Dr. Wilson-Robles: I think that mentorship is a two-way street. You do have to show that you're willing to work hard and get the work done. You often have to take that first step. Being willing to just say what you don't know, I need help, has been really helpful to open doors. If you have a good connection with someone, even if they're not in your field or in your area, if they've been successful, they probably have lessons they can teach you about what you're trying to do. And so following up with those guys and creating your own mentor-mentee relationships instead of waiting for someone to assign you one. 

Dr. Venable: Welcome to the Veterinary Cancer Pioneers Podcast, the show where we delve into the groundbreaking work of veterinary professionals who are dedicated to advancing the field of veterinary oncology. I'm your host, Dr. Rachel Venable, and I'm thrilled to embark on this journey with you.

Dr. Venable: Welcome to the Veterinary Cancer Pioneers Podcast. I'm your host, Dr. Rachel Venable, and I am so excited today to present our guest, Dr. Heather Wilson Robles, who I'm doing my best to say her last name, but I know some of you are going to chuckle, so. But Dr. Wilson, she has done so much in our profession. She is a veterinary oncologist. She had her veterinary degree at the University of Tennessee, internship at the University of Minnesota and residency at the University of Wisconsin-Madison, so lots of great programs there. She was a faculty at Texas A&M for several years. She was a professor, actually received over $8.1 million in research funding, which I find amazing. She's written all kinds of things, published lots of things, lots of research. Now, actually, she is the chief medical officer for Volition Veterinary Diagnostic, so kind of pivoted now a little bit into industry, but still in clinics. She works for Ethos Discovery and The Oncology Service, and she was also the president of the Veterinary Cancer Society, so also quite the achievement. So Dr. Wilson, I am just amazed at everything you've done and so glad that you're on today. 

Dr. Wilson-Robles: Oh, thank you so much. I'm really excited to sort of share my experiences and be a part of this podcast.

Dr. Venable: Well, thank you. We are definitely excited to hear. And, you know, I like to start kind of at the basics, you know, what got you into veterinary medicine?

Dr. Wilson-Robles: You know, it's a, some parts of it's pretty cliche. Like ever since a little kid, I have loved animals and loved science and was one of those nerdy girls who always liked the science fiction shows. I used to watch all the bad science fiction movies with my dad on Sunday afternoons. And so I think between loving science and biology and loving animals, it was sort of a natural fit. I always knew I wanted to go into medicine of some kind and landed on veterinary medicine. And I think that served me well.

Dr. Venable: I love it. You know, I was also one of those nerdy girls and also with my dad. Watch sci-fi. I don't know what it is about the dads, but yes, kind of the, you know, the old be terrible. 

Dr. Wilson-Robles: Oh, awful. 

Dr. Venable: Yes, absolutely. Right. I think our kids today would be like, What is this? But yes, I was also one of those. Definitely can relate to what got you into veterinary medicine. How about oncology specifically? You know, I feel like it is just a small group of us, but also it is very unique. I mean, I always get when people find out that I'm a veterinary oncologist, they're like, Wow, what, What got you into that? So how about you? What's your story?

Dr. Wilson-Robles: I went to a small Catholic school in Memphis, Tennessee, and they had an agreement with Le Bonheur. And so a lot of the kids who were undergoing cancer treatment could go to that school for free because they had traveled from internationally or wherever. So I was introduced to a lot of kids with cancer as a young person in school. And actually one of my classmates in second grade who lived there and had been going to school with us since kindergarten and developed osteosarcoma. And he was a good friend and he ended up, he passed away two years later, I think, in fourth grade. But just watching that path, watching his family, seeing sort of what they went through, kind of made me even start at a very early age to say, we have got to do better. Like this isn't good enough. You know, how can this happen to someone who's my age? Who's a kid? 

