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How Health Systems Are Reshaping Clinical Decision-Making by Turning Molecular Data into Actionable Care · Becker’s Healthcare Podcast

• 0:00
  Hello, everyone. This is Erica Spicer Mason with
• 0:02
  Becker's Healthcare. Thank you so much for tuning
• 0:05
  into the Becker's Healthcare podcast series today.
• 0:08
  So today, we're going to talk about how
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  health systems are reshaping clinical decision making by
• 0:13
  turning molecular data into actionable care.
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  And joining me for this conversation is Solomon
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  Moskovich,
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  the president of clinical diagnostics
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  at Natera.
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  Solomon, welcome to the podcast. It's so great
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  to have you with us today.
• 0:27
  Thank you. It's great to be here. Well,
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  I'm excited to learn more about what's going
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  on at Natera. And before we get into
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  that conversation, I wanted to just learn a
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  little bit more about you and your work
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  in health care.
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  Really feel free to share whatever you think
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  will be helpful for our listeners to know.
• 0:44
  Wonderful. Yeah. First, I wanna introduce the company,
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  and I can talk about myself briefly.
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  Natera has been around for about twenty years,
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  started by
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  engineers out of Stanford University
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  and MIT,
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  and the company has developed unique and patented
• 1:02
  technology for analyzing
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  DNA
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  from blood.
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  And, we've had an incredible impact
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  now applying our technologies to improve care for
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  pregnant women, for people with cancer,
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  and for people with organ transplants
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  and chronic kidney disease.
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  We, have a a very significant pipeline to
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  expand the applications for our technologies,
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  And, I'm very proud that we're serving millions
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  of patients every year,
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  and and their physicians. These are medical tests
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  ordered by by physicians.
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  Myself,
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  I've been at the company for almost fifteen
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  years,
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  got a background in mathematics,
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  and,
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  I'm very passionate about the impact that our
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  technologies have on patients, including many in my
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  own family. So I'm really glad to be
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  here.
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  It's great to have you with us, Solomon,
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  and I appreciate the overview
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  about Natera and learning a little bit more
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  about you as well. And it sounds like
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  the company really is overseeing,
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  this technology that's helping a number of conditions
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  and and really important
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  conditions for hospitals and health systems when we're
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  talking about, of course, pregnancy, cancer, chronic kidney
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  disease.
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  So excited to get some of your insights
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  on that. But I wanted to start a
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  little bit high level and acknowledge
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  that precision medicine, it it's evolved rapidly
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  in the last decade. I I feel like
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  every year we hear more about really impressive
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  advancements in this field. So from your perspective,
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  what are the most important advancements in in
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  how we identify disease status and guide care?
• 2:38
  Yeah. This field has, has evolved so quickly.
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  It's a very, very exciting time to be
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  in
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  genetics and genetic medicine,
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  and precision
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  medicine. So,
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  you know, the
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  the prior ten years, I think, were full
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  of discoveries,
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  about what you could do with information,
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  genomic profiling information from a
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  tumor sample from a patient with cancer.
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  And that led to really growth of the
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  whole concept of precision oncology.
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  If you find a certain mutation in a
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  gene in the patient's cancer, that might
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  that might, mean that the patient is likely
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  to benefit from a targeted therapy,
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  for example, and there's just been an explosion
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  of different gene linked therapies,
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  from multiple different biopharma companies, which have made
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  a huge impact on on patient survival.
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  There's also been the introduction of immunotherapies
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  and immuno oncology,
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  unleashing the power of the patient of the
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  patient's own immune system,
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  to fight cancer.
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  But,
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  the predictive tools for who is going to
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  benefit, who needs additional therapy,
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  who maybe does not need additional therapy and
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  can avoid the unnecessary toxicity,
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  and cost
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  of being on therapy, sometimes for years.
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  That has, it has really,
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  not been
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  acted upon until recently. And so the the
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  big
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  new area of innovation in precision oncology, specifically,
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  has been
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  MRD testing. That's molecular residual disease testing.
