By John Steele

> “For the loved ones we’ve all lost, for the families that we can still save, let’s make America the country that cures cancer once and for all.” > > — President Barack Obama, State of the Union Address (2016)

Patrick Soon-Shiong is set to transform cancer treatment. On January 12, 2016, he, along with a collaborative effort spanning industry, government, and academia, launched the Cancer MoonShot 2020. This ambitious initiative seeks to move away from traditional trial-and-error methods and instead train the body’s immune system to recognize and combat cancer cells. Soon-Shiong believes that our immune system is fully capable of identifying and destroying cancer with precision, provided it can first detect the abnormal cells.

Soon-Shiong has a proven track record of success. In July, one of his companies achieved the highest-value biotech IPO ever. His cancer medication, Abraxane, is approved in over 40 countries to treat breast, lung, and pancreatic cancers. His journey from medical school in South Africa through various prestigious roles has equipped him with a unique perspective and the necessary resources to lead such a groundbreaking project.

During our discussion after the MoonShot announcement, Soon-Shiong expressed his fascination with the advancing cancer science and his optimism regarding imminent breakthroughs. It appears that this is a pivotal moment to reassess our approach to cancer.

What’s wrong with current cancer treatments?

Presently, cancer treatments largely rely on empirical methods and incomplete data. The wealth of information available today underscores a long-held belief of mine: that we possess innate defenses against cancer and infections. The body’s response to infections mirrors its fight against cancer.

Have we oversimplified our understanding of cancer?

Absolutely; this oversimplification is a significant factor in our ongoing struggle against cancer. Medical training often emphasizes a reductionist view, adhering strictly to protocols. However, cancer is inherently complex and nonlinear, existing within a chaotic framework. There is no singular method to control it; we must adopt a multifaceted approach, monitoring and adapting our strategies continuously. This may sound abstract, but recent findings highlight that even biopsying different areas of the same tumor can yield varying genetic sequences. This variability challenges reductionist models and complicates treatment strategies.

Cancer signifies a breach of the human body’s inherent agreements.

How do you perceive cancer?

I view cancer as a collection of unique diseases, each with its distinct molecular makeup. Various subtypes of lung cancer, for example, can effectively deceive the immune system into ignoring their presence. If we can educate the immune system to recognize and eliminate these cells, we could revolutionize cancer treatment. The prevailing approach of administering high doses of chemotherapy that suppresses immune function must be reconsidered. Instead, we should leverage our understanding of cancer’s complexity to trick it into self-destruction.

Is cancer a normal aspect of life?

Indeed, cancer is part of our physiological reality. The process known as apoptosis describes how normal cells die, akin to autumn leaves falling. Cancer represents not merely uncontrolled growth but a failure of cells to die when necessary. Even as we converse, your body is generating cancer cells, which are usually eliminated by the immune system. Thus, cancer and regenerative medicine are intertwined, as cancer stem cells are essentially normal stem cells that have deviated from their intended function.

Do these cells exhibit intelligence?

Observing how cells interact reveals a remarkable level of intelligence. They engage in what I term the "dance of proteins." A natural killer cell, for instance, has around 30,000 receptors that allow it to perceive its surroundings and modulate its activity. The immune system operates with astonishing elegance; understanding this orchestration opens up new avenues for cancer treatment.

What is the Cancer MoonShot 2020?

The Cancer MoonShot 2020 aims to harness the body’s immune system in the fight against cancer. My involvement began when Vice President Biden reached out regarding his son’s brain cancer, which spurred my work in diagnostics. Following his son’s passing in May, I drafted a white paper in October outlining strategies for accelerating cancer immunotherapy through genomic sequencing and big data. This document became the MoonShot’s guiding principle. My role encompasses coordinating various efforts as a physician, surgeon, oncologist, immunologist, former NASA scientist, and corporate leader. We are embarking on an ambitious journey—not necessarily to cure cancer by 2020, but to activate the immune system to combat it effectively. This week, we will present a groundbreaking neoepitope targeting antibody aimed at mutant cancer proteins, showing promising results in patients with advanced colon cancer who have exhausted all other treatments.

Cancer research now allows us to interrogate cells in real time using cutting-edge CRISPR technology.

How does modern genetics contribute to the MoonShot?

In 2003, many believed cancer could be solved with the mapping of the human genome, a notion that was overly simplistic. The focus should be on gene expression outputs rather than the genes themselves. What was once considered "junk DNA" actually plays a critical role in regulating gene activity. Whole-genome sequencing has revealed that it’s not merely the genes but the proteins they produce that matter. Understanding the complexities of gene interactions and pathways is crucial for identifying cancer-causing mechanisms.

Is gene editing technology significant?

Our grasp of cellular mechanisms has reached unprecedented levels. CRISPR technology enables us to manipulate cells in real time, allowing us to test our hypotheses effectively. We can now assess numerous biomarkers within the immune system to further our understanding of protein interactions.

How crucial is big data to the MoonShot?

Big data serves as a vital tool, but it must be applied dynamically to validate hypotheses. My concern with existing big data discussions is that they often focus on retrospective data rather than real-time, actionable information. The real-world data I gather during treatment is what drives our approach.

What sparked your interest in science?

Growing up in South Africa without television, I immersed myself in radio and literature. Magazines like Knowledge and Look and Learn fueled my fascination with science. At 13, I resolved to pursue a career in this field. My educational journey began at a Chinese high school, where I took on the responsibility of teaching my class when our science teacher fell ill.

What was your medical education like?

I completed a six-year medical program followed by a year of internship in South Africa, where I received comprehensive training across various medical disciplines. This broad exposure laid the groundwork for my later studies in Canada, where I focused on protein interactions while completing my surgical residency.

What drew you specifically to cancer?

The initial pancreas transplant patients I worked with had successful outcomes, yet both rejected their transplants. This experience prompted me to question the appropriateness of my interventions. I then pivoted to regenerative medicine, seeking to improve transplant outcomes. My exposure to NASA's research on stem cells for astronauts on Mars intensified my interest in the immune system, culminating in the invention of Abraxane, a pioneering cancer drug.

This post was originally published on Nautilus on January 28, 2016.