And so I think that was getting my feet wet into it and then getting to know these other kids who are undergoing treatment for leukemia and things like that most of which did very well and were able to go back home, but I think seeing that journey that they took got me very interested in oncology. And for a while, I thought I wanted to be a pediatric oncologist until I actually shadowed in the clinic and realized that it's not for me. And so, I sort of settled on veterinary medicine, and I was just going to go out into general practice, but I met this wonderful man named Alfred Legendre when I was at school at the University of Tennessee, and he just changed my whole perception of the world and what we could do. You know, he just kind of took me aside and said, "I think you need to do this." And so, fortunately, I listened and ended up in veterinary oncology. And I still keep in touch with him today, we are pen pals get to catch up and see him at ACVIM and other meetings whenever I can. But yeah, I think he absolutely changed the course of my path almost single-handedly.

Dr. Venable:  And Dr. Legendre, I've met him a couple times. Super sweet man. That is really interesting that you were able to get quite that mentorship. And is that something other than, I guess kind of how it got you into oncology. How else do you think, 'cause you said you still keep in touch. So is that something that's still helping you throughout maybe your career today or just kind of having that nice guide leadership for you?

Dr. Wilson-Robles: Yeah, I've been really, really blessed and super lucky to have some amazing mentors throughout my entire career. And I think the thing about Dr. Legendre is literally the kindest human being you'll ever meet in your life. He's so patient and while he's brilliant. He's boarded in internal medicine and oncology and I started working with him in research on feline leukemia virus and things on the internal medicine side first but sort of gained my interest in oncology which is kind of the direction he pushed me. On top of just being a career mentor. He's had this great balance in his life and he's managed you know tragedy, and he's managed success and he's managed you know so many of the ups and downs that we all go through with such grace. And so I think having him as that mentor and being able to say, “Hey, here's what I'm going through, what do you think?” And he'll have some great anecdote or story about how he went through it and half the time it's how he didn't handle it the way he thought he should, which is great and the other part of it is how he handled it really well, but he's not afraid to admit where things have been hard, and he's not afraid to admit where things have been successful. And I think definitely continued to be a guide. And so I know a lot of us who graduated from Tennessee sort of see him that way. I don't know how he keeps in touch with all of us. He's just amazing. But yeah, he's been a real joy and a wonderful influence. 

Dr. Venable: And I love how he shares his failures and successes that you can learn so much, right? I feel like we learned so much from our failures, but often we don't necessarily think about sharing that, you know, like how it could affect other people. So that's really cool that he's willing to open up and stay in touch. I love that.

And, you know, you were in academia like he was for quite a while. How do you feel just wearing all the different hats, right? Like from academia and private practice and now industry, how would you, I don't know, just describe how you do that.

Dr. Wilson-Robles: Again, I've been very lucky and have been able to sort of try different things. I feel like my life has been a series of sort of happy accidents. Things have come along and fallen in my lap and I've said, sure, I'll try anything once. Let's see how this goes. And it's been really fun and a good adventure to have. 

And so, you know, academia was a wonderful time. I was at Texas A&M for 15 years really enjoyed that growth that I was able to have there. Through the mentorship people like Dr. Claudia Barton and Kanita Rogers through the trust that group put in me to be a clinician scientist even though I didn't have a PhD to give me a lab to let me do research and those types of things. I think was really great. At the same time, I think there are some limitations to academia that we all run into of frustrations that happen. That's just the nature of being in such a large institution that manages so many different areas of education. 

And so I think being able to branch out from that and spend some time in the industry where the pace is completely different and the goal is completely different. It's about trying to see the big picture instead of the small window of working on this pathway and what happens in this pathway, being able to sort of broaden that, expand that. 

And then being in private practice, the pace certainly is quite different from the pace in academia. I've really enjoyed that. Being able to do research in the nonprofit sector, I sort of feel like I've been able to build the perfect job for myself in that. I can still write grants, I can still write papers, I can still mentor young researchers, I can still do all those things that I loved the most in academia, but I can also see clients and see patients in the clinic. And I can do this in industry, which has given me a much better idea into the inner workings of how we get our drugs, how they get to the market. What happens when this trial doesn't work? How do you manage this? And so I think that has been really an education I hadn't expected and have really enjoyed getting.