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  And, Natera is the, the leader in solid
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  tumor MRD.
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  I'll explain the what the product does,
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  but its purpose
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  is to identify disease
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  circulating in the blood,
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  and identifying, you know, which patients still have
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  disease, residual disease, MRD,
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  and need additional therapy, and which patients maybe
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  do not have detectable disease in their blood
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  after some curative intervention
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  and can safely avoid unnecessary therapy going forward
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  and and have amazing outcomes.
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  So Natera developed a test called the Signatera
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  test. It's the first ever in history
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  personalized test for every single patient.
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  So the way that test works is that
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  we,
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  we do a a whole exome or whole
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  genome sequence
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  of the tumor sample from resection or from
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  biopsy.
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  We identify the unique complement of mutations
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  in that cancer
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  that are not present in the background DNA,
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  and then we custom design and manufacture
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  a test for every single patient's cancer that
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  only looks at that unique signature
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  of mutations
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  and looks for it in the blood,
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  which is extremely highly specific. The test can
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  detect recurrence,
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  like, a year earlier than you'd see it
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  on a scan,
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  and with extremely high specificity.
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  And what that's enabled and that and that
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  works across cancer types. It's extraordinary.
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  And that has enabled,
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  really a, a sea change in how
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  in how oncology
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  is practiced
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  across the country and increasingly across the world,
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  with huge implications
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  for health economics
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  as well as clinical outcomes.
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  So, you know, I'm I'm looking forward to
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  getting to the discussion with you
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  about
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  how Natera is partnering with health systems
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  and health system executives
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  to make sure that these technologies are are
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  deployed in an evidence based way
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  that not only improves patient care and outcomes,
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  but, also, it makes a really big difference
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  for the ballooning health care costs in our
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  country.
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  And
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  and, you know, that has an implication not
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  only in cancer, but in the other disease
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  areas where we're operating.
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  Yeah. Solomon, thank you so much for the
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  overview.
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  It's really exciting to hear about these advancements
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  and and what's possible now in precision medicine
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  and testing and diagnostics.
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  And as health systems, to your point, as
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  they're
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  looking more into how to integrate some of
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  these innovations into routine care and routine decision
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  making,
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  What challenges are you seeing leaders face as
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  they bring these more sophisticated tools into their
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  clinical workflows?
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  Yeah. There's some there's some significant challenges, but
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  also with that comes huge opportunities.
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  So the first step to
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  integrating,
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  new diagnostics
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  and new precision medicine tools into care is
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  generating
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  the clinical evidence.
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  And that's an area that that Natera and
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  our partners have invested really significantly. We've got
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  hundreds of peer reviewed papers and scientific
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  presentations across
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  not only cancer, but also,
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  detecting
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  genetic abnormalities during pregnancy and
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  identifying,
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  different predispositions,
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  towards chronic kidney disease and and more.
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  And so we've generated that evidence, and we're
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  continuing to invest now over half $1,000,000,000.
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  That's with a b. Over half $1,000,000,000
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  this year and next year and and going
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  forward to continue driving
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  that innovation and that evidence.
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  But that's just the first step. So how
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  do you integrate it into care once you're
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  convinced you want it? And that's where Natera
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  is partnering with health systems
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  to deploy
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  artificial intelligence based solutions
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  to help identify the patients who are eligible
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  for an intervention,
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  eligible for a test,
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  and really develop the clinical decision support
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  tools and solutions
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  that are going to
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  improve adoption of evidence based medicine,
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  identify gaps in care,
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  integrate seamlessly with the electronic medical records.
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  Ornateira is already integrated as a clinical,
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  laboratory across, really, most of the systems across
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  the country now and measure those outcomes and
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  and measure the any gaps and and potentially,
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  you know, improvements in care from deploying these
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  solutions. So we're super excited about,
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  how AI enables us and our partners to
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  accelerate that effort,
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  and ultimately improve patient care.
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  Yeah. And I appreciate you touching on the
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  role AI is playing here, Solomon,
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  because I I know that digital tools and
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  AI are becoming more essential to helping clinicians
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  also translate
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  complex
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  molecular data
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  into those clear care pathways and next steps
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  as you've mentioned.
