Chairman and Chief Executive Officer, NantWorks
Owner and Executive Chairman, Los Angeles Times and The San Diego Union-Tribune
Dr. Patrick Soon-Shiong, as one of the leading scientists in our industry, you’re a surgeon, CEO, professor, inventor, and philanthropist. Tell us about this remarkable journey, and why you chose surgery as your specialty.
My father was a medicinal herbalist in China. After the Japanese invasion, my parents moved to South Africa, where my father still practiced. I think my father’s work influenced what path I chose in life. I remember, as a child, seeing him treat members of our community, and realizing the body could protect itself from disease and heal. I was 16 when I went to medical school. Choosing surgery was a difficult choice because I also wanted to be involved in pediatrics, to monitor and care for children suffering and dying of cancer. I soon realized that it was emotionally too difficult. I wanted to be in a specialty where I could immediately see and feel the outcome of my actions and treatment—so I became a surgeon.
How have you been able to excel in so many different areas? What is your philosophy in life?
I believe that everything is possible if you work hard and set your mind to it. I am both a scientist and biologist, actively translating science into medicine— as a physician and surgeon. My curiosity started at a young age. I had this belief that one day, society would be able to understand the human body at a level we’ve never seen before—at the genomic, proteomic level. That ability could enable us to figure out what makes this amazing biological system—the human body— work, and that’s what drove the curiosity. To get into this chasm of three billion base pairs of human cells, we needed to create technology that didn’t exist.That’s what drove me to work at NASA in the very early stages of my career. It may not be well known, but I was a scientist at their Jet Propulsion Lab.I received a massive grant from NASA while I was also an academic surgeon, and another huge grant from the National Institute of Standards and Technology (“NIST”) on nanotechnology. This was in the 80s, and we were way ahead of the curve in understanding not only the need for, but the potential of both nanotechnology and supercomputing. Because of my exposure to NASA, machine vision, and machine learning, I recognized that some of these technologies didn’t exist. Therefore, I needed to not only understand them deeply but also build infrastructure, so that we could drive knowledge at the level necessary for us to translate that into medicine. From early on, I had exposure to NASA’s Jet Propulsion Lab (JPL) while I was a surgeon at UCLA, and that’s the beauty of Los Angeles. You have Cal Tech, JPL, and UCLA. Then together with Intel and BASF, I co-founded the California Nanosystems Institute at UCLA. This convergence allowed me, very early on in my career, to quickly build infrastructure that didn’t exist. That was the underlying motivation to understand the biology of the human system. In doing so, we could create universal therapies for things like cancer and infectious diseases, which we are intimately involved with now.
Now, I look at nanotechnology as a mechanism for understanding human biology. How do you take a human cell down to a single base pair into a human body, and transfer that information into 7 billion people on the planet? That’s exactly the challenge that drove me and still drives me today. The first question was understanding the proteins in the human cell and the human body, rather than understanding technology. I call this the “dance of proteins.” However, it was like looking for God’s particle on the Large Hadron Collider,* in real-time, in the human body. Therefore, very early on, I got involved with the National LambdaRail (NLR), the first transcontinental 10 Gigabit Ethernet network. This fiber-optic infrastructure connected Bern, Switzerland, with all the major medical academic centers and astrophysicists. I took over the NLR very early on, ran it for four years, and rebuilt it into a fiber infrastructure to integrate supercomputing across the network—which we now run, because it’s like looking for God’s particle in the human body for every single patient, every day. NantWorks has now accomplished that with the genomic DNA/RNA human immunotherapy, which just received FDA approval last December. The FDA approval was the result of about 25 years’ worth of work: creating the fiber infrastructure; supercomputing; machine learning; taking normal samples of tumor tissue as well as infectious diseases like HIV, Zika, Ebola, and the Coronavirus, understanding their genetic makeup, and then figuring out how to create therapies at the biological level.
