Dow R. Wilson, President and CEO
Kolleen Kennedy, President, Oncology Systems and Corporate Exec. VP
Gary Bischoping Jr., Sr. VP, Finance and CFO
Patrick Joda, Sr. VP, Global Operations
Moataz Karmalawy, Ph.D., VP and General Manager, Worldwide Particle Therapy
Deepak Khuntia, M.D., Sr. VP and Chief Medical Officer
NO. OF EMPLOYEES: 6,600
GLOBAL HEADQUARTERS: Palo Alto, Calif.
There is an enormous difference between standard X-ray radiation cancer treatment and proton therapy. Although X-ray radiation techniques will control many cancers if administered in sufficient doses, healthy tissues may receive a similar dose and sustain damage because of the clinician’s inability to adequately conform the irradiation pattern to the cancer. As such, a less-than-desired dose is often used.
Delivered by an appropriately futuristic-sounding device called a cyclotron, proton therapy sends a high-energy beam of positively charged particles through the skin toward the tumor. However, the energy distribution of protons can be directed and deposited in tissue volumes designated by physicians in a 3D pattern from each beam used. Protons are also energized to specific velocities, which means they deposit their maximum energy at a specific point within the body. These dose-distribution characteristics mean the radiation oncologist can tune the dose to be stronger at the tumor site while reducing it to surrounding normal tissues.
The proton therapy market is a highly lucrative opportunity area for West Coast-based Varian Medical. According to Market Realist, the global proton therapy market is set to double by 2022. And although the United States currently has the largest proton therapy market, by 2022, the Asian market is expected to triple, and the European market is forecasted to see a double-digit CAGR.
The Varian Particle Therapy (VPT) business, which houses its cyclotron machines, is a relatively miniscule part of the company’s $2.7 billion fiscal 2017 revenue (ended Sept. 29). Comprising just 7 percent of the total 2017 revenue, the promising segment did show double-digit growth from the previous year, rising 13 percent to reach $173 million. The continued production of installation of VPT projects—most notably $56 million of revenue garnered from the 2017 completion and financing of the Georgia Proton Treatment Center—was the main driver for sales expansion.
Varian’s single-room ProBeam Compact system gained momentum through the year with its first three orders. Combined with multi-room U.S. and Chinese orders, Varian booked six orders during the fiscal year. By the year’s end, Varian was delivering proton treatments at five centers globally and several more sites were in the process of being equipped, and were expected to commence treatments in the months to follow.
The business was further bolstered by last May’s Japanese Shonin approval for the ProBeam proton therapy system. ProBeam is the first system offering intensity modulated proton therapy, which enables more efficient and adaptive therapy.
ANALYST INSIGHTS: Varian is aggressively trying to expand into emerging markets—specifically China. It was recently spurned on its $1B+ offer for Sirtex by a Chinese investment competitor. Watch for Varian to “regroup” and make aggressive moves in Asia, with a focus on China.
—Dave Sheppard, Co-Founder and Principal, MedWorld Advisors
Varian completed the separation of its imaging components business into the established Varex Imaging Corporation at the end of last January. A month before that, however—still within Varian’s fiscal year—the company began a $276 million deal to acquire PerkinElmer’s medical imaging business to fortify the soon-to-be-shed Varex. The business added digital flat panel X-ray detectors serving as components for industrial, medical, dental, and veterinary X-ray imaging systems to Varex’s product mix. The new company will be a high-volume manufacturer of X-ray tubes, flat panel detectors, and high voltage connectors, as well as a supplier of imaging software and specialized accelerators for high-energy X-ray imaging. Varian also received an approximate $200 million cash transfer from Varex Imaging immediately prior to stock distribution.
After the spinoff, Varian became a standalone cancer management company and underwent a fundamental re-brand. According to CEO Dow Wilson, Varian aspires to double the number of patients helped by their products from 3 million to 6 million. Longer term, the company will set its sights on continued global growth in radiation therapy and become the cancer therapy ecosystem for its customers.
