Hello, everyone. This is Erica Spicer Mason with
Becker's Healthcare. Thank you so much for tuning
into the Becker's Healthcare podcast series today.
So today, we're going to talk about how
health systems are reshaping clinical decision making by
turning molecular data into actionable care.
And joining me for this conversation is Solomon
Moskovich,
the president of clinical diagnostics
at Natera.
Solomon, welcome to the podcast. It's so great
to have you with us today.
Thank you. It's great to be here. Well,
I'm excited to learn more about what's going
on at Natera. And before we get into
that conversation, I wanted to just learn a
little bit more about you and your work
in health care.
Really feel free to share whatever you think
will be helpful for our listeners to know.
Wonderful. Yeah. First, I wanna introduce the company,
and I can talk about myself briefly.
Natera has been around for about twenty years,
started by
engineers out of Stanford University
and MIT,
and the company has developed unique and patented
technology for analyzing
DNA
from blood.
And, we've had an incredible impact
now applying our technologies to improve care for
pregnant women, for people with cancer,
and for people with organ transplants
and chronic kidney disease.
We, have a a very significant pipeline to
expand the applications for our technologies,
And, I'm very proud that we're serving millions
of patients every year,
and and their physicians. These are medical tests
ordered by by physicians.
Myself,
I've been at the company for almost fifteen
years,
got a background in mathematics,
and,
I'm very passionate about the impact that our
technologies have on patients, including many in my
own family. So I'm really glad to be
here.
It's great to have you with us, Solomon,
and I appreciate the overview
about Natera and learning a little bit more
about you as well. And it sounds like
the company really is overseeing,
this technology that's helping a number of conditions
and and really important
conditions for hospitals and health systems when we're
talking about, of course, pregnancy, cancer, chronic kidney
disease.
So excited to get some of your insights
on that. But I wanted to start a
little bit high level and acknowledge
that precision medicine, it it's evolved rapidly
in the last decade. I I feel like
every year we hear more about really impressive
advancements in this field. So from your perspective,
what are the most important advancements in in
how we identify disease status and guide care?
Yeah. This field has, has evolved so quickly.
It's a very, very exciting time to be
in
genetics and genetic medicine,
and precision
medicine. So,
you know, the
the prior ten years, I think, were full
of discoveries,
about what you could do with information,
genomic profiling information from a
tumor sample from a patient with cancer.
And that led to really growth of the
whole concept of precision oncology.
If you find a certain mutation in a
gene in the patient's cancer, that might
that might, mean that the patient is likely
to benefit from a targeted therapy,
for example, and there's just been an explosion
of different gene linked therapies,
from multiple different biopharma companies, which have made
a huge impact on on patient survival.
There's also been the introduction of immunotherapies
and immuno oncology,
unleashing the power of the patient of the
patient's own immune system,
to fight cancer.
But,
the predictive tools for who is going to
benefit, who needs additional therapy,
who maybe does not need additional therapy and
can avoid the unnecessary toxicity,
and cost
of being on therapy, sometimes for years.
That has, it has really,
not been
acted upon until recently. And so the the
big
new area of innovation in precision oncology, specifically,
has been
MRD testing. That's molecular residual disease testing.
And, Natera is the, the leader in solid
tumor MRD.
I'll explain the what the product does,
but its purpose
is to identify disease
circulating in the blood,
and identifying, you know, which patients still have
disease, residual disease, MRD,
and need additional therapy, and which patients maybe
do not have detectable disease in their blood
after some curative intervention
and can safely avoid unnecessary therapy going forward
and and have amazing outcomes.
So Natera developed a test called the Signatera
test. It's the first ever in history
personalized test for every single patient.
So the way that test works is that
we,
we do a a whole exome or whole
genome sequence
of the tumor sample from resection or from
biopsy.
We identify the unique complement of mutations
in that cancer
that are not present in the background DNA,
and then we custom design and manufacture
a test for every single patient's cancer that
only looks at that unique signature
of mutations
and looks for it in the blood,
which is extremely highly specific. The test can
detect recurrence,
like, a year earlier than you'd see it
on a scan,
and with extremely high specificity.
