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SANTA MONICA, Calif. –- You have been diagnosed with lung cancer.
There is a bewildering array of drugs, and combinations of drugs, that may shrink the tumor and prolong your life. Or they could make matters worse and give you terrible side effects.
In the past, this decision was mostly a crude guess, and it was often wrong.
No longer.
Now, your doctor draws blood and tissue, sends the information to a medical Big Data center that, in seconds, sequences your entire genome and, more importantly, maps how the proteins and the cells in your body are translating your specific DNA mutation into tumor cells. Your doctor then accesses a secure global “bank” of cancer DNA and tissue, and develops an individual cocktail for you, administering it with precise nanotechnology. You recover at home, monitored by high-information devices connected through transmitters to your doctor and clinic.
This is a glimpse of the future that Dr. Patrick Soon-Shiong of Los Angeles has spent a decade imagining -- and is now rapidly assembling. The technology and science are all at hand, he says. It’s “just” a matter of putting them together into a logical and humane whole.
“We now can create a pathway to fight cancer to a standstill,” Soon-Shiong tells me in an interview here. “Not to cure it, per se, but to make it a survivable feature of the human condition.”
While he is focusing on cancer -- his specialty -- his basic idea is at once profound and simple: to map the molecular life of all of mankind in the service of better health for each individual. Linking research, treatment and careful monitoring is also the only way to control costs and create accountability in medical care, he says.
The question is whether his approach is practical, or even possible. Soon-Shiong is out to prove that it is -- and that it is, in fact, the only way forward.
While the most powerful man in Washington struggles to expand health insurance, the richest man in Los Angeles is methodically constructing a far more fundamental medical effort: a digitally enabled, science-driven, personalized health care system.
With Washington distracted by the insurance issue -- and with federal science and tech research hampered by “sequester” budget cuts -- privately funded efforts such as Soon-Shiong’s are all the more crucial.
President Barack Obama and Dr. Soon-Shiong share certain affinities, including vaulting ambition, a multicultural background, a knack for systematic thinking and an obsession with basketball.
But while Obama grapples with health care from the outside-in –- from government and politics –- Soon-Shiong works literally from the inside-out, guided by his own knowledge of everything from the molecular structure of cancer to the balance sheets of hospitals and the computing and fiber-optic requirements of Big Data.
In a secure warren of office suites on the west side of Los Angeles, the surgeon-turned-drug-magnate-turned-entrepreneur has laid out his health care vision in a series of floor-to-ceiling flowcharts.
The proprietary charts, and the money and medical experience behind them, are the road map that Soon-Shiong has refined over a decade on his way to courtside Lakers seats and a net worth of $7 billion from the drug companies and patents he’s sold.
Known in-house as “The Rocket Ship,” the mostly privately funded project aims to link supercomputers, super-fast data networks; personal monitoring devices; wired hospitals, clinics and phones; nanotechnology; and genome and molecular “proteomic” sampling into a system that can provide individually tailored wellness care and cancer therapy at affordable prices.
So far, Soon-Shiong tells me, he has poured $800 million into 60 companies, university research programs and his own “do tanks” -– all under the aegis of a company he calls Nantworks, in honor of the nanotechnology he used to create a breakthrough cancer drug.
The son of Chinese émigrés who originally settled in South Africa, Soon-Shiong isn’t the first corporate buccaneer to have had such a vision, nor is he the only one now. The founders of Netscape and AOL were early movers, and now everyone from drug companies to telecommunications giants want in on the action. Universities, seeking both pure research triumphs and business for their hospitals, are working hard on pieces of the system, too.
After all, health care is one-sixth of the economy, and the Baby Boom is aging fast.
But, at a youthful 61, Soon-Shiong may have the right combination of polymathic mind, medical experience, research chops, financial resources, ego and salesmanship to get his comprehensive “Rocket Ship” off the ground before anyone else.
Indeed, parts of the flowcharts have come to life. They include a supercomputing facility in Arizona for rapidly sequencing entire human genomes; a national high-speed network called National LambdaRail; a research “bank” with tissue samples and sequenced genomes of cancer patients; a company that produces low-power medical monitors for easy home use; another that produces sophisticated body monitors; and research affiliations with hospitals, clinics and cancer-care centers nationwide. He also has deals with AT&T, Verizon and Vodafone.
Just last week, Soon-Shiong struck a deal with government officials in London to provide data processing services to the U.K.’s DNA data bank. ?
“In the past, the scientific, technological and digital pieces did not in exist to assemble the whole,” Soon-Shiong says. “Now they do. I like to look for patterns, in science and life. It’s what I do.” Only an interconnected, instantaneous, molecule-to-manufacturer managed care system can tap science and save money, he insists.
Studying Soon-Shiong’s flowcharts recently, a potential tech vendor marveled at what, at first glance, seemed like the work of a NASA programmer and a physics professor who stayed up too late one night.
“Looks like you’re trying to boil the ocean here,” the vendor said, using a dismissive engineering phrase for an answer too large for the problem.
“Let me correct you,” Soon-Shiong replied in his stately South African accent. “I am boiling the ocean.”
If anyone can boil the ocean, it might be Soon-Shiong, says Dr. Eric Topol, author of The Creative Destruction of Medicine and the director of the Scripps Translational Science Institute in La Jolla, Calif.
“His sense of hypomania as he pursues this can be overwhelming,” says Topol, who has no ties to any of Soon-Shiong’s Nantworks projects. “But he has had a career of purposeful activity so far, to be sure. I am very supportive of the concept he is pursuing. I hope he can do it, and maybe he is the kind of guy who can do it.”
Soon-Shiong all of his life has been taking on seemingly impossible tasks, finding bigger answers for lesser questions, thinking far outside of the box.
