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 from Becker's by visiting our podcast page at beckershospitalreview.com.