Abstract
A week after the first participants began enrolling in the million-person “All of Us” research cohort piece of the NIH’s Precision Medicine Initiative, Quest Diagnostics laid groundwork for launching its own personalized treatment effort in Texas, focused on cancer.
The company has put the first pieces of this vision in place via its planned acquisition of two laboratory businesses in Lewisville, TX—med fusion and ClearPoint Diagnostic Laboratories. The labs are envisioned as the first pieces of a new Precision Oncology Center of Excellence, through which Quest can provide cancer precision medicine diagnostic services in the Southwest. The center is designed to provide a range of advanced services, such as molecular infectious disease testing and specialized pathology, for providers and patients within its region of the country.
Quest says the network is a response to several trends. First, community oncologists deliver 70% of the nation’s cancer care, according to the Community Oncology Alliance, a non-profit that advocates for community oncology practices and their patients. Second, the number of people diagnosed with cancer each year, and who are living with the disease, is increasing. Tied to this is an increasing number of genomic discoveries and FDA–approved precision medicine therapies.
A histopathologist prepares a sample for analysis.
In addition, the FDA has signaled a significant shift in cancer characterization and treatment through its approval in May of Merck & Co.’s cancer immunotherapy Keytruda (pembrolizumab) as a treatment for adults and children with unresectable or metastatic solid tumors that express either microsatellite instability-high (MSIH) or mismatch repair deficient biomarkers, regardless of tumor location.
“Our approach aims to address these dynamics by standardizing and simplifying precision medicine diagnostics for cancer,” Wendy H. Bost, Quest Diagnostics senior director, corporate communications, said. “Building off the med fusion model, we aim to create services for specific cancers that are evidence– and guideline–based and available within the care pathway.”
A physician treating a patient for a certain type of cancer would have access, Bost said, to an appropriate test based on that patient’s cancer type and disease stage within the electronic health record. “It is a way to simplify an area of medicine that is inherently complex in order to improve clarity, confidence and quality,” she said.
Addressing Hurdles for Oncologists
Lori Brisbin, med fusion’s chief commercial officer and head of product development, said the new center of excellence is designed to address two hurdles in providing state-ofthe-art cancer diagnostic services to community oncologists:having nationwide commercial service and support, and staying abreast of advances and innovations in precision medicine.
“Quest has a strong commercial presence throughout the country and is adept at providing services, including logistics, account management, and support throughout the country. The partnership with Quest will allow med fusion to grow our concierge precision medicine service to a nationwide scale,” Brisbin added. “In addition, the investment in the Precision Medicine Oncology Center of Excellence will allow for investment in state of the art technologies and tools to ensure the service offering continues to advance as new information and capabilities become available.”
A scientist processes samples for next-generation sequencing. Quest is acquiring two labs in Texas to launch a center of excellence in precision medicine diagnostics for cancer.
med fusion and ClearPoint are being acquired from co-owners that include Baylor Scott & White Health (BSWH), Texas’ largest not-for-profit health care system; The US Oncology Network (The Network), supported by McKesson Specialty Health, a division of McKesson Corp.; Texas Oncology; and Pathologists Bio-Medical Laboratories (PBM).
Upon completion of the transaction, expected in the third quarter, Quest will become a preferred provider of advanced oncology diagnostics for The Network, including its Texas Oncology affiliate. The Network consists of more than 400 locations across the U.S., with more than 1,400 independent, community-based physicians, including the 420-plus physicians of Texas Oncology.
The Precision Oncology Center of Excellence would be Quest’s fifth center of excellence nationwide. Athena Diagnostics, Quest’s neurological and rare disease business, is based at its Center of Excellence in Marlborough, MA. Full-service labs at the centers in San Juan Capistrano, CA, and Chantilly, VA, provide advanced services such as next-generation sequencing for inherited cancer screening and mass spectrometry for endocrinology. And the center in Valencia, CA, features a specialized lab focused on prescription drug monitoring and nephrology. Quest also operates full-service labs in Houston and Irving, TX.
Advanced Diagnostics Services
Quest said it will provide diagnostics services that include tumor sequencing and other genomic and pathology testing through which oncologists select and monitor treatment and predict disease progression. Quest’s preferred provider relationship will not include testing for inherited genetic conditions typically offered by non-oncologists, such as for BRCA breast cancer screening.
However, Quest will be a preferred provider of a full range of inpatient and outpatient diagnostic services for 12 North Texas hospitals of BSWH, formed in 2013 from the merger of Baylor Health Care System and Scott & White Healthcare. The services will be offered from the center of excellence site in Lewisville upon close of the transaction. Quest and PBM will also have a preferred provider relationship for several services once the deal is completed.
Following the closing of the transaction, Quest Diagnostics will collaborate with McKesson Specialty Health, The Network, and Texas Oncology on developing standardized, evidence-based services for guiding treatment decisions within the providers’ electronic medical record and care plan workflow, through a model applied by med fusion.
med fusion and Quest both have broad in-network coverage with most third-party commercial payers, Brisbin and Bost noted.
“We are in early stages of planning our transition, but we believe the standardized, evidence– and guideline–based approach to precision medicine diagnostics envisioned for this relationship may be appealing to health plans.
Added Bost: “Quest’s goal is to develop and grow from the foundation created by med fusion-Clear-Point. We are in early phases of this transaction, but over time we expect to consider ways to infuse new resources and energy into their approach to take it to the next level.”