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  So where are you seeing these technologies make
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  the biggest difference right now, and what opportunities
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  do you think they present for the future
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  of precision medicine?
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  Yeah. I'll give two examples, two or three
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  examples that I think can really paint the
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  picture of where things are going.
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  So the first is in,
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  is in cancer management.
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  So we just had a New England Journal
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  of Medicine,
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  publication
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  concurrent with a major presentation at the European
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  Society of Medical Oncology
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  showing that
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  MRD
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  guided
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  care that's using Signatera, our MRD test. The
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  Signatera MRD guided care in the adjuvant setting
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  for muscle invasive bladder cancer patients,
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  can improve
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  overall survival by over forty percent,
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  by treating MRD positive patients
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  with immunotherapy
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  and completely
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  avoiding any adjuvant treatment
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  for muscle invasive bladder cancer patients who are
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  Signatera negative and who stay negative,
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  after surgery. So that's more than half of
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  patients
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  are negative for their for residual disease after
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  surgery and can safely avoid
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  treatment,
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  which is just incredible because the the prior
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  standard of care
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  is to treat all of those patients with
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  immunotherapy
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  for over a year,
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  which is expensive, which is toxic, and which
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  we've proven is just unnecessary
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  for most patients. So that's just one example.
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  And then
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  another example is in chronic kidney disease. So
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  this is now outside of cancer. There's a
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  different test. It's called the rinosyte
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  test,
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  and that is a test for germline mutations
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  that are associated with,
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  different types of chronic kidney disease.
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  And there's just been
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  a significant
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  inflection point in,
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  in CKD recently, which, by the way, affects
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  over forty million Americans at the diagnosis of
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  chronic kidney disease. And the goal is to
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  avoid
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  progressing to end stage renal disease and dialysis
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  and needing an organ transplant.
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  But in the past year and a half,
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  the amount of evidence
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  and new guideline recommendations for genetic testing
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  of patients who have symptoms
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  of kidney disease has increased significantly.
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  So think of where, like,
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  BRCA testing was twenty years ago for identifying
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  patients who are predisposed towards
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  breast cancer, ovarian cancer,
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  and other, like, inherited types of cancers.
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  Genetics in chronic kidney disease is where
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  cancer was twenty years ago.
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  And so there's gonna be a sea change
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  in,
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  how those patients are diagnosed,
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  and how they're managed based on their genetic,
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  their genetic status.
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  So
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  the challenge, though, for adoption in a system
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  is,
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  okay. I've got,
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  some cases, over a million patients in my
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  system
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  who have various signs and symptoms of kidney
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  disease,
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  and their, you know, their records in the
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  primary care setting might not even have a
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  diagnosis
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  of CKD, but they have symptoms. So how
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  do you go and identify
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  those patients who need to get a test
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  and actually get them that care? How do
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  you close that care gap? And that's where
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  these, digitally enabled,
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  and AI driven solutions
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  start to play a big role. So we're
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  excited to part we're partnering with several different
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  systems
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  right now,
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  to identify those patients in a in an
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  intelligent
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  EMR integrated manner and to get them,
• 13:13
  tested and then get them the right intervention
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  depending on the result of that test.
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  So I think those are that's two examples.
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  I'll just I'll just plug one other one,
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  and that is early cancer
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  screening. So this is now you know, there
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  there's been,
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  a really exciting,
• 13:31
  innovation in the field,
• 13:33
  doing blood based cancer testing
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  to find colorectal cancer and, and soon other
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  cancer types as well for patients who are
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  otherwise asymptomatic.
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  So how do you do that? Right? How
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  do you deploy a population level
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  test like that,
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  with the expectation that it's going to detect
• 13:52
  cancer at an earlier stage,
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  which everyone knows is linked with better outcomes?
