AT A GLANCE
$2.91 Billion
Prior Fiscal: $2.61 Billion
Percentage Change: +11.5%
No. of Employees: 7,174

It’s a picture-postcard late spring day, but Victoria Anderson is too distracted to truly enjoy it.

Recently diagnosed with Stage 1 breast cancer, the 45-year-old meets with doctors to devise a treatment plan. Vicky’s thoughts are not on the weather. As she waits for her multidisciplinary cancer care team (MCCT) to assemble, Vicky recounts the moment of diagnosis and ensuing cascade of emotions that inundated her psyche. In retrospect, the moment becomes surreal, leaving Vicky to wonder whether her doctor ever uttered the word “cancer.”

“…circulating tumor cells…blood…” Vicky recalls hearing. “…liquid biopsy…indicative…early-stage breast cancer…”

Vicky had trouble focusing after that. As she discusses her treatment options with her cancer care team, Vicky is obviously anxious. But she is not afraid.

Although serious, Stage 1 breast cancer is by no means is a death sentence, Vicky’s MCCT leader reassures her. The prognosis, actually, is quite positive: With current treatment options, standardized protocols, and integrated care management, disease-free survival rates for early-stage breast cancer patients now averages 96 percent at five years, 92 percent at 10 years, and 91 percent after 20 years.

The MCCT leader tells Vicky he is confident she not only will survive but will be cancer-free over the long-term. Encouraging news, certainly, but Vicky remains anxious. Still, she’s not afraid.

The MCCT devises a personalized treatment plan for Vicky using an algorithm that shows all options, including radiation therapy, combination immunotherapy, robotic surgery, microwave ablation, and emerging technologies like nanoparticle therapy. The plan will be adjusted in real time based on companion diagnostics and treatment response assessments through imaging during Vicky’s medical care. The MCCT also will connect Vicky with the cancer center’s survivorship and healthy lifestyle teams to learn about behaviors affecting breast cancer survivors and make necessary adjustments.

Armed with a wide range of treatment options, a personalized battle plan, and a clear understanding of the assistance she’ll receive from her care team, Vicky is hopeful she will conquer her cancer.

Her anxiety is gone. Vicky is now free to enjoy the rest of that glorious spring day in June 2048.

By 2018 standards, Vicky Anderson’s cancer odyssey (with her big data-inspired, artificial intelligence-driven treatment plan) is completely fictional—20-year survival rates for early-stage breast cancer currently hover around 85 percent and 40-year survival averages 80 percent. Also, integrated care remains elusive, and precision medicine solutions are still in their infancies. Yet Vicky’s creator is confident that her story and courage will be the norm within a generation as society gradually learns to conquer its fear of cancer.

“What if we lived in a world without the fear of cancer? What might that world look like? Is it even possible or just a science fiction dream?” Varian Medical Systems asked last fall in releasing a new vision paper that describes such a fearless future world (and begets Vicky Anderson). “Varian does not believe it is science fiction…”

Varian’s 2,380-word paper outlines the challenges the medtech industry faces in eradicating the fear and anxiety associated with cancer. They include earlier disease detection, more localized treatment options, better cost management, physician skill set changes, and an integrated care approach (the latter challenge is perhaps the most daunting). However, advances in global networking, cloud computing, and digital communications, along with new discoveries and methodologies in diagnostics, genomics, immunotherapy, AI, robotic surgery, radiotherapy, and data analytics could be used synergistically to improve future cancer survival rates, Varian charges.

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ANALYST INSIGHTS: Varian is focused on expanding both geographically and incrementally across adjacent spaces. With a strong history in Radiation Oncology, it is seeking to position itself to deliver across cancer segments through additional presence in interventional radiology and expanding its leadership in IGRT (Image-Guided Radiation Therapy).

—Dave Sheppard, Co-Founder and Managing Director, MedWorld Advisors

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“Achieving this vision of a world without fear of cancer within the next 30 years may sound like science fiction to some,” Varian states in its paper. “Cancer remains one of the deadliest and most difficult to treat diseases in the world. There are today more reasons to be hopeful for the future of cancer care than ever before. Over the next 30 years, some experts predict that it is entirely possible that cancer can become a manageable, chronic disease, similar to diabetes, so that a cancer diagnosis will no longer hold the fear that it does today. At Varian, we believe our focus on products and services that span the cancer care continuum places us in an ideal position to be an integrated solutions provider driving the progress of cancer care for the next 30 years and beyond. Our focus is on creating a world without fear of cancer.”