Dr. Venable: Yeah, it sounds like you've been able to do a little bit of everything. Like, and even right now still balance and do a little bit of everything. You said the non-profit research. What is the the non-profit area that you're involved with? 

Dr. Wilson-Robles: So I work with Ethos Discovery as well. And so Ethos Discovery is the non-profit arm of the sort of Ethos Vet Health conglomerate. And so I work with Chand Khanna, who I know you interviewed fairly recently. And so I'm the director of research for that group as Chand steps one foot into retirement, not really into retirement, a retirement adjacent maybe. He's still sort of working three days a week and still doing more work than any one person does in an entire seven day week. But as he sort of steps more into that role, I'm trying to step more into the director of research role. And so I get to do so many fun things because I do get to do oncology, but this year I helped write a grant for neurology and for surgery and for other groups as well. And so I get to learn so many new things that I don't think I would have had the opportunity to learn otherwise. And so I still get to do a lot of those things that I really enjoyed. I get to do them differently, maybe with slightly less red tape, which I enjoy very much. And so that part's been good. None of these things would have been possible if it weren't for the 15 years I spent in academia. So I certainly think these build upon each other, it's been really a lot of fun to get into that sector and see how that is slightly different from academia as well.

Dr. Venable: Yeah, and you mentioned all this research that you're getting to do, but you don't have a PhD. You know, often we do think like if you wanna be involved with just R&D and just research kind of in general, you need to have a PhD. So can you walk us through or like, you know, if there are other young vets that are thinking, you know, I like to get into research, but I don't necessarily wanna go back to school for PhD? Like, do you have any tips or can kind of walk us through how that's possible?

Dr. Wilson-Robles: Yeah, I think in veterinary medicine, it is still possible to do. I think there are other areas of science where it isn't. But I think in veterinary medicine, it is still possible to do. And I was fortunate enough that I ended up in a residency in Wisconsin in Madison, where I worked under the Davids. And so we had David Argyle and David Vail. David Vail was the clinician-scientist extraordinaire doing the trials, learning how to run trials in the clinic. David Argyle was more classically trained benchtop researcher, so I was able to be exposed to both of them. And one of the things I loved about their program was you spent almost 100% of that first year on clinics, and you spent about half, maybe 80% of your time in the second year on clinics, but you spent almost all of your third year in the lab. And so instead of doing, you know, running to the lab on the weekends or having a two-week off block where you're like, I have to get this experiment done in two weeks. And that's it. I have months in the lab where I was able to do almost a master's level type research project with David Argyle, with presenting a lab meeting, seeing exactly what that side is. And while it didn't 100% set me up for being able to be a successful researcher, it definitely let me know that this was a path that I wanted to be on, something I really wanted to do and sort of built my love for research that way. 

And then when I was able to get hired on at Texas A&M as faculty, for some reason, they let me have a lab. They gave me a startup and they let me do it. And if I'd known how hard it was at the time, maybe I wouldn't have done it, but I'm glad I did, it was worth the effort and energy and sometimes ignorance is bliss. You just walk in and think, "Sure, I can do this. What's so hard about it?" Turns out lots of things, but if you're going through it, you're already halfway in it, so you might as well just finish it. And so I think once I got the lab set up and going, it was actually really great fun and I learned a ton and there were so many wonderful mentors at Texas A&M who helped me out and helped guide me and would collaborate with me and the things I didn't know how to do, they could do. And so it was actually a ton of fun and was able to do it. 