*World’s largest and highest-energy particle collider/accelerator
"A full understanding of this mechanism will lead to universal treatment for all tumor types in terms of cancer and in-progress infections—like the Coronavirus"
You’ve developed many firsts, in diabetes and cancer: the first whole-pancreas transplant at UCLA; the first encapsulated-human islet transplant for Type 1 diabetes; the first pig-to-man islet-cell transplant in diabetic patients; and the first human protein nanoparticle chemotherapeutic drug, Abraxane, approved for breast, lung, and pancreatic cancer. What was the impetus behind such innovative developments? Is there a common denominator, or was each uniquely motivated?
The common denominator was the human biology of cells. About four years ago, my frustration was, “How do I explain to people, and how do I connect the dots?” So, I started a thing on Twitter called “Connect the Dots,” to tell people that they could be strengthened by their cells. As a surgeon, one of the things that I treated was pancreatic cancer, and I performed the Whipple procedure (a challenging pancreatic cancer surgical operation). I also wanted to take on pancreatic transplants, so I did. Finally, I realized that it was just the Yin and the Yang: In transplant, I’m trying to help the body not to reject the organ, and in cancer, the cancer cells trick the body to believe that the cancer is normal and not to kill it. Thus, I quickly realized that the body has all the mechanisms within its cells to treat cancer appropriately. Moreover, when I became aware that stem cells could regenerate cancerous cells,I wanted to learn everything about stem cells—and I did. Then we did the world's first islet cell transplant from stem cells. I discovered that not only do stem cells require albumin to transport Zinc to make insulin, but also that cancer cells use albumin for transport intercellularly. I thought, if albumin goes into every cell as a normal physiological mechanism to drive messages, why not make an albumin nanoparticle to trick a cancer cell?—and that’s Abraxane. Abraxane is now one of the ubiquitously used agents in immunotherapy.
Abraxane falls into what I call the tumor microenvironment; by developing Abraxane, I began to understand the mechanisms of the cancer cell’s ability to hide from the immune system. Now, the focus of my entire career is looking at what turns the immune system on and off. That’s why studies of the Coronavirus, HIV, influenza, and cancer are based on the same biological mechanisms –the Yin and Yang, the balance of the human body that can discern exactly what turns the balance on and off. The immune system has molecules to manipulate or modulate. A full understanding of this mechanism will lead to universal treatment for all tumor types in terms of cancer and in-progress infections—like the Coronavirus.
You established NantWorks, the integrated network of companies pursuing next-generation pharmaceutical development. The network includes NantHealth and NantKwest. What needs did you see in the industry that motivated you to create NantWorks? What made you expand from drug development to healthcare IT?
Information technology, or cognition, is necessary to discern what’s going on at the cellular level. Therefore, I refer to cancer as a knife fight, and the same goes for the Coronavirus. You need cell-to-cell combat unless you can understand the human body at the cellular and molecular level, which requires information technology. You’d have no wisdom as to what drugs might work and how to develop them. When I sold everything to the pharmaceutical world, my concern was that we were empirically developing drugs. One approach is to do an early trial to sort out what happened, and another approach is to understand the human body and create very deep wisdom, rather than knowledge. Unless you can go from knowledge to wisdom, it’s like developing things in the dark. You can’t go from knowledge to wisdom without information technology, machine learning, and machine vision; you also need supercomputing access and fiber optics technology, which we have now.
You have participated in businesses not only in healthcare but also in publishing, such as the LA Times. Why did you become interested in journalism?
When I grew up as a kid in apartheid-era South Africa, my only access to knowledge was the newspaper. Unless you have access to valid news, as opposed to fake news, the infrastructure, democracy, and truthfulness will be lost.
In South Africa back then, Asians had no right to own property or to vote, and we even had segregated schools. Sometimes it was a little bit of a blessing because the Chinese community even hired teachers from Taiwan to educate the kids. When I was in medical school, there was a quota for how many Chinese could get in. I think there were only 3 out of 200. I was the first Chinese doctor ever to be allowed to work in the white hospital—the “General Hospital.” To hire me, they had to go to the Pretoria Government, which gave permission as long as I took 50% of the salary of my Caucasian peers. I was happy to do so for learning. My upbringing has formed everything I do here now; what we do as an organization of NantWorks, culturally, is figuring out a way to help the underserved and the underdogs. It has formed a lot of what we do, both businesswise and philanthropically.