The re-branding also welcomed some new faces to the Varian executive team. Throughout the year, the leadership changes and additions included Gary Bischoping Jr. as CFO; Thomas Rodden as chief information officer, Dr. Dee Khuntia as chief medical officer, Corey Zankowski as chief technology and innovation officer; Terilyn Monroe as chief people officer and senior vice president of human resources; and J. Michael Bruff as vice president of investor relations.
Since Varian set Varex off to forage on its own, its $2.7 billion in fiscal 2017 sales actually represents a 15.6 percent drop in revenue from the year prior. Oncology systems—now the majority of the firm’s business—rose a slight 1 percent in revenue to $2.5 billion. Product proceeds dropped 3 percent from the previous year to $1.4 billion. This was primarily due to a revenue decrease from hardware products resulting from a lengthening backlog conversion cycle due to a larger part of the backlog being from emerging markets, as well as customer readiness delays in a number of countries.
Service revenues for oncology systems, however, rose 7 percent to reach $1.1 billion. Increased customer adoption of service contracts as the warranty period expired on TrueBeam systems and an overall larger number of service contracts contributed to this gain. Oncology system revenues were also split almost evenly between the North American and international regions, demonstrating Varian’s ambition to penetrate both established and emerging markets.
Last May, Varian launched the Halcyon system for cancer treatment, and it gained FDA clearance about a month later. Halcyon simplifies and enhances virtually every aspect of image-guided volumetric intensity modulated radiotherapy. It features a 100 cm gantry opening (larger than those on standard CT scanners) that is capable of rotations four times faster than c-arm gantries, and can generate volumetric imaging in 15 seconds. It also features large touchscreens on both sides of the machine for easy patient setup, and according to Varian, is two times quieter than other systems.
“The technology of radiation oncology is evolving at an increasingly rapid rate,” Dr. Dwight E. Heron, director of radiation services at UPMC Cancer Center, and director of oncology at UPMC International, said when Halcyon was released. “New technology that integrates advanced adaptive treatment and imaging in a fully integrated form factor will enable consistent, high-quality, state-of-the-art radiation therapy for even the busiest clinics. As a global cancer care provider, we view such technological advances as a welcome tool in our fight against cancer worldwide.”
Last August, the HyperArc high-definition radiotherapy (HDRT) system conducted its first treatment worldwide in Italy. HyperArc HDRT treatments deliver more compact radiation doses that can fully saturate a targeted tumor and “fall off” sharply outside the target zone, minimizing the dose to specific organs requiring more protection. By the end of the fiscal year, Varian had received 40 orders for HyperArc upgrades.
A month later, the company released Eclipse 15.5, the newest iteration of its treatment planning system. It features proprietary MCO software, which lets clinicians explore the effects of varying clinical criteria—for example, the degree to which certain organs are spared versus coverage of the targeted tumor. To expedite finding the optimal treatment plan with minimal trial and error iterations, Eclipse 15.5 leverages the company’s RapidPlan software and existing optimization workflows. Eclipse 15.5 also supports HyperArc to efficiently plan treatment for and automate the delivery of complex stereotactic radiosurgery.
Varian was also enmeshed in patent litigation with Elekta—a Swedish company that provides radiation therapy, radiosurgery, related equipment, and clinical management for cancer and brain disorder treatment—that reached resolution during fiscal 2017. Last November, an administrative law judge with the United States International Trade Commission (USITC) issued an initial determination in its favor on Varian’s VMAT patents. The 465-page decision found Section 337 violations based on Elekta’s importation and sale of radiotherapy systems using linear accelerator-based VMAT technology. Further, the judge found public interest factors did not preclude relief in this case, and recommended the USITC cease and desist limited exclusion orders preventing Elekta from selling and importing its radiotherapy systems with infringing VMAT capabilities into the United States.
Last April, Varian and Elekta reached a confidential settlement agreement to end the ongoing patent litigation involving VMAT technology. The settlement resolved the multi-year disputes in the United States, Germany, and the United Kingdom, with no payments exchanged by the plaintiffs and defendants and no future financial obligations.