View PDF - The Journal of Precision Medicine

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Most conversations with a biomedical
researcher looking for new ways to treat
cancer won’t lead to a discussion on the
Large Hadron Collider, the search for the
Higgs boson (also sometimes referred to
as the God particle), the Space Shuttle or
the National LambdaRail high speed computer
network. But that is some of the broad
territory you will cover with Dr. Patrick
Soon-Shiong when discussing human
biology and the technologies that need
to be deployed in order to deliver
precision medicine.
Biotech billionaire
Dr. Patrick Soon-Shiong
brings multidisciplinary
approach to answering
biology’s most basic questions.
by Chris
Anderson, Senior Editor
When you hear Soon-Shiong elucidate his
vision of the future of healthcare and the
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development of new therapeutics, the holistic
approach he intends to take with his company
NantWorks and other scientific disciplines-like
particle science- become clear.
As he sees it, the interactions occurring inside
the human body are not disimilar to those
being studied at the Large Hadron Collider on
the border of France and Switzerland, where
physicists slam subatomic particles into each
you cross that chasm of scale in real time, you have an
apartheid.” Born of Chinese immigrant
at nearly the speed of light in an attempt to
opportunity to not only control disease but to understand
parents who had fled China during World
discover the Higgs boson – the elusive,
how chronic disease works, and that it may be cured.”
War II, it was both his heritage and the world
subatomic particle theorized to give mass to
matter.
It’s a line of thinking that has been a
constant thread for Soon-Shiong since he
of inequality he experienced growing up that
shaped who he is today.
“We are nothing else but a set of moving proteins or
first became a doctor in South Africa more
As medical student Soon-Shiong strove to
peptides – what I call the dance of particles,” said
than 40 years ago. And it has propelled him
be the first Chinese appointed an intern at
Soon-Shiong recently in an interview with the Journal of
to such accomplishments as the first person
Johannesburg’s General Hospital, an honor
Precision Medicine. “In a biological setting they are
to perform a full pancreas transplant, the
reserved for only the top four graduates in
continually colliding with each other and – taking this
first to conduct encapsulated human-to-
a class of roughly 200. When his class
human and pig-to-human islet transplants
standing put him in line for the internship,
and development of the first nanoparticle
the government in Pretoria agreed he could
delivery technology for cancer that produced
take the position – at 50% of the salary of his
the drug Abraxane.
white counterparts. Soon-Shiong’s first patient,
complex astrophysics way of thinking – if we could
interrogate human biology down to that fundamental
level and bring it up from the collision of proteins to the
cellular level, to the tissue level, to the organ level, to
the anatomy level, to the human anatomy level, to the
Upbringing in South Africa
human physiology level, to the phenotype level, and
Soon-Shiong describes the South Africa of
his youth as “a country of great contradictions.
It’s a country that is one of the most beautiful
in the world but I grew up in the world of
an Afrikaner, refused to be examined by him
and only consented under threat of immediate
discharge from the hospital. The same man
was soon loudly singing his praises after he
successfully diagnosed and treated a sinus
infection no other doctors had diagnosed.
While Soon-Shiong was formally schooled to
the first to complete a full pancreas transplant
become a doctor, he was also greatly influenced
and later via his work with islet cells,
by his father, who provided herbal remedies to
Soon-Shiong continued to ponder the “dance
the local Chinese community. He watched his
of particles” within the human body and
father concoct remedies, pastes and compotes
was keen to unravel the mystery
and also watched as these herbal treatments
of the most basic biological
yielded results. “That was very satisfying,”
interactions that contribute
he noted. “I became very interested that
we have biological mechanisms to
unleash in the face of diseases to
protect yourself and heal yourself.
That’s when you begin to see
the train of thought and the
train of science that I have
been pursuing all my life.”
Not a typical doctor
Being a practicing physician
was never Soon-Shiong’s sole
focus. While many interns
look forward to getting time
off from the gruelling workload,
Soon-Shiong spent one of his
first vacations writing a grant
application to the Imperial
College of London for the
treatment of pancreatitis.
Later, as a medical resident
at the University of British
Columbia (UBC) in Vancouver,
he realized he had significantly
more experience than other
residents in the same program.
“As part of the training in South
Africa I had already delivered 100
babies including forceps delivery,
vacuum delivery and participated
in cesarean sections,” he said.
“When I saw my chief resident starting
to do that, I realized I had an opportunity
while I was a resident to do a PhD in science.”
When he inquired about a program for medical
residents to simultaneously work toward a PhD,
the pancreas won multiple awards
he was told no such
and cemented him as a life sciences researcher
program existed. He settled for a Masters
on the rise.
program, working nights and weekends amid
his medical residency studying protein-protein
interactions under Professor John C. Brown.
His Masters thesis on the gastric inhibitory
polypeptide that controls insulin release in
In the early 1980s, Soon-Shiong moved to UCLA
for a surgical residency at the behest of one of his
mentors at UBC, Haile deBas, who had taken a
fellowship with the university. Yet even as he
became a surgeon of some renown at UCLA, as
to both health and disease.