• 13:57
  And, again, that's an area where the terrorists
• 13:59
  taking a leadership,
• 14:01
  approach,
• 14:02
  both with developing what we believe is gonna
• 14:04
  be, you know, a leading
• 14:07
  performance
• 14:08
  early cancer test,
• 14:10
  based on methylation technology
• 14:13
  as well as the smartest ways to partner
• 14:16
  with systems to actually deploy that technology
• 14:18
  to help their patients at a wide scale.
• 14:21
  Those are three good examples of, of how
• 14:23
  we're approaching this.
• 14:25
  Yeah. I really appreciate the clear examples too,
• 14:28
  Solomon. These are great. And as you were
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  explaining
• 14:31
  all of these advancements and and what's on
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  the horizon here, just the sheer number of
• 14:35
  patients at the population level this could impact
• 14:38
  is it sounds remarkable. And
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  I also to your first point or your
• 14:42
  first example mentioning how these innovations could help
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  with,
• 14:48
  I can't think of another word for it,
• 14:49
  but kind of prudent use of resources in
• 14:52
  the health care environment, which is so important
• 14:54
  from a cost perspective. It's just interesting to
• 14:56
  see how this affects everything from
• 14:58
  cost to the patient journey to health outcomes
• 15:02
  and, you know, that upstream approach to preventing
• 15:04
  conditions like cancer.
• 15:07
  So, again, I so appreciate the examples. I
• 15:09
  think that's really helpful,
• 15:10
  for myself and for listeners.
• 15:13
  But before I let you go today, you
• 15:14
  know, is there anything else that you wanted
• 15:16
  to share that maybe we haven't touched on
• 15:18
  yet, whether it's a final takeaway or maybe
• 15:20
  anything exciting on the horizon for Natera?
• 15:23
  Yeah. Ultimately, Natera is a highly patient centered
• 15:27
  organization.
• 15:28
  We employ
• 15:29
  over 6,000
• 15:31
  amazing, talented scientists, engineers,
• 15:34
  and more. And
• 15:36
  the number of people at our company
• 15:39
  who have either directly benefited from our technologies
• 15:42
  or have family members who have benefited is
• 15:45
  extraordinary. And you can visit our website and
• 15:48
  see
• 15:49
  so many patient testimonials and physician testimonials
• 15:52
  about how our technologies have impacted care,
• 15:55
  and improved patients' lives.
• 15:57
  So I'm I'm really proud of that, and
• 15:59
  I I'm very, very optimistic
• 16:02
  about the next phase for Natera and for
• 16:05
  the precision medicine industry.
• 16:07
  Really, like you said, you know, optimizing
• 16:10
  the use of resources,
• 16:12
  getting treatment to patients who need it, and
• 16:14
  the right treatment at the right time, which
• 16:17
  takes precision diagnostics,
• 16:19
  and also helping patients avoid unnecessary treatment or
• 16:22
  unnecessary interventions
• 16:24
  when it's not necessary. That's something that we
• 16:26
  accomplished in prenatal testing, where our Panorama
• 16:30
  noninvasive prenatal test
• 16:32
  now has probably resulted in an over eighty
• 16:35
  percent reduction in in amniocentesis
• 16:38
  and chorionic biopsy procedures across the country. It's
• 16:41
  just amazing.
• 16:42
  And so, you know, I'm I'm proud of
• 16:44
  what we do, and we've got a really
• 16:46
  bright future. So looking forward to, to continuing
• 16:50
  this conversation.
• 16:51
  Oh, likewise, Salomon. We're excited to keep tabs
• 16:54
  on Natera and all of the developments ahead.
• 16:57
  And your passion comes through throughout this whole
• 16:59
  conversation about the work that you do and
• 17:01
  that your team is doing. So I just
• 17:02
  wanna thank you for making the time for
• 17:05
  Becker's today and sharing your insights with us.
• 17:07
  Thank you so much. We'd also like to
• 17:09
  thank our podcast sponsor for today's episode, Natera.
• 17:13
  Listeners, be sure to tune into more podcasts
• 17:15
  from Becker's by visiting our podcast page at
• 17:18
  beckershospitalreview.com.