I would say now, if you're a young veterinarian, if you're a resident and you really have an interest in doing research, but you don't want to do that PhD or it's just not in the cards to do because you have a family and you're already doing this training, I think there are options. We have two genomic fellows with Ethos Discovery who are not PhDs, who are in labs doing amazing research. Some of that will be presented at ACVIM, but they're doing wonderful things. So it is possible, but you have to be sort of open to not say no. Sometimes you have to get into a lab and start working on something that may not be the most interesting thing to you. You're gonna learn how to be a scientist. You're gonna learn how to write a paper, how to write grants, how to review papers, how to understand them. And that's probably the biggest step, that's probably one of the biggest things you learn in a PhD. And so I think it's really important for people to take advantage of those opportunities as they become available and reaching out to people who've done it. So in academia, at Ethos Discovery, places like that, there are opportunities for that. They're not tons, but I don't think there's tons of us who necessarily want to go into research. You don't want to choose this path. 

Dr. Venable: You've mentioned a lot of just the different mentors and things that you've had throughout your career and experience. I feel like also there's probably something that you're doing too that connects you with these mentors. Sometimes I feel like, you know, maybe they're there, but we're not always connecting. So how are you connecting? I'm guessing you're doing something that's also introducing you. How would you recommend for other people as far as getting mentors? You know, that's a big thing they talk about in veterinary any more as having mentorship, whether it's research or in the clinic or what have you, I feel like you're doing something. So what are you doing to help get that mentorship? 

Dr. Wilson-Robles: That's a great question. I think that mentorship is a two-way street. You do have to show that you're willing to work hard and get the work done. You often have to take that first step. One of the things I noticed when I was faculty at Texas A&M is we had this assigned mentor program and that rarely worked out because you just sort of try to assign people with similar interests, but there was no real assessment about personality or how people might work together, things like that. And so sometimes it worked out well, but a lot of times it felt like more of a chore for both the mentee and the mentor to do. 

I think a lot of the mentorship that I have had has happened from like a grassroots situation. So, you know, I think of George E. Lees's who was an internist who worked in Alport syndrome at Texas A&M and had nothing to do with oncology, but that man knew how to work the research system. He knew where to put your grants in, he knew where to do whatever. And his office happened to be next door to mine, and we both really liked coffee. And so between like that, I was able to have a mentorship relationship with him where he guided me through those things just because we would sit and have coffee and I could ask him questions. 

I think some of it too is being willing to just sort of say what you don't know. One of the things that I've always tried to do in my life is just be upfront about I'm not an expert. I don't necessarily know what I'm doing. Sometimes I've fallen into these things and I need help. And so I think being able to go and say, “I have no idea what I'm doing, can you please help me?” It has been really helpful to open doors and maybe, I don't know, people just feel sorry for me, but they've been willing to step in and say, yeah, absolutely, we'll help you get this done or whatever. 

But I think seeking out the help, if you have a good connection with someone, even if they're not in your field or in your area, if they've been successful, they probably have lessons they can teach you about what you're trying to do. And so following up with those guys and creating your own mentor-mentee relationships instead of waiting for someone to assign you one. 

Dr. Venable: I like that. And I also like how you talk about, you have to say what you're not good at or what you need help with. You know, I think that kind of hearkens back to your mentorship with Dr. Legendre, you know, like he's willing to say, I think being open and vulnerable, it just moves the needle, doesn't it? It just helps you have that better connection. And I like that. And I like that mentorship is a two-way street 'cause I think often maybe we're just waiting for someone to come to us, but we just need to be proactive. 

Dr. Wilson-Robles: Yeah, no one's just going to walk up and drop a knowledge bomb on you. Like you're going to have to, you know, go and ask and do the work and say, and sometimes you have to give someone that rough draft of your grant or your paper and just let them shred it. And you just have to know or hope that they're not going to think less of you afterwards. And if they do, then you just have to get them a better draft later. So they think better of you. But I think it's a matter of like you said, sort of being vulnerable and going out and just being like I need help and if I want to be successful and I don't need to be the best today, I just need your help to be better tomorrow.

Dr. Venable: I love that. That's a good one. Be better tomorrow for sure and needing help. I think that's perfect. And I want to kind of switch gears a little bit and dive in. How did you end up connecting with Volition? So you've been actively involved with them, definitely part of the research, and presented the research. So how did that connection happen?