With more than 7,000 employees and an 8,000-plus cache of radiation oncology treatment systems globally, Varian is in a propitious position to help the world vanquish its cancer terrors. In fiscal 2018, however, the company upped the ante through a series of product approvals/introductions and targeted acquisitions.

Varian further expanded both the scope and potency of its Halcyon radiotherapy system in its most recent fiscal year (ended Sept. 30, 2018), winning regulatory approval in Brazil, Japan, and Taiwan. Halcyon’s human-centered and user-friendly design aims to improve clinical workflow, accelerate installation timeframes, expedite commissioning, simplify training, and automate treatment. The system requires only nine steps from the start to the end of treatment compared to up to more than 30 steps with older technologies.

Last spring, Varian enhanced the Halcyon system by incorporating new technologies into the product. Halcyon 2.0 features kV Conebeam computed tomography (CBCT) and Iterative CBCT imaging for soft tissue definition—advanced treatment capabilities that will help improve patient outcomes. The update enables Halcyon to produce kV CBCT images in about 15 seconds and helps ensure proper patient positions while accelerating treatment workflow.

Varian unveiled Halcyon 2.0 amid U.S. regulatory approval for its Calypso anchored beacon transponder and release of Velocity cancer imaging software. Designed for use with its TruBeam, Edge, and Clinac C-series medical linear accelerators, the Calypso system and anchored beam transponder detect tumor movement and more accurately deliver lung stereotactic body radiotherapy. The anchored beam transponders are implanted in small airways within or near tumor targets and emit non-ionizing electromagnetic signals tracked in real time to keep the treatment beam focused on cancerous cells.

The FDA-cleared Velocity 4.0 Rapidsphere module is designed for Y90 selective internal radiation therapy dosimetry analysis and provides improved information on tumor responses and normal-tissue toxicity for patients undergoing SIRT (selective internal radiation therapy). The Velocity 4.0 software includes Varian’s Velocity M3i multi-modality motion imaging, the Velocity Aria sync, and the Velocity tumor and dose tracking components.

In addition to its wealth of organic innovations (including a sneak peek at its vision for adaptive radiotherapy), Varian also boosted its arsenal of cancer-fighting weapons in fiscal 2018 through a series of acquisitions that expanded its treatment workflows and motion-management product portfolios.

Its deal for Mobius Medical Systems expands Varian’s treatment plans QA and machine QA technologies. Mobius’ quality assurance software is used at over 1,000 facilities globally; its 3D dose verification and treatment delivery QA system for intensity-modulated radiation therapy and volumetric modulated arc radiotherapy provides modular staged testing to ensure treatments are smoothly executed.

Similarly, the addition of Evinance Innovation Inc. to Varian’s 360 Oncology care management platform is expected to enhance clinical workflow and decision support for doctors and patients, as well as ensure adherence to evidence-based guidelines.

Workflow simplification attracted Varian to HumediQ, developer of the Identify automated patient identification, positioning, and management system for radiation therapy. The automated workflow solution for surface-guided radiation therapy features a palm reader for patient identification, radio-frequency identification reader, automatic synchronization with oncology IT systems, and SGRT cameras for patient positioning and motion monitoring.

Varian attempted to enter the interventional oncology market through the purchase of Sirtex Medical Limited, but the company was outbid by a Chinese investor just days before the deal was set.

The defeat didn’t really affect Varian (financially) in fiscal 2018, though it may impact the company’s long-term mission to create a stronger, more fearless, cancer-fighting world. Revenue jumped 11.4 percent to $2.91 billion, with Oncology Systems sales surging 14 percent to $2.77 billion due primarily to higher volumes of hardware unit shipments and increased demand for software products.

Oncology System profits were partially offset by an 18 percent drop in Proton Solutions revenue ($148.9 million) attributed to financing completion for the Georgia Proton Treatment Center, a facility with five treatment rooms and dedicated research capabilities.

Despite the loss in Proton Solutions sales, Varian delivered strong growth across every region in fiscal 2018, expanding Oncology Systems orders 17 percent in Europe, the Middle East, and Africa; 9 percent in Asia-Pacific; and 5 percent in the Americas. Five consecutive quarters of double-digit growth allowed the company to achieve $1 billion in Oncology Systems orders for the first time in its history. A particularly robust fourth quarter throughout the world helped foster a record 31 percent increase in Asia-Pacific orders.

“Not only do these accomplishments align with our growth initiatives,” Varian CEO Dow R. Wilson said in the company’s FY18 annual report, “but more importantly, they demonstrate our commitment to helping customers, and the patients they treat, achieve new victories against cancer.”

Fear no more, Vicky.