No one has questioned his intellect or drive. His family fled China during the war with Japan in the late 1930s. His father, Chan Soon-Shiong, became a grocer and respected dispenser of Chinese herbal remedies. Both parents were Hakka, an ethnic group admired in China for brains and ambition, but seen as outsiders who stressed kinship and mutual help for their own.
From the start, Soon-Shiong refused to be trapped by circumstances or tradition. Despite living in the twilight zone of South Africa's apartheid –- neither “white” nor “colored” –- he studied medicine at the country’s premier university and managed to get an internship (for half pay) at the top “white” hospital. His chosen specialty was the pancreas and, later, pancreatic cancer. Why? “The pancreas is by far the most complex organ in the body,” he says.
It didn’t take Soon-Shiong long to start thinking beyond South Africa. He got a research grant from the Royal College of Surgeons in London, and moved with his young wife, Michele Chan Soon-Shiong, to Vancouver, to pursue graduate research. Three years later, UCLA invited him to join the school’s faculty. He performed the first successful pancreatic transplant on the West Coast.
That’s a career for some doctors. But at 30, Soon-Shiong was just getting started. He had his father’s interest in medical chemistry and his own eye for the main chance. He saw it in pharmaceuticals. He used Asian connections to build a business manufacturing generic drugs.
But that was a means to another end: inventing new drugs. While working on a NASA grant to study the behavior of human cells in weightless space, he became fascinated by the role of protein molecules in cells. If healthy cells grow by ingesting protein, why not use albumin protein to deliver cancer-killing drugs to tumor cells?
The ultimate result was Abraxane. It encases a well-known tumor-fighting drug (paclitaxel) in injectable nano-packets of protein. Soon-Shiong developed a complex system for freezing the material and spraying it through tiny nozzles to manufacture the particles. The idea was to target the drug and avoid the side effects of paclitaxel.
There were medical skeptics, and others who questioned Soon-Shiong’s business practices as he built his pharmaceutical empire. He once settled a corporate case out of court with his own brother. His pride and salesmanship occasionally clash with scientific caution. The FDA once ordered him to tone down promotional claims about his nanotechnology standards. Early in his career, he touted a diabetes treatment based on what turned out to be only a temporary success with a single patient.
But the FDA first approved the Abraxane technique in 2005. Abraxane is now approved in the U.S. for breast, lung and pancreatic cancer treatment. Regulators in Europe recently gave Abraxane tentative approval for its first use there, for pancreatic cancer.
Soon-Shiong eventually sold both his generic drug company and the company he built around Abraxane. He took stock in Celgene, the company that that acquired Abraxane. Celgene's stock price has soared 188 percent since the acquisition was announced in June 2010.
He is the richest man in LA. His wife retired from her career as an actress to rear their two children. One is in college and the other is heading there.
So now what? He has signed the "Buffett Pledge," promising to give at least half his fortune to charitable causes. Some people might retire, or turn entirely to philanthropic work. Not Soon-Shiong.
Having plunged as far as possible into the micro-world of cell and cancer biochemistry -- down to peptides and organelles -– Soon-Shiong has turned the lens around to look at humankind as a whole, as though we are a gigantic cellular system.
“I’ve been thinking about this nearly a decade,” he says.
He began acquiring companies and patents, some seemingly far afield from medicine. For example, Soon-Shiong owns numerous patents in the hot field of machine vision. How he can integrate that into his health care pursuits isn’t clear.
But give him time.
“I probably could make more money -– a lot more money -– from that business, but I want to stay focused on medical care,” he tells me.
“I have an obligation to use what I know to try to bring real, usable medical science to every doctor and bedside and patient,” he says.
In a sense, he is returning to his ethnic communitarian roots as Hakka Chinese. Only now, the community is the entire human race and all of the DNA, proteomic and cellular information we possess.
“We need to and must protect privacy,” Soon-Shiong says. “But I think that people will be willing and even eager to share medical information about themselves for the greater good of mankind.”
Until recently, few outside of the health care industry or LA knew about Soon-Shiong. But now, he is carefully stepping into the media limelight to promote his ideas, his company and his values.
Proud of his achievements but restless for more, Soon-Shiong has decided that visibility means business and more attention for his holistic approach to medical care. A dedicated sports fan, he bid on, but failed to win, the Dodgers. He bid on, but failed to win, rights to a new National Football League team in LA. But he did manage to buy Magic Johnson’s interest in the NBA’s Lakers.
When the Lakers are at home, you often can see Soon-Shiong (usually with his wife) in his courtside seat in the Staples Center.
He watches with a player’s appreciation of the game, having started shooting on netless hoops back in South Africa when he was 10. When he arrived in LA in 1980, he was able to play pickup games at UCLA’s Pauley Pavilion, and became a rabid Lakers’ fan. The Lakers were then reemerging with a fast-paced, flowing but disciplined style of play they called “Showtime.”
Soon-Shiong fell in love with “Showtime.” Lakers games, he says, are “a sacred space” for him –- the only time he isn’t thinking of his work.
But of course there is a science and a pattern involved even in being a fan. It has to do with where he sits.
Given his net worth, many years as a fan and close ties to the team, he could have any seat, with the possible exception of Jack Nicholson’s.
Soon-Shiong chose seats at the end of the court, halfway between the basket and the corner. It’s the end of the court on which, as the home team, the Lakers play the last quarter. So Soon-Shiong can watch the action under the basket and study fast breaks as they come toward him.
There are other angles. The seats are close to the Lakers bench, which he can observe and eavesdrop –- or visit during breaks. He is visible in the arena -– political and business leaders know where to find him –- but isn’t center court, with the Hollywood crowd. He is near the tunnel through which the Lakers enter and leave.
“This is the perfect place to sit,” he explains at a recent game. “I see everything.”
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