Dr. Wilson-Robles: It's another happy accident that has sort of been the theme of my career, I think. So Volition is first and foremost a human epigenetics company based in Belgium. They had a chief medical officer in the U.S. working on trials for getting the test approved by the FDA here for humans in the U.S. And he happened to be an Aggie and happened to be based in Austin, Texas when I was in Texas A&M. So they had a person on their board who was a veterinarian who had said, you know, and an investor, and he had said, “Have you looked at this in animals? Like it could be a thing in animals too.” And so they reached out to me and said, hey, can we look at this in animals? And I was like, sure, why not? Let's try it. And so we did some initial pilot studies. We validated the antibody that they used for the ELISA and found that histones are conserved across many species and was able to work in birth dogs and humans. And so that's where it started. And then it's just kind of snowballed from there into what's now become the veterinary subsidiary, which is Volition Veterinary.

Dr. Venable: Yeah, and can you describe, 'cause I'm sure some listeners aren't familiar with new cue, which is the animal, the veterinary side. So can you kind of describe how it works?

Dr. Wilson-Robles: Yeah, I think it's a really interesting test because what we are really doing is we're looking at nucleosomes. And nucleosomes are a part of your chromosomal DNA. So if you remember way back to seventh grade when we were learning about DNA and its construction and those things, what you basically had are these histones, right? And they're almost like pearls and you have your DNA wrapped around those histones. So you kind of have this bead and then those beads are further twisted and twisted and that's what makes your chromosomal structure. And the histones sort of provide that support for the DNA. And when a cell dies or when you have massive inflammation, what ends up happening is the cell will sort of release that DNA, sometimes in small fragments, sometimes in giant nets. And so they release that DNA into the bloodstream. And if it's still wrapped around the histones, it's safer in the plasma or in the blood than it if it were just free DNA. So it, and it can actually still affect other pathways, affect other cells nearby, things like that. So what we're doing is we're measuring those nucleosomes, the concentrations in the plasma using a simple ELISA test. What's nice about that is it is a quantitative assessment, but it's cheap and it's easy and it's quick. And so you can run it fairly easily. Now, it's a surrogate for cell-free DNA, really. So any disease that might increase your cell-free DNA is going to increase your nucleosome concentrations. What that means is inflammation, cancer, a lot of those things are going to increase cell death, cell turnover, and therefore increase your cell-free DNA and nucleosomes. So really, I think of the NuQ as a biomarker. It's another tool in our toolbox that's there to sort of help us differentiate maybe a healthy state from a disease state. 

So if you have a six-year-old golden retriever who's walking in, carrying his ball, happy wagging his tail, everything seems fine, but his cell-free DNA levels are high, his nucleosomes are high, there's something going on. In that case, if he otherwise feels good, cancer might be the most likely thing, but it can be other things as well. We had a dog who came in for our healthy studies and was supposed to be one of our normals that we were getting and the NuQ was high and we went back and worked this dog up and she'd been kicked by a cow I guess three weeks beforehand and her liver values were high and she had like a giant hematoma on her liver and I was like well that explains that so it's not always cancer and otherwise she seemed pretty healthy and happy by the time we saw her three weeks later. But fortunately, we were able to manage her liver hematoma without that being an issue. So that was good. But I think it just sort of depends on the circumstance. 

So I think like any test, it doesn't necessarily stand alone as your single diagnostic, but it is a tool in that toolbox to sort of help you differentiate whether this dog is healthy or not. It can also be used to monitor response to therapy. We have a paper that we published, I think in 2023, that looks at monitoring with lymphoma and we have a couple leukemias and things in that group of dogs. I mean, it really does track with the disease. So whether they're in remission or not, you can sort of see those levels kind of go up and down and monitor that response to therapy or sort of predict when they're coming out of remission. So I think it's a useful tool when applied correctly. I think it has a lot of applications even outside of cancer potentially. And so I think it's a cool test. 