$2.6 Billion
NO. OF EMPLOYEES: 5,700

Pamela Percival was diagnosed with a high-grade sarcoma in her abdomen, which meant she was at high risk for it metastacizing. The sarcoma being high-grade also meant that she would likely face a combination of surgery, chemotherapy and radiation therapy. Varian Medical was able to provide her with the radiotherapy technology she needed, and today Percival is living cancer-free. What makes her recovery even sweeter, however, is that she is a Varian employee, and was able to see first hand how the technology her company produces helps real people in very real ways.

“I’ve always believed in the mission of Varian,” she said, “But it’s never been so personal as when it’s your own life. Seeing that our own machine was treating me gave me a sense of comfort and pride.”

Varian’s Oncology Systems unit has been enjoying annual market growth of 8 percent over the last five years, and contributed $2 billion to the company’s overall reported revenue of $2.6 billion for fiscal year 2011 (ended Sept. 30), an 8.5 percent increase from FY2010. According to the company’s annual financial report, Varian received approval from the State Food and Drug Administration in China to market its TrueBeam System there in April 2011. The TrueBeam system is a radiotherapy device that has been on the U.S. market since April 2010, and is designed to treat tumors with elevated speed and accuracy, even if the tumor is difficult to pinpoint due to breathing motions of the patient. In the third quarter of FY2011, the Japanese Ministry of Health, Labor and Welfare granted Varian approval for the device to be marketed in Japan. Through the end of the fiscal year, Varian received more than 380 orders for the system, most orders coming from North America.

In a letter to stockholders, President and CEO Tim Guertin said the Oncology Systems team was able to “improve treatment capacity and patient access to [Varian’s] life-saving technology” over the course of FY2011. A range of other products in this portfolio performed well, including Varian’s RapidArc, a drug-delivery system that is touted to improve dose conformity while significantly shortening treatment times, which exceeded 2,000 orders.

X-ray products didn’t disappoint either. X-ray products represented 18 percent of total revenues in FY2011, compared to 17 percent in 2010. They generated $469 million in revenue in FY2011, an increase of $66 million compared with the previous year. Varian produces X-ray tubes for CT scanners, radiographic or fluoroscopic imaging, mammographies and special procedures. Its flat-panel detectors, based on amorphous silicone imaging technologies, have found broader applications as alternatives to image intensifying tubes and X-ray film. These panels have found their way into filmless medical diagnostics, dental, veterinary and industrial applications, which only has translated into more revenue for Varian.

Also included in Varian’s revenue were the company’s Security and Inspection Products, which provide group cargo screening system manufacturers and others with products for high-energy X-ray imaging. These technologies generated $106 million in revenue in FY2011.

The company posted net income of $399 million, up 10 percent from $360.4 million in 2010.

In terms of acquisitions, Guertin is particularly excited over the agreement Varian reached with Augmenix in May 2011. Varian agreed to make a $15 million minority equity investment in Augmenix, which is developing hydrogel products to improve outcomes in radiation oncology. “[The technology] could be used to position the prostate away from sensitive tissues for high-dose radiosurgery,” Guertin explained in the annual report. The hydrogel, called SpaceOAR, works by solidifying as soon as it is injected into the space between the prostate and rectum in men. The rectum then moves away from the prostate, limiting its exposure to radiation during treatment. Varian’s investment includes an option to buy Augmenix, which hasn’t taken place as of time of publication.

In September, just before the close of the fourth quarter, Varian announced an agreement to acquire Calypso Medical Technologies Inc. for $10 million plus a portion of earnings generated from Calypso products during the ensuing 30 months. Calypso is a privately owned, Seattle, Wash.-based developer and supplier of specialized products and software for real-time tumor tracking and motion management during radiosurgery and radiotherapy.

“With Calypso’s technology, Varian will be able to offer cancer treatment centers real-time, non-ionizing tumor tracking tools for enhancing the precision of their treatments,” Guertin said. “These products are a perfect complement for Varian’s motion management technology, including our TrueBeam platform, respiratory gating and dynamic imaging tools for highly focused radiosurgery. These products should enhance Varian’s growth as we integrate them and make them more broadly available to the clinical community through our global marketing and sales channels.”

Looking to the future, Varian will continue growing its radiation business. In FY2011, the company’s particle therapy business booked an $88 million order for a system that is being installed at the new Scripps Proton Therapy Center in San Diego, Calif. Particle therapy is a form of radiotherapy that uses energetic protons, neutrons and ions for cancer treatment. Treatment with the system is scheduled to begin in 2013 for patients with cancers where it particularly is necessary to protect surrounding healthy tissue. Guertin expressed confidence that this would be “a catalyst for more accessible financing for future centers.”

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