As a philanthropist, you founded non-profit organizations such as the Chan Soon-Shiong Family Foundation, and the Chan Soong-Shiong Institute for Advanced Health. What are the foundations’ goals, and what do you hope to achieve through such philanthropic activities? What made you decide to establish not one, but two charities?
Chan is Herald Chan, my wife’s father, who took me under his wing, and Soon-Shiong is my father, who died when I was still in medical school. So, the foundation’s name came from my two fathers. The goals of my two non-profit organizations, namely the family foundation and the Institute of Advanced Health, are well-aligned. Our goal is that the family foundation, as well as NantWorks, address what we believe are critical issues that face humanity. We hope to help the underserved in many ways, whether it relates to healthcare or just basic fundamental services, like bringing energy, food, and education to underserved communities. The issues that face humanity and the underserved are universal, and healthcare was obviously my forte. That’s why we supported the development of the Martin Luther King Community Hospital, which serves the disadvantaged community in downtown L.A. Before our support, this hospital had shut down because people were literally dying due to a shortage of budget.
I knew situations like this had to stop, and so I worked with the L.A. county, specifically Mark Ridley Thomas, to build and open up a new hospital there. Then I turned my attention to major academic centers, several local community hospitals, and small Catholic hospitals, like Saint John’s medical center in Los Angeles. After that, I looked to Windber, a community hospital for poor coal miners in Pennsylvania. Now, I am working with the Navajo and Apache Nations in Phoenix, AZ. These are truly some of the most underserved in the entire nation, and this is really the focus of healthcare. The Institute for Advanced Health strives to leapfrog these underserved communities—ones that struggle to receive even a chest x-ray—to the next generation treatment. The support would allow these communities to have machine learning or artificial intelligence, get next-generation care for infectious disease, make sure patients are cared for, and provide access to clinical trials. It can also help educate healthcare providers; my concern has always been that it takes almost 17 years for a medical breakthrough to integrate into the regular practice of medicine. These reasons are different but possess overlapping goals.
You and NantKwest are aiming to create the Cancer Memory Vaccine to achieve high-dose, chemotherapy-free, biologically-driven immunotherapy for the prevention and early treatment of cancer. Could you please explain the idea behind the vaccine? How does this work affect our understanding and treatment of the Coronavirus?
That's a complex question that I've grappled with for maybe 30 years of my career. Finally, in the year 2020, we have some clinical evidence for the hypothesis that cancer cells are quietly generating—and a thought experiment has come to light. The human body has evolved, not from a species, but from cells that have evolved over 500 million years to protect the human body. Until now, we did not realize this. Even worse, we did not realize that these highly protective cells—cells that create memory and protection against things like the Coronavirus, HIV, and cancer—are universal cells that we are born with and that we have inadvertently been wiping out with our treatment. That's a very frightening statement, and I was not prepared to make this statement public until I could prove it. Now, I am ready to do so, but it is complex.
We are born with multiple cell types in our blood that have different functions. Red blood cells form to provide oxygen, and if you don’t have enough of those red blood cells, you get anemic. If you don’t have enough white blood cells, you have a condition called neutropenia. You have three other cell types to protect you from cancer, the Coronavirus, and HIV; these are the natural killer cell, the T cell, and the dendritic cell. These three cells, which I call the “triple offense”, are key to curing cancer and generating what I call a memory NK and T cell—a cancer vaccine.
For the past 40 years, the scientific and medical communities have gone down the assumption path that to kill cancer, we should bomb it with high dose chemo and radiation. Inadvertently, in doing so, we wiped out the “triple offense” which were there to protect us. While the industry has developed treatments to replenish red blood cells (Epogen) and anti-ineffective cells and to replenish cells to fight infection (neutrophils) in the form of Neupogen, nobody has addressed reducing the cells that protect us from cancer—the lymphocytes consisting of NK and memory T cells. In addition, nobody has addressed what happens when you wipe out these protective lymphocytes.
Enter the Nant cancer vaccine. We have developed techniques and biological mechanisms to awaken and rescue the lymphocytes, the triple killers (the natural killer cell, T cell, and the dendritic cell), the CD8, the memory cell, and the macrophage. Focusing on the cells that matter rather than cells we've wiped out is what we do in NantWorks, ImmunityBio, NantKwest, and NantHealth.
