on that response, and hopefully, you find a way to put the cancer into remission before the worst happens.
With ImpriMed, you take a slightly different approach.
Once canine lymphoma or leukemia has been diagnosed, you take more samples of the tumor and send them to ImpriMed. What does ImpriMed do with them? They test them against a variety of common and uncommon lymphoma treatments. Using live, actual cells from real, actual tumors (rather than generalizations from breed, cancer, and other factors), these tests can ideally identify which treatments are most likely to work and which ones should be avoided.
At the same time, ImpriMed uses machine learning – what they call Artificial Intelligence, though it doesn't share much in common with the current big trending AI machines like GPT – to make predictions about other classes of drugs, based on various factors, including the results of the live testing. This allows them to analyze and predict how a drug may perform much more quickly than if they had to perform a bunch of individual testing.
Within 3-7 days, ImpriMed performs these tests and their AI evaluation and sends you (the vet) a report. This report includes information on what drugs performed in what ways and recommends the predicted most effective treatment plan.
"The predictions include estimates of both (1) the likelihood of a positive clinical response (partial response/ complete remission) to individual anticancer drugs and (2) the likelihood of complete remission after 1 or 2 cycles of CHOP therapy, and the likelihood of early relapse after a successful CHOP regimen." – ImpriMed FAQ.
From there, you and your patient determine the available treatment options, which can include:
The recommended treatment.
Different treatments, subject to the availability of drugs.
Alternative options, subject to price limitations.
Options to refer your patient to a more specialized practice if you can't administer the recommended treatment.
You decide on a treatment, you administer the treatment (or refer the patient to a specialist who can), and you see how it goes.
Unfortunately, there are never guarantees in medical treatment; ImpriMed's goal is to try and predict the efficacy of treatment. It doesn't guarantee remission or cure.
What Are the Drawbacks and Limitations of ImpriMed?
ImpriMed is an impressive use of technology to improve outcomes for dogs with lymphoma or leukemia, but it's not perfect because nothing in life ever is. There are a couple of noteworthy drawbacks you should know before you invest in ImpriMed.
The first is that, as much information, technology, machine learning, and experience that ImpriMed has, it's not a guarantee. It might help improve the chances of positive outcomes for patients, but it can't guarantee remission. It's one more diagnostic tool in your arsenal. If you're a veterinary oncologist, the information it provides might be helpful. If you're a general practitioner or specialist in another kind of veterinary care, you may still benefit from referring the patient to a specialist instead of relying only on ImpriMed to help you make decisions.
The second is that ImpriMed is (currently) limited to dogs. As a vet, you see a variety of different kinds of patients, and pretty much any living thing has the potential to get cancer. Sadly for our feline friends, ImpriMed does not offer a similar service for cats.
Note: This may be changing eventually. ImpriMed offers a genetic profiling option for cats, which, while it doesn't have the full drug testing and recommendation system that their service for dogs does, is likely a way for them to harvest information to train their machine learning models on cats and build out a similar service.
The third is that ImpriMed only works with blood cancers like lymphoma and leukemia. Other kinds of cancers, like melanomas or sarcomas, aren't available for this consultation. Blood cancers are quite common in dogs, especially older dogs, so it's not like ImpriMed is a very niche service – you can still get a lot of value out of them – but it won't help you with every single cancer patient you have.
Finally, ImpriMed only tests across thirteen of the most common treatment drugs for blood cancers. They are Doxorubicin, Cyclophosphamide, Vincristine, Vinblastine, Prednisone, Rabacfosadine (Tanovea), L-Asparaginase, Lomustine, Mitoxantrone, Mechlorethamine, Dexamethasone, Chlorambucil, and Melphalan. While the company may add more drugs over time, these are the current options.
How Much Does ImpriMed Cost?
Pricing varies depending on a lot of different factors, including what level of diagnostic package you want to order from the company.
They offer:
MultiDrug Sensitivity Genotyping (Both stand-alone and as an add-on to other packages.)
PARR (PCR for Antigen Receptor Rearrangements) tests.
Flow Cytometry tests.
Immunoprofiles combining PARR and Flow Cytometry.
A full prediction profile combining the Immunoprofile with their AI/ML prediction system.
If you're interested in requesting a price sheet, you can fill out a form to submit here.
Are There Alternatives to ImpriMed?
Of course. While ImpriMed specializes in canine lymphoma and leukemia, other companies and technologies offer broader or different specialties.
For example, another use of modern technology is the Yale EGFR/HER2 vaccine. This takes things a step further than ImpriMed; rather than providing predictions for standard cancer drugs, they are working to create a specific vaccine for certain kinds of cancers. Where ImpriMed targets blood cancers, the Yale vaccine targets osteosarcoma, hemangiosarcoma, and transitional cell carcinomas, for now. It's another example of how modern technology is being leveraged for canine cancer care.
Another example is Torigen. Torigen is a sort of combination of the two aforementioned services. You can send a biopsy for a histopathology report identifying a cancer and then excise a larger sample of the tumor to send in. They then develop a customized vaccine for that specific cancer in that specific dog, which can be administered to train their immune system to fight it. It's a relatively new adaptation of a technology that is still being explored in human medicine, and it shows a lot of promise as a cancer treatment for the future.
More comparable examples to ImpriMed are FidoCure and Vidium. These two services, which are generally similar in function, allow you to send a biopsy or tumor excision to them for sequencing. They perform tests to identify the specific cancer and offer additional testing and predictive modeling to identify the cancer drugs most likely to work.
FidoCure and Vidium both differ from ImpriMed in two key ways. The first is that they have a much broader base of options; rather than being restricted to just blood cancers, they can analyze any canine cancer and predict how it may respond to different kinds of treatment. They also use a lot less machine learning and AI and more standard statistical models and predictions, so it may not be quite as tailored to the individual dog as ImpriMed's recommendations.
This is only scratching the surface, as well. Veterinary care is currently seeing a bit of a renaissance when it comes to novel treatments and new technologies, as computing power is increasingly leveraged to expand our options. At the same time, an ever-increasing amount of money and attention is being poured into cancer treatments of all kinds and pet care of all kinds, leading to a growing and thriving market of alternative options.
Finally, you have us. At Hope Vet, we specialize in a variety of common canine and feline problems. Whether it's cancer and oncology, dermatology, neurology, internal medicine, or emergency/critical care, our experienced vets are on call and available for consultations. We work with general practitioners to provide expertise where you don't have access to it and to provide second opinions for patients who want them for their own peace of mind.
If you're interested in more information on our services or you want to request a consult, you can click the "request a consult" button above or email us at consults@hopevetspecialtyservices.com. We're always standing by to discuss your needs.