During the 1980s and 1990s, however, Soon-
to Celgene in a deal worth roughly $3 billion.
Shiong felt challenged as technologies to
Another Soon-Shiong company, American
interrogate human biology, capture data and
Pharmaceutical Partners was sold two years
then translate it to clinical science was still
earlier for a total of $5.6 billion.
developing. So in order to learn broadly about
concepts and technologies that could eventually be brought to bear, he became involved
in projects ranging from work with the Space
Shuttle to study how stem cells fared in space,
to the National LambdaRail. This fiber optic,
high-speed, national computer network aimed
at overcoming bandwidth limitations in order
to serve science researchers working with
increasingly intensive data and computational
demands. (Soon-Shiong would later purchase
Flush with cash from the two sales SoonShiong, now 63, was not ready to ride into
the sunset. “The sales were important as it
gave me the full freedom by 2010 to envision
this dream I have that we are nothing more
than a dance of proteins,” he said. But to
make his dream of delivering more precise
care to individual patients a reality, his current
company NantWorks will need to harness
clinical research advances with information
the financially wobbly organization in 2011 only from electronic medical records and data from
wearable and remote health monitoring tools
to shut its operations in 2014).
to inform nuanced healthcare derived from a
“I began to see that the rate limiting step of
computational power was going to be very
quickly reached and would exceed our capacity
to utilize it and if we didn’t’ utilize it, we
would be wasting an opportunity for us to
interrogate the dance of particles,” he said.
“But at that time, the country was still looking
at kilobytes and megabytes. I was beginning
to see that we needed terabytes, exabytes and
yottabytes, so that we could get to machine
learning and artificial intelligence.”
Building on the vision
significantly richer set of patient-specific data.
“Since we are looking at first principals, rather
than looking to capture retrospective patient
data which is almost always obsolete, we are
prospectively capturing data in real time,”
he explained. Currently that data is flowing
to NantWorks via partnerships with health
organizations representing more than 1.5
million lives in projects in the United States,
Canada, Scotland and England with other
agreements in the works.
It was while working with NASA on his stem
And with this new company Soon-Shiong
cell diabetes study, that the kernel of the idea
intends to incorporate many of the concepts
that eventually led the cancer drug Abraxane
from astrophysics, computational networks,
came to Soon-Shiong. An albumin study being
machine learning and of course the first
conducted at the same time interested him and
principals research he hopes will lead to a
soon he conducting his own research on the
detailed understanding of biological interactios.
properties of albumin and associated proteins.
“I’m trying to cross an almost unfathomable
“I realized that albumin was what drove zinc
chasm all the way at the peptide level to the
into the cell to make insulin and I came up
protein level to the crashing of particles in real
with a conclusion that with albumen and a
time that change, in a quantum way, into one
nanoparticle I could feed the tumor “So I
single human being then also across seven
make a nanoparticle in my lab and I inject it
billion people. That is what excites me,” he
into mice with breast cancer and lung cancer
pointed out.
cell lines and it wipes it out.”
“Think of a human being as a flying object, like
The ensuing two decades proved Soon-Shiong’s
an airplane, and measure the person across
doubters wrong about the commercial viability
time and space, in real time. That is what I am
of his nanoparticle. Abraxane, approved by the
doing at NantWorks – to actually interrogate
FDA in 2005 and in the EU in 2008, was gain-
the dance of proteins in a human being in real
ing momentum on the market and in 2010 he
time across time and space. That is what I mean
sold the maker of the drug, Abraxis BioScience,
by precision medicine.”
SoonShiong on…
…Evolving cancer terminology
from site-specific to its specific
mutation
“Finally we are getting there, but we
are not there yet. I termed a word just to
be controversial ‘quantumoncotherapeutics,”
meaning that it’s not the genetics you are
born with, nor a genetic mutation, but it
is a continuous heterogeneous change
that is going to happen as a result and a
consequence of your treatment.”
…The current state of genomic
testing for cancer
“The country is very well satisfied with
looking at 200-gene panels when we have
20,000 genes and those 20,000 genes are
modulated in their own right by 3 billion
bases, which means you’ll need to go to
whole genome sequencing and to protein
expression.”
…His pitch to potential
investors to buy the company
what would become American
Pharmaceutical Partners
“I’m a surgeon at UCLA working on this
nanoparticle and my background is
pancreas transplantation and diabetes.
But I think I have a drug that can cure all
cancer and I want to buy a business that
is losing one and a half million dollars a
month with 500 people. Would you
lend me the money?”
…his disdain for current
electronic medical records (EMRs)
“I call them medical bridges to nowhere.
There is no interoperability of data or
processes across any of these systems,
because, inherently, this is the current
business model and the U.S. government
encouraged and enforced that.”
Illustration by Gabriel Moreno