Right now it's positioned as a screening test to be used in healthy dogs as a wellness test. So if you're going in for that annual visit and you've got a dog who is either at risk for cancer, we all know those breeds four to six years old or for an older maybe running it. Normal sort of mixed breed dogs like my dog who just turned 16 this week, she just had her new cue run last month and it was low, yay. But for a mixed breed dog like her starting at seven, I think would be good.

Dr. Venable: And you're saying like four and seven because that's when they're at a higher risk of cancer? 

Dr. Wilson-Robles: Just for our at-risk breeds, I think we start to see middle age, so seven to nine is the most common age group for those guys to get cancer. I think we definitely see every day in our practice those goldens, boxers, rottweilers who come in and they're four and five and six years old. So I think maybe starting to screen them a year or two before that risk to kind of jump up starts to make sense. It gives you some sort of context for where they normally sit with the NuQ level so that you can see because you do get a quantitative number changes and be able to use that trend. I think the trend is important. 

Dr. Venable: Yeah and I like how you sort of went through the different ways to use the test. So it sounds like as a screening test for healthy dogs and like you said the whole goal is to catch it before they get cancer. So, you know, doing that sooner and you have a number that you can monitor. So that's interesting. And then monitoring as well. So lymphoma, are you guys looking into other cancers you think for monitoring? Or I guess what's on the horizon research-wise?

Dr. Wilson-Robles: Yeah, yeah, so many things. I'm so glad you asked. So we're working actually with the Ethos Discovery in the push study, which is up to 400 dogs diagnosed with stage 2 hemangiosarcoma, the goal is to get a percentage of those dogs into the different treatment groups and follow them out. So we are collecting samples at diagnosis when they present to the ER, we're getting samples from the hemoabdomen blood samples, and then as they progress through treatment to the point of recurrence, we're getting those samples so that we can hopefully better define monitoring for dogs with hemangiosarcoma. That hopefully will start presenting some of that data, both at ACVIM and VCS this year, so that should be good. But there's some really good information there for Hemangiosarcoma. We're also working with a couple of other groups for some of the carcinomas that are a little harder to detect, things like anal sac carcinomas and those where you're having to do expensive screening tests regularly. I think being able to use a monitoring tool to sort of help guide that is really helpful. 

We're also looking at cats, trying to hopefully see if we can define this test for cats, cats as we know are not small dogs and will always make things harder than it needs to be, but we are working on them. And we're also looking at methylation patterns, cancer in the blood, looking at these nucleosomes, the histones carry a lot of methylation changes that have to do with how the DNA is processed and transcribed. And so we're looking at some of those, there are some trends that are sort of general global changes that happen to the methylation patterns in cancer. And so we're looking at that as well.

Dr. Venable: So would that be more like epigenetic change? Like how your DNA, like maybe the code is one way, but the way it's processed, I don't know if I'm saying this very accurately, but so are you looking at that as another cancer screening or what were you playing on doing with the methylation part?

Dr. Wilson-Robles: Yes, I think there's always this question of, okay, So the NuQ’s high now what do I do? And I think being able to say here's a follow-up test that we can look at is important. I think being able to say okay let's see if we can differentiate cancer from inflammation or you know you have a lymphoma but it's one of the 25% where the NuQ wasn't high from the beginning or a hemangio it's one of the 10 or 15% where the NuQ wasn't high from the beginning but you want to monitor them this may be a way to do that, even if the NuQ isn't high. So there are some opportunities there. The methylation patterns are exactly right. It's not the sequence of the DNA. It's how the DNA is transcribed ultimately. So what genes actually get translated or not, who's turned on, who's turned off, those types of things. You know, in cancer, we see a global hypomethylation that happens across the board, but certain areas of the DNA, the CPG islands where a lot of that transcription is happening are hypermethylated. And so you see the things you don't want turned on, turned on, and the things you don't want turned off, turned off, and so that sort of promotes that overall cancer syndrome that we sort of see. And it does affect the DNA globally. And then you can see as people get better, as they respond to therapies and stuff that they return to a more normal methylation pattern on their DNA. So we'd like to take what we've learned in humans and be able to apply some of that to dogs, and hopefully eventually cats, but dogs are still better annotated than cats and they're nowhere near as well annotated as people. But hopefully, we'll be able to take some of that information and be able to build on the base that we have to help answer that ‘Now, what's next?’ question. 