And what that's enabled and that and that
works across cancer types. It's extraordinary.
And that has enabled,
really a, a sea change in how
in how oncology
is practiced
across the country and increasingly across the world,
with huge implications
for health economics
as well as clinical outcomes.
So, you know, I'm I'm looking forward to
getting to the discussion with you
about
how Natera is partnering with health systems
and health system executives
to make sure that these technologies are are
deployed in an evidence based way
that not only improves patient care and outcomes,
but, also, it makes a really big difference
for the ballooning health care costs in our
country.
And
and, you know, that has an implication not
only in cancer, but in the other disease
areas where we're operating.
Yeah. Solomon, thank you so much for the
overview.
It's really exciting to hear about these advancements
and and what's possible now in precision medicine
and testing and diagnostics.
And as health systems, to your point, as
they're
looking more into how to integrate some of
these innovations into routine care and routine decision
making,
What challenges are you seeing leaders face as
they bring these more sophisticated tools into their
clinical workflows?
Yeah. There's some there's some significant challenges, but
also with that comes huge opportunities.
So the first step to
integrating,
new diagnostics
and new precision medicine tools into care is
generating
the clinical evidence.
And that's an area that that Natera and
our partners have invested really significantly. We've got
hundreds of peer reviewed papers and scientific
presentations across
not only cancer, but also,
detecting
genetic abnormalities during pregnancy and
identifying,
different predispositions,
towards chronic kidney disease and and more.
And so we've generated that evidence, and we're
continuing to invest now over half $1,000,000,000.
That's with a b. Over half $1,000,000,000
this year and next year and and going
forward to continue driving
that innovation and that evidence.
But that's just the first step. So how
do you integrate it into care once you're
convinced you want it? And that's where Natera
is partnering with health systems
to deploy
artificial intelligence based solutions
to help identify the patients who are eligible
for an intervention,
eligible for a test,
and really develop the clinical decision support
tools and solutions
that are going to
improve adoption of evidence based medicine,
identify gaps in care,
integrate seamlessly with the electronic medical records.
Ornateira is already integrated as a clinical,
laboratory across, really, most of the systems across
the country now and measure those outcomes and
and measure the any gaps and and potentially,
you know, improvements in care from deploying these
solutions. So we're super excited about,
how AI enables us and our partners to
accelerate that effort,
and ultimately improve patient care.
Yeah. And I appreciate you touching on the
role AI is playing here, Solomon,
because I I know that digital tools and
AI are becoming more essential to helping clinicians
also translate
complex
molecular data
into those clear care pathways and next steps
as you've mentioned.
So where are you seeing these technologies make
the biggest difference right now, and what opportunities
do you think they present for the future
of precision medicine?
Yeah. I'll give two examples, two or three
examples that I think can really paint the
picture of where things are going.
So the first is in,
is in cancer management.
So we just had a New England Journal
of Medicine,
publication
concurrent with a major presentation at the European
Society of Medical Oncology
showing that
MRD
guided
care that's using Signatera, our MRD test. The
Signatera MRD guided care in the adjuvant setting
for muscle invasive bladder cancer patients,
can improve
overall survival by over forty percent,
by treating MRD positive patients
with immunotherapy
and completely
avoiding any adjuvant treatment
for muscle invasive bladder cancer patients who are
Signatera negative and who stay negative,
after surgery. So that's more than half of
patients
are negative for their for residual disease after
surgery and can safely avoid
treatment,
which is just incredible because the the prior
standard of care
is to treat all of those patients with
immunotherapy
for over a year,
which is expensive, which is toxic, and which
we've proven is just unnecessary
for most patients. So that's just one example.
And then
another example is in chronic kidney disease. So
this is now outside of cancer. There's a
different test. It's called the rinosyte
test,
and that is a test for germline mutations
that are associated with,
different types of chronic kidney disease.
And there's just been
a significant
inflection point in,
in CKD recently, which, by the way, affects
over forty million Americans at the diagnosis of
chronic kidney disease. And the goal is to
avoid
progressing to end stage renal disease and dialysis
and needing an organ transplant.
