Can Patrick Soon-Shiong silence his many critics?

After his recent appointment to a national health IT advisory committee, Soon-Shiong explained how his life’s work is now converging towards major advances in cancer and healthcare more broadly.

LOS ANGELES, CA - MARCH 22: CEO of Abraxis Health Institute Patrick Soon-Shiong during a Urban Economic Forum co-hosted by White House Business Council and U.S. Small Business Administration at Loyola Marymount University on March 22, 2012 in Los Angeles, California. Topics discussed at the forum included the Obama administration's support for policies that create private sector-jobs and future entrepreneurs. (Photo by Kevork Djansezian/Getty Images)

On the phone, Patrick Soon-Shiong speaks slowly and deliberately. He clearly trusts himself, but he doesn’t trust journalists anymore.

A series of scathing articles by STAT News and Politico sent stocks in his publicly-traded companies tumbling earlier this year. On Monday, he has an opportunity to change that narrative somewhat, with the unveiling of his full cancer vaccine program at a major oncology conference.

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The stories allege that despite his bold claims, Soon-Shiong’s NantWorks subsidiaries are underperforming and reliant on contracts from other companies in the group. Reporters have also claimed that one of his companies, NantHealth, has received contracts from institutions that had received donations from his nonprofit foundation — a major conflict of interest. This was not adequately disclosed prior to the massive initial public offering of NantHealth, they argue, which may violate SEC laws.

For his part, Soon-Shiong, dismisses the allegations noting that part of the motivation behind those stories was political: “They had never written about me until they saw this picture of me with Trump.”

Speaking to MedCity on Wednesday after his recent appointment to a national health IT advisory committee, Soon-Shiong detailed how the various threads of his career are converging toward a pivotal moment. A solution for healthcare is almost within reach and he’s poised to unveil work underway on what he believes is a disruptive cancer therapy – the Nant vaccine – at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago on Monday.

This story clearly clashes with many other viewpoints in the industry.

How can you “solve healthcare?” How can you “cure cancer” when tens of thousands of oncologists currently meeting in the Windy City can’t?

Soon-Shiong may have achieved success as a scientist, as a CEO, and as practicing physician. That doesn’t mean he’s in a position to fix the tremendously complex U.S. healthcare system.

He, however, begs to differ. 

“The opportunity now to give input into the complexity of healthcare is something I’ve spent my life working on,” he declared.

Soon-Shiong wants to innovate from the inside out, applying his 25 years of experience wearing different healthcare hats. 

It all began in the 1980s, with an early role as a NASA-funded scientist at UCLA experimenting with pancreatic transplants for patients with cancer or diabetes. That work led him to stem cells, which he discovered to be “the exact heads and tails of the biology of cancer.”

Stem cells drove him to understand the inner workings of proteins, which drove him to genomics and proteomics, which ultimately led to machine learning. 

“We needed to create a machine learning tool because the biggest code on the planet is the human genome. The next was the transcriptome which led to protein pathways. So we needed to create supercomputing,” Soon-Shiong explained. 

As he dove into each field, he found new tools that could help tackle the big challenges within healthcare, including the need to have patient data available in real time. 

The availability of data would help to treat the world’s seven billion humans instead of a select few, something that he stressed repeatedly. To make this happen would require widespread interoperability.

“So HIT [health IT] or interoperability is one element of really a big question of integrating healthcare as a system; from the knowledge domain, which is 21st Century medicine; to the delivery domain, which is dis-coordinated [sic] trial and error care; to the payer domain, which creates unintended consequences with fee-for-service.”

If these three silos can be integrated into a single system, then healthcare can be transformed. 

“And once you’ve done that you can create a new paradigm for cancer treatment, which would end up as what I call the cancer vaccine,” Soon-Shiong said.

At ASCO, NantWorks will be unveiling the full extent of the program. As with Soon-Shiong’s ideas about healthcare, the cancer vaccine has been brewing for decades. 

After working as a physician-scientist, Soon-Shiong moved into drug development. In 2001, he founded Los Angeles, California-based Abraxis Sciences. It was there he made his fortune — now estimated at around $8.6 billion. Much of it came through the development of the cancer drug Abraxane and the subsequent sale of the company to Celgene in 2010.

Then, it was time to take on the bigger integrated healthcare idea and a therapeutic for cancer that would also disrupt the current paradigm.

Soon-Shiong began to build a network of for-profit and nonprofit entities all operating under a holding company called NantWorks. The website currently lists nine subsidiaries. Each was created to fill a specific gap in the healthcare puzzle he is trying to put together. Once it’s complete, he will reign over it all — according to the NantWorks website.