Dr. Venable: How interesting. I wonder how much that affects just the cancer behavior. Like you mentioned anal sac. Like I find those tumors so so frustrating 'cause there's somewhere it's like, I don't know, is surgery gonna be enough? And then others where it just spreads like wildfire and some of them it spreads, but then it just seems to smolder. Like I feel like it's very unpredictable. I feel like the research we have doesn’t really show when you clinically see some of these guys in practice. I find that would probably be an interesting side note just to learn as you guys get more information, like how does that change the cancer? Is that something else that we need to look at to give us a better sense for treatment and prognosis. So that's really exciting.

Dr. Wilson-Robles: Yeah, I'm excited about it. And I think we're just scratching the surface, not just at volition, but as a profession and what we can do where, you know, we always know we're behind on the human side, but we can catch up faster because we can learn from their successes and failures. And so I think we have a lot of opportunity to really take this to the next level. We have to figure out how to make it affordable, we have to figure out how to make it accessible. I think that's actually not the hardest part of it, and I think we can do it. So I'm excited to see what the next 10 or 20 years bring because I think we are headed into our genetic age of veterinary oncology. 

Dr. Venable: Yeah, I know there are definitely some challenges there, but I'm with you. I think you'll be very exciting to see in 10 years what will this conversation look like. You know, what will we be talking about, and hopefully we'll have something on cats. I love it that you guys are at least trying.

Dr. Wilson-Robles: I'm such a cat mom and it breaks my heart that they're so hard to work with, but one day eventually by sheer force of will, I will make it happen. 

Dr. Venable: I love it. I love it. Now the cat people and also the veterinarians, I feel like I get so many questions about, you know, because it's just so hard to sample and so questions about what do I do? I know this, we should do surgery to sample this, but what else can we do? So they'll be great, you know, if we can get some more tests and things. And, you know, what else, you talking about like Volition and everything you guys are doing, any other testing or research, I know we talked about genetics just in general, anything else on the horizon that you're excited about or maybe worried about?

Dr. Wilson-Robles: I think there's a lot of opportunity. And I had listened to your podcast with Amy LeBlanc and I think she sort of brought some of this up as well. But I think, you know, the idea of we're heading into that genetic age where we are starting to sequence things where we're getting more information about, instead of just calling a tumor by its anatomic site, maybe we start to call tumors by their molecular signature. I think that's gonna be really important, but I think with that comes a responsibility to understand that molecular signature, you know? And so you could take something like a BRAF mutation and in humans with UV-induced melanoma, that's a driving force behind their cancer and a BRAF inhibitor is a successful therapeutic agent for many of those patients. However, you could take the exact same mutation in colon cancer, and when you treat those same patients with a BRAF inhibitor, you actually shorten their survival. And so I think we have to understand what these mutations mean, what these genetic signatures mean. And so we need to find them, but then we need to do the work to understand, does it affect the prognosis? Is this a drugable target or is this a bystander? Is this an important genetic mutation? So I think that's exciting because it just means there's so much more work to be done and a huge opportunity to do it. And I think if we can partner, I think if industry and academia can partner, the nonprofits in academia and industry can partner and put all of our energy and efforts into being able to answer some of these questions, I think we could do it a lot faster. 

One of the things I like about Ethos Discovery that I didn't have in academia is we have 150 specialty practices that we are using to help us get these trials done. There are studies I couldn't even dream about in academia that I can now because it's not about my caseload, it's about our caseload. And so that ends up being a really powerful tool to help answer some of these questions. So I think we need the academicians to help us identify these pathways. And as Amy said, you know, You start with the cells in the petri dish and you go to the mouse and then we get to the dog and all that still has to happen. And then I think there's a place where we can bring in industry and nonprofits who can take it to the next level and we can all work together to push it forward. So I'm excited to see those things happen. I'm excited to see some of this new testing, some of our new ability to understand tumors better on a molecular level. I think that's all really good. 

