Quest makes hay for $300m

Five months from company launch to acquisition: full marks to the management of the liquid biopsy group Haystack Oncology. Quest Diagnostics, needing to bulk up following a sharper than expected decline in its Covid testing revenues, yesterday bought Haystack for $300m cash up front, gaining Haystack’s cancer blood test for minimal residual disease. The unnamed test identifies circulating tumour DNA in a patient’s bloodstream following tumour resection; Quest plans to adapt the assay and launch it next year. Initial efforts will focus on developing MRD tests for colorectal, breast and lung cancers, with Quest paying out up to $150m more on achievement of performance milestones. Quest chose Haystack after holding “many discussions with many of the players in the MRD space”, Jim Davis, Quest’s chief executive, said on the group’s first-quarter earnings call yesterday. Quest believes that Haystack’s test is one of the most sensitive, and “best in class”. But five similar tests are already available, and while not all will compete directly with Quest’s new test the presence of large groups like Guardant could make for a tough battle for market share.

Selected liquid biopsies for minimal residual disease
Company Liquid biopsy Tumour type Status
Natera Signatera Multi-cancer Launched as LDT Aug 21, 2017; Natera will seek individual FDA approvals as CDx
Guardant Health Reveal Colorectal Launched as LDT Feb 16, 2021, price approx $3,600
Neogenomics RaDaR Head and neck Approved in Europe Jan 2022 and in US as LDT Mar 16, 2023
Burning Rock brProphet Multi-cancer Launched Mar 2022
C2i Genomics C2inform Multi-cancer Approved in Europe Apr 2022
Quest Diagnostics (ex Haystack Oncology) Unnamed Colorectal, breast, lung  Launch planned for 2024
Invitae Unnamed Colorectal, bladder, lung  Maria trial to report 2026
Exact Sciences Unnamed Colorectal Correct-MRD II trial to report 2028
Grail (Illumina) Unnamed Multi-cancer In development
LDT = lab-developed test. Source: Evaluate Medtech & company websites.

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