“NantWorks is the vision of Dr. Patrick Soon-Shiong: scientist, doctor, inventor and technologist. The NantWorks name derives from the Apache word, “Nantan,” which means he who speaks for the people. It has always been Dr. Patrick Soon-Shiong’s hope and dream to create a company that bridges people’s desire for knowledge with their ability to access it. NantWorks is that dream.”

If it needs pointing out, this is an unusual approach to company formation. The subsidiaries aren’t created with a business opportunity in mind. Their aim, instead, is to execute one part of Soon-Shiong’s vision and he has personally committed money to the cause.

“I’m in the fortunate position of, I’ve never asked anybody to donate any money. I’ve not received any government grants. We’ve used our own money when I could have done something else with it, to actually find a path to share this with the country,” he said.

There are some problems with the above description. According to investigations done by STAT News and Politico, Soon-Shiong has used his “charity” the Chan Soon-Shiong NantHealth Foundation to boost some of these businesses. There was internal collaboration and a grant given to the University of Utah by the foundation, which then spent the money contracting the services of a Nant subsidiary.

Some also question whether the tax-exempt status of his foundation is being abused. For his part, Soon-Shiong vehemently denies any wrongdoing. 

“The truth about our foundation is we donated $200 million in 2015. Didn’t take a penny of any tax deduction,” he stated. “There’s really not a word of truth in Politico.”

It’s possible that if NantWorks can deliver what Soon-Shiong is confident it will, then the business issues will fade away.

But can he really deliver?

Developed within NantKwest, a San Diego-based subsidiary, the cancer vaccine draws on the power of natural killer cells. It traces back to a paper Soon-Shiong published in the 1990s, which he said showed that natural killer cells were one of the immune system’s chief controls for stopping the spread of cancer.

The problem is that for years, medicine has turned to high dose chemotherapy and radiation to destroy malignant tumors. This suppresses the immune system – natural killer cells included – and allows cancers to metastasize.

Soon-Shiong said he wants to shift the paradigm towards boosting patients’ immune systems (i.e. immunotherapy). NantKwest has developed engineered natural killer cells that can be used in combination with existing monoclonal antibody therapies to beef up the immune system and beat back the tumor.

They’re scalable and “off-the-shelf” so-to-speak; there’s no need for self-transplants as with CAR-T immunotherapies. Large-scale manufacturing capacity is currently being ramped up because; “even at the time of clinical trials, we know we’re going to be overrun,” he said.

Hard data is not yet available, but Soon-Shiong talks of complete and durable responses that will convert nonbelievers.

“It’s very clear that we are completely on the right path,” Soon-Shiong declared. “And then you’ll see the pipeline, which I won’t reveal now. But we’ll reveal it at the [ASCO] booths, in all its glory.”

It’s one thing to be confident, it’s another to share unbridled optimism with the rest of the world regarding a killer disease that one renowned author/oncologist has famously called the “The Emperor of All Maladies”.

Aside from the self-assuredness, Soon-Shiong has drawn heat recently for sharing incredible patient stories for an unproven cancer therapy.

When asked whether he was overstepping the boundaries by marketing an experimental cancer therapy, Soon-Shiong didn’t miss a beat.

“Look, just so you know; I’ve been working with the FDA for 15 years,” he said. “I’m completely aware of the requirements. What we did was put up reports of patients that wanted to tell their stories to doctors, to educate them. And you know, you can go on the website and look at those stories. And there’s no marketing of anything, other than to tell the patient story with regard to the clinical trial effect of natural killer cells.”

When asked why his message is so different from the standard scientific tone, Soon-Shiong said he knows how close he is to a cure. As a physician, he has seen firsthand patients with metastatic cancers that have lived for years thanks to the cancer vaccine. 

“So the hopefulness is not born out of pure hypothesis, it’s born out of the patients that I actually touch and feel and see. I think we have a sort of mission to be able to share that… optimism. Because there is hope.”

Not share in an unresponsible way, he adds. The vaccine is still being tested in clinical trials, but he does feel obliged to share that optimism. Even as conservative scientists recoil. On Monday, detractors and supporters alike will have more information to make that call.

Correction: A previous version of the story incorrectly stated that Soon-Shiong will release the first clinical data about his cancer vaccine. Information on the vaccine has been available at the ASCO booths since Saturday but no clinical data has been released. It also incorrectly stated that Soon-Shiong’s subsidiaries had not raised venture capital. Per his quote, they did not receive government grants or angel investment. 

Photo: Kevork Djansezian, Getty Images