But in the past year and a half,
the amount of evidence
and new guideline recommendations for genetic testing
of patients who have symptoms
of kidney disease has increased significantly.
So think of where, like,
BRCA testing was twenty years ago for identifying
patients who are predisposed towards
breast cancer, ovarian cancer,
and other, like, inherited types of cancers.
Genetics in chronic kidney disease is where
cancer was twenty years ago.
And so there's gonna be a sea change
in,
how those patients are diagnosed,
and how they're managed based on their genetic,
their genetic status.
So
the challenge, though, for adoption in a system
is,
okay. I've got,
some cases, over a million patients in my
system
who have various signs and symptoms of kidney
disease,
and their, you know, their records in the
primary care setting might not even have a
diagnosis
of CKD, but they have symptoms. So how
do you go and identify
those patients who need to get a test
and actually get them that care? How do
you close that care gap? And that's where
these, digitally enabled,
and AI driven solutions
start to play a big role. So we're
excited to part we're partnering with several different
systems
right now,
to identify those patients in a in an
intelligent
EMR integrated manner and to get them,
tested and then get them the right intervention
depending on the result of that test.
So I think those are that's two examples.
I'll just I'll just plug one other one,
and that is early cancer
screening. So this is now you know, there
there's been,
a really exciting,
innovation in the field,
doing blood based cancer testing
to find colorectal cancer and, and soon other
cancer types as well for patients who are
otherwise asymptomatic.
So how do you do that? Right? How
do you deploy a population level
test like that,
with the expectation that it's going to detect
cancer at an earlier stage,
which everyone knows is linked with better outcomes?
And, again, that's an area where the terrorists
taking a leadership,
approach,
both with developing what we believe is gonna
be, you know, a leading
performance
early cancer test,
based on methylation technology
as well as the smartest ways to partner
with systems to actually deploy that technology
to help their patients at a wide scale.
Those are three good examples of, of how
we're approaching this.
Yeah. I really appreciate the clear examples too,
Solomon. These are great. And as you were
explaining
all of these advancements and and what's on
the horizon here, just the sheer number of
patients at the population level this could impact
is it sounds remarkable. And
I also to your first point or your
first example mentioning how these innovations could help
with,
I can't think of another word for it,
but kind of prudent use of resources in
the health care environment, which is so important
from a cost perspective. It's just interesting to
see how this affects everything from
cost to the patient journey to health outcomes
and, you know, that upstream approach to preventing
conditions like cancer.
So, again, I so appreciate the examples. I
think that's really helpful,
for myself and for listeners.
But before I let you go today, you
know, is there anything else that you wanted
to share that maybe we haven't touched on
yet, whether it's a final takeaway or maybe
anything exciting on the horizon for Natera?
Yeah. Ultimately, Natera is a highly patient centered
organization.
We employ
over 6,000
amazing, talented scientists, engineers,
and more. And
the number of people at our company
who have either directly benefited from our technologies
or have family members who have benefited is
extraordinary. And you can visit our website and
see
so many patient testimonials and physician testimonials
about how our technologies have impacted care,
and improved patients' lives.
So I'm I'm really proud of that, and
I I'm very, very optimistic
about the next phase for Natera and for
the precision medicine industry.
Really, like you said, you know, optimizing
the use of resources,
getting treatment to patients who need it, and
the right treatment at the right time, which
takes precision diagnostics,
and also helping patients avoid unnecessary treatment or
unnecessary interventions
when it's not necessary. That's something that we
accomplished in prenatal testing, where our Panorama
noninvasive prenatal test
now has probably resulted in an over eighty
percent reduction in in amniocentesis
and chorionic biopsy procedures across the country. It's
just amazing.
And so, you know, I'm I'm proud of
what we do, and we've got a really
bright future. So looking forward to, to continuing
this conversation.
Oh, likewise, Salomon. We're excited to keep tabs
on Natera and all of the developments ahead.
And your passion comes through throughout this whole
conversation about the work that you do and
that your team is doing. So I just
wanna thank you for making the time for
Becker's today and sharing your insights with us.
Thank you so much. We'd also like to
thank our podcast sponsor for today's episode, Natera.
Listeners, be sure to tune into more podcasts
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