"Our goal is that the family foundation, as well as NantWorks, address what we believe are critical issues that face humanity"
What is the Nant cancer vaccine? Well, the first cell that I am completely obsessed with is the natural killer cell, called the NK cell. It was born 500 million years ago to prevent us from getting bacterial and viral infections, and I think it will have a major role in combatting the Coronavirus. If you look at patients who died from this novel virus, the common denominator is lymphopenia, which is exactly what happens when a patient has high dose chemotherapy and radiation. Thus, we are now seeing complete responses in very late-stage cancers (triple-negative breast cancer, metastatic pancreatic cancer, and head and neck cancers). Ironically, we have done so by addressing the lymphopenia with the natural killer cells grown completely off the shelf with the engineered natural killer cells, or by introducing molecule IL-15, which stimulates the natural killer and T cells. We are in a registrational trial for lung cancer, pancreatic cancer, breast cancer, local cell carcinoma, and bladder cancer. In fact, we've just filed a Phase 1 study with the FDA to use molecule IL-15 for the Coronavirus. We now have treated 700 patients safely; using thousands of doses with normal volunteers, we have shown that it activates the NK cell of the T cell, which is exactly the cell that could kill a Coronavirus-infected cell.
What is your biggest goal? What do you hope to see in the future as a result of following the path you pioneered?
Well, I’ve got some big problems I’m trying to fix right now—cancer, HIV, and the Coronavirus. I have always been fearful of a pandemic such as this one, but I think we will have a universal treatment that can address it. We only have 8,000 doses of the drug that can mitigate the infection, which is still challenging. Thus, that's the big goal—trying to get that all done, together with the generating capability. The next goal is working on climate change. Today, we have a huge inflow of industrial heat that can change the way of generating electricity or create next-generation plastics that are completely renewable. Maybe we will be able to use hydrogen as a source of energy. These are the challenges I am very excited about. My colleagues and I have taken about three years into that development, and I want another two years for quiet work before sharing the results with the world.
Dr. Soon-Shiong, you have been a leader in many of the fields you are involved in. Many of our readers will find your path to be an inspiration. Could you please share a message for future entrepreneurs/physicians that aspire to exceptional careers and accomplishments?
Follow your passion. I think that's probably the most important statement I can make. Follow your passion, and then also follow the science. I think you have to be realistic about the fundamentals of science. If you really have a scientific basis for a belief, a therapy or a treatment, and can demonstrate it scientifically, then you should pursue that belief with all your passion. The most important message I would like to share with the WAMJ readers is: have perseverance and believe in yourself.
Patrick Soon-Shiong, M.D.
Chairman and Chief Executive Officer, Nantworks
Owner and Executive Chairman, Los Angeles Times and The San Diego Union-Tribune
Patrick Soon-Shiong, M.D., is a physician, surgeon, professor, researcher, philanthropist, and a billionaire entrepreneur. He is the Chairman and CEO of NantWorks, the umbrella organization for an ecosystem of companies aiming to create transformative global health information and next-generation Pharma development network. Dr. Soon-Shiong invented and developed the revolutionary blockbuster drug Abraxane, which is known for its efficacy against lung, breast, and pancreatic cancer. Over the span of his career, he has also pioneered novel therapies for both diabetes and cancer, published over 100 scientific papers, and issued over 230 patents worldwide for groundbreaking advancements spanning myriad fields of technology and medicine. As a surgeon, he performed the world's first encapsulated human islet transplant, the first engineered islet cell transplant and the first pig-to-man islet cell transplant in diabetic patients. With the mission to erase disparities in access to healthcare and education, he founded non-profit organizations, the Chan Soon-Shiong Foundation and the Chan Soon-Shiong Institute for Advanced Health. Dr. Soon-Shiong's visionary leadership and commitment to advancing medical and scientific research and bringing new treatment options to cancer patients was recognized by many international and national awards, including the Franklin Institute Award in 2016. In addition to his businesses in the healthcare arena, he is also the owner of the Los Angeles Times, The San Diego Union-Tribune, and part-owner of LA Lakers.