Two recent acquisition bids by Genzyme stand to suddenly amplify the company's presence in oncology. If the bids go through, the acquisition of Ilex Oncology will bring Genzyme a marketed anti-cancer product, a drug candidate gearing up for Phase II trials and some development capacity. Buying Impath out of bankruptcy will bring Genzyme a diagnostic testing laboratory. Genzyme's managers see no near-term synergies from the firms, but clearly hope eventually to intertwine diagnostics and therapeutics.

The importance of tissue analysis in diagnosing and characterizing disease, notably cancer, can't be underestimated. But analysis of tissue as a source of predictive medical information has been slow to evolve. Aureon Biosciences is changing this situation by developing a new tissue analysis platform to create predictive tests that oncologists can use to guide selection of cancer treatments.

A few years ago, Quest Diagnostics, the nation's largest reference lab, began a pilot program offering direct access testing (DAT) in a few locations in the South and West. In DAT, the premise is that consumers are willing to pay out of pocket to obtain accurate, timely information about their health-and that laboratory tests are much less expensive than some of the other health services that are offered to the general public and not reimbursed. Recently, The American Association for Clinical Chemistry held an audioconference on DAT. Speaker Lawrence Killingsworth, PhD, the chief science and technical officer at the Sacred Heart Medical Center in Spokane, WA, spelled out the process of transforming a physician-oriented laboratory testing service into one geared towards consumers, in essence building a retail health care business.

LabCorp.'s proposed purchase of Dianon Systems, followed by the announcement of Welsh Carson's bid for AmeriPath, reflect different paths taken by two fierce competitors.They are also the inevitable consequence of rapid laboratory consolidation at the national level. LCA wants Dianon so that it can expand its position in cancer testing. Welsh Carson, in contrast, is a financial buyer who would have to "clean up" AmeriPath, which has run into difficulties due to its physician practice management business model.