Another area I'm really excited about is immunotherapy. On the human side we're going to learn just as quickly in dogs as they did in people that it will never probably stand on its own as a single therapy. I think it will always have to be combined with other therapies but I think the fact that we have the opportunity to potentially start to provide some of those immunotherapies to our patients and do it in combination. 

I know at University of Wisconsin Dr. Vail is doing a lot of research immunotherapy with surgery, with chemo, with radiation, and I think there's a lot of opportunity there for those. So I'm excited about a lot of those things. And I think hopefully that will kind of change the way we see oncology, change the way we're doing things. I'm really sick of giving the same lymphoma talk day after day after day. I'd really like to say something else. And so I'm really hoping that we can maybe take this to the next level so that before I retire, I didn't have a different feel for my clients when it comes to things like lymphoma, hemangio, osteo. 

Dr. Venable: Amen. I agree. I would love to change up my talk. The things you pointed out are just great, but also important. I think it is so important how you mentioned the BRAF for one cancer is helpful. The other one, not looking at treatment and I think also like you said, we have to work together because I think sometimes, especially veterinarians, maybe they don't always understand that you need so many pets enrolled in one trial, you need so many patients to really get any meaningful data. These observations of five or 20 dogs, that's really all it is is observations, right? We do stats on it, so it makes us feel better, but the reality is it can be totally different if it was 5,000 dogs. So I do love what you guys are doing at Ethos. And like you said, If we can all work together, then I think we can push that needle. I think if you stay separate islands, you know, it's not going to work. So I think it's great how you're sort of bridging every gap. You're like doing a little bit of everything and bringing it all together. So I love it. Definitely support you. I hope you can continue this amazing work and thank you for all that you're doing.

And as we're wrapping this up, you know, I always like to ask if there's anyone else that you would recommend having on this podcast.

Dr. Wilson-Robles: Oh yeah, well, I've had a wonderful time. Thank you so much for including me. I feel really privileged to be in this amazing list of people that you have interviewed thus far. As far as other people, you know, I think there's a few that would be really great. One person that I think doesn't always make the radar who has really had a tremendous career is Kanita Rogers. She is a veterinary oncologist who was also an associate dean at Texas A&M but is now retired from that but she goes around the country and even internationally and speaks on conflict management and she does mediation training and DEI workshops and things like that and she's just a wealth of knowledge and a resource and I think her experience in her career has been really interesting and unique so I think she's a great person. Of course, I think Cheryl London, Heather Gardner, these guys are really you know pushing the envelope and coming up with some amazing things on the genomic side of things. I also think if we think about David Vail who's had a very storied career and has done some really amazing things as far as bringing clinical trials into the vet clinic, but also expanding that One Health Dogs as a model for disease. I think he's been instrumental in that. I know those are a few I can think of off the top of my head.

Dr. Venable: Well, those are great. We will definitely reach out to them. Thank you so much. And again, thank you so much for being on the podcast. I feel like our listeners can learn so much. I know I've learned so much. And again, I love what you're doing and continuing to enjoy. I'll wait for all your research you're gonna present. Always excited to see what you have coming up.

Dr. Wilson-Robles: Well, thank you so much. This is lovely. Thank you for everything you do for the veterinary oncology profession as well.

Dr. Venable: Well, that's it for this episode of the Veterinary Cancer Pioneers podcast. If you enjoyed this episode and gained valuable insight, we would be so grateful if you could share our podcast with your friends and colleagues. And it would be even more wonderful if you want to give us a five-star rating, positive review, or any kind of feedback on Apple Podcasts or wherever you listen. The Veterinary Cancer Pioneers Podcast is presented to you by ImpriMed.