With the addition of sensitive MRD liquid biopsy technology to its portfolio of cancer diagnostics, Quest Diagnostics completes the acquisition of Haystack Oncology, Inc.

United States: On Wednesday, June 21^st, 2023, Quest Diagnostics announced the acquisition of Haystack Oncology which is a maker of minimal-residual disease (MRD) testing technologies. Based on 20 years of study and development by Johns Hopkins University, Haystack was established in 2021 and has created a ctDNA-based technology exclusively for MRD identification. Professor Nick Papadopoulos, Ph.D., and Kenneth Kinzler, Ph.D., and Bert Vogelstein, M.D., three scientific pioneers from Johns Hopkins, backed Haystack's public launch in November with a $56 million series A fundraising round headed by Catalio Capital Management.

Following the completion of acquisition, Quest plans to use the Haystack MRD test as the foundation for brand-new clinical lab services that will be made accessible in 2024. The initial emphasis of development efforts will be for MRD testing of colorectal, breast, and lung malignancies. Before releasing the test to the public in 2024, Quest intends to integrate the MRD liquid biopsy technology into existing platforms for solid tumor sequencing and expand its reach through its established businesses of blood sample collection. With an initial focus on colorectal, breast, and lung cancers, the objective of Quest is to concentrate on making the test accessible to the public.

Quest's expertise and scale will be used to its advantage in oncology, genetics, and pathology sector. Through its AmeriPath specialist pathology-diagnostics business, Quest has employed around 400 pathologists and offers roughly 7,000 patient access points in the US for the collection of blood and other specimens. Quest's proficiency in next-generation tumor sequencing also extends its capacity to recognize patient-specific mutations for Haystack's tumor-informed MRD strategy. Additionally, Quest offers services to a wide range of healthcare professionals and connects to about 850 electronic health records (EHRs), enabling simple electronic longitudinal MRD reporting.

As per the terms of the acquisition agreement, Quest has agreed to pay $300 million in cash at closing, net of cash acquired, and up to an additional $150 million upon reaching future performance objectives.

According to the Chairman & CEO of Quest Diagnostics, Inc., “Haystack’s liquid biopsy technology, combined with Quest’s strengths in screening, pathology, and sequencing, will now position us to lead in the fast-growing MRD category. Working with Haystack, we have an opportunity to broaden access to MRD insights and potentially improve favorable long-term outcomes from cancer,” said Jim Davis, chairman and chief executive officer of Quest Diagnostics.

According to the CEO and President of Haystack Oncology, Inc., “Combining Haystack with Quest is a major step forward in translating two decades of world-class liquid biopsy research and development into clinical laboratory services that are highly reliable and broadly accessible. Like looking for a needle in a haystack, accurately detecting MRD has been very challenging to date,” said Dan Edelstein, CEO and President, Haystack. “With Quest, we expect to increase and accelerate access to important tests that will improve the quality of cancer MRD detection and recurrence monitoring for patients. Working together, we have the potential to greatly transform the patient journey and save lives.”

According to TechSci Research, Minimal Residual Disease (MRD) testing is a rapidly expanding subset of liquid biopsy tests which is emerging as a most advancing approach in the field of oncology as it can locate circulating tumor DNA (ctDNA) in patients' bloodstreams after the completion of cancer surgery and treatment. MRD testing can help doctors better prepare for future therapy by precisely identifying cancer that is still present. As MRD testing is thought to be less invasive or convenient than existing lab tests due to the requirement of quick blood test as an option of minimally invasive biopsy technique, it is gaining wide acceptance among the cancer patients. Independent of the genesis of a tumor, Haystack has designed its MRD testing platform which is intended to help guide clinical interventions through the development of personalized diagnostic panels to individually tailor the best treatment regimens for each patient.

Liquid biopsy has been more popular recently since it offers quick access to tumor-derived biomarkers with less possible risks for the patient than a surgical biopsy. Finding MRD has always been like searching for a needle in a haystack but with the acquisition of Haystack Oncology by Quest Diagnostics, the prevention and treatment of cancer patients by using its ctDNA-based technology specifically designed for MRD detection can increase the rate of survival of patients.

According to the National Centre for Health Statistics, the majority of cancers are caused by solid tumors and the United States is expected to see 609,820 cancer deaths and 1,958,310 new cancer cases in 2023. Since cancer is the second most common cause of death in the United States and a major global public health issue, the application of highly sensitive minimal-residual disease cancer-detection technology can improvise the personalized cancer care of patients. By leveraging combined resources of both the companies, it is expected to accelerate the application of minimal residual disease (MRD) assay and commercialization efforts with biopharma. In the past ten years after the first therapeutic cancer vaccine was approved, immuno-oncology has made some impressive clinical strides, but the field is constantly evolving. By 2050, immuno-oncology drugs are expected to be utilized for treating majority of solid tumors, thus it's important to assess the significant trends in the field of oncology as many companies are improving their oncology product portfolio and services by increasing investment in R&D along with the rising trend of acquisitions among large biotech companies.

As MRD is emerging as a strong predictor of relapse, the technology can benefit large number of patients who are suffering from blood cancers, such as leukemia, lymphoma or multiple myeloma etc. because if residual disease is found, it is possible to increase the possibility of survival of the cancer patients. With rising cases of cancer in the country, companies are concentrating more on providing earlier, more accurate diagnosis of residual and recurrent tumors in order to personalize therapy and significantly enhance results for cancer patients. Thus, the future of liquid biopsy technology is poised to bring about significant advancements in disease diagnosis, monitoring, and personalized treatment with more market players entering the field of MRD testing. Moreover, continued research, technological innovations, and collaborations across multiple discipline of life sciences will enhance the potential of liquid biopsies in improving patient outcomes and transforming healthcare practices.