Soon-Shiong Q&A: Targeted cancer therapy is doomed to fail

Dr. Patrick Soon-Shiong spoke today at the Future of Genomic Medicine’s 9th annual conference in San Diego. The obvious focus of his presentation was the Cancer Moonshot 2020 initiative.

Patrick Soon-Shiong

Dr. Patrick Soon-Shiong spoke today at the Future of Genomic Medicine, Scripps’ annual conference in San Diego. The obvious focus of his presentation was the Cancer Moonshot 2020 – the U.S. government-sanctioned effort to speed up the development of cures for cancer through immunotherapy.

As Soon-Shiong put it, oncologists must learn to be immunologists because as things are currently, we have “lost the war on cancer.”

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The NantWorks founder sat down at the conference after his presentation for a one-on-one interview and elaborated on his mission and why what is being done currently to diagnose and treat cancer is not working and needs to change.

Can you share more about why immunology is the essential direction in attempting to conquer cancer?

We have medical insights that we’ve never had before. We really need to think of cancer almost like an infectious disease. In fact it really is because when you think about Hepatitis C and HPV, these things all cause cancer – it is not by accident. It causes cancer because it takes over the genome and you get those mutations.

What is not realized is that what you have in your body, you and I sitting here, we have material that we need to harness, so we don’t need drugs from a drug company – we just need to harness the drugs in our own body. We need to activate these molecules and not destroy them. In order to activate them, we need to better understand our bodies and think like the cancer or the virus. On the other hand there are ways with combinations of drugs to cure diseases like Hepatitis C that previously appeared to be incurable. We are the same flexion point with cancer.

What does that mean for oncologists right now based on the training they’ve always based a practice on?

It means we need to figure out a way to take the incredible experience that currently exists, because medicine is still an art, not a science, and add scientific knowledge to that is so complex but bring it down to point-of-care in understandable, actionable terms.

That’s why we’ve created the tumor board, but the tumor board is actually an educational board. While we need to take the current generation of oncologists and re-train them as clinical scientists, we also need to train the next generation that is in medical school. They will be the smartest oncologists that will supersede.

It’s like asking someone to get rid of a fax machine when you have a smartphone. Everything that’s being done in hospitals is still being done with fax machines. It’s hard to believe. The only industry that still relies on fax machines.

If you take the fax machine and smart phone analogy and compare it to hydos chemotherapy and immuno-oncology, that’s the struggle. That’s the gap.

You use the phrase “we’ve lost the war on cancer.” Can you explain why you look at it that way?

We take cancer as a single battle at a time. The battle is that you’ve got this mass, and I need to reduce it to see if there is a complete or partial response. Depending on how much you reduce might think, “Oh my God, I’ve won.” But you’ve not won because what’s happening is you’ve just thrown the resistance clones into somewhere hiding, so it can reappear, if it is multi-clone.

There are instances where the mutation is a single mutation, like how we have treated an cured testicular cancer. But with solid tumors – breast cancer, lung cancer, colon cancer – there are just multitudes of mutations.

The whole point is we’ve had the wrong assumptions. So when I say we’ve lost the war, not only has all of our training been based on wrong assumptions, we’ve based treatment on anatomy and just enough so that it won’t kill you, but it will kill the cancer.

We win certain battles, but we lose the war.

What’s your relationship like with Joe Biden as you work on Moonshot together?

We speak often. He visited us in November. We got very close during the time when we were taking care of his son. But more importantly, his role is to work through what he can do, which is working with the government – HHS, CMS, FDA. My role is to integrate the community, which is the private sector and the philanthropists for example. We work together with a common goal, and that is to accelerate immunotherapy within the next ten years.

Do you think ten years is…

Ambitious. Yes. But why not make it ambitious.

If we work together as a nation – think about this – 1.1 million new diagnosis a year, 13.5 million cancer patients a year, we [Moonshot] are talking about 20,000 cancer patients in four years. Why can’t we do that? Think about that. Is that ambitious?

It sounds ambitious because only 4 percent of patients go through clinical trials. But the reason for that is because of most patients and their community. I need to support the community oncologists, and that’s another part of the Biden initiative – creating collaboration and sharing information.

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