You may not know the name Dr. Patrick Soon-Shiong, but the White House certainly does. Earlier this year, Vice President Joe Biden tapped the billionaire surgeon and biotech entrepreneur to advise the Obama Administration's Cancer Moonshot program to develop genetically tailored cures for the diseases.
On November 19, the man Biden described as a "brilliant, sometimes controversial guy" had dinner with two other controversial guys, President-elect Donald Trump and Vice President-elect Mike Pence. Of the meeting at Trump's New Jersey golf course, the transition team said in a statement that the trio discussed "innovation in the area of medicine and national medical priorities that need to be addressed in our country."
Soon-Shiong (who donated $50,000 to Hillary Clinton's campaign effort, according to the FEC) thinks big, puts himself at the center of issues, and doesn't mind taking credit for things he isn't wholly responsible for (like the advancement of immune-based therapies). "I'm sort of this doctor with a complete scientific bent," Soon-Shiong told Fast Company in one of several conversations from the past few months. Though many experts have been working to harness the body's own immune system to fight off cancer, Soon-Shiong's name has been widely associated with the concept. "Maybe in my lifetime, we can maybe find a way to cure cancer," he says.
The 64-year-old surgeon and entrepreneur has made a fortune and won praise for his health tech ventures, such as creating Abraxane, the targeted chemotherapy for breast cancer that made him a billionaire. (Forbes estimates his net worth at $9.8 billion.) But he's also drawn warnings from federal regulators, spurred lawsuits, and received a skeptical reaction from some peers in the medical community.
While aiding the government's Cancer Moonshot program, Soon-Shiong also launched his own private-sector effort with the confusingly similar name Cancer MoonShot 2020. It's an outgrowth of his company NantWorks, a conglomerate of firms that aims to play a role in every aspect of cancer research and treatment, from genetic testing and analysis to chemotherapy development to hospital information systems to immunotherapies. He says that immune-system treatments might tackle catastrophic viral infections like Zika and Chikungunya, too.
Instead of assaulting the patient's body with devastating blows of toxic chemicals or radiation, Soon-Shiong advocates coaxing its immune system to discretely attack just cancer cells—the way it does so effectively against invaders like viruses and harmful bacteria. This requires priming the immune system, like with a vaccine developed from the defective proteins in a patient's own tumors, what Soon-Shiong calls neoepitopes. "So it's like an infection," he says. "So think of . . . treating yourself for flu or treating yourself for strep throat."
Cancer research has been heading in this direction for years, and Soon-Shiong is an eloquent advocate of the approach. In March, at the Future of Genomics conference in San Diego, cardiologist and geneticist Eric Topol interviewed Soon-Shiong in front of some of the world’s top genetics and cancer researchers after the billionaire’s keynote address. "Nobody could ever accuse you of not thinking big," Topol said. "You're basically this portal from challenging dogma to building hope."
Like Trump, Soon-Shiong has made bold promises that beget skepticism. "These guys that make wild claims are inherently not to be trusted. We’re told in the scientific community that the data should speak for itself," says Dr. Ethan Weiss, a cardiologist and professor at the UCSF School of Medicine, when asked about Soon-Shiong's bold assertions.
"He’s a hype merchant propping up a lucrative empire with almost no real substance," tweeted Daniel MacArthur, a genetics researcher at Massachusetts General Hospital, regarding Soon-Shiong's meeting with Trump. (MacArthur later deleted his Tweet, telling Fast Company over Twitter, "It was an ill-advised joke that was taken out of context—now deleted.")
In 2014, a thorough profile of Soon-Shiong by Matthew Herper in Forbes surfaced a common complaint among medical experts: the doctor's penchant for pushing dramatic claims over details. He promised, for example, that in just 47 seconds, NantWorks' total health solution would be able to analyze a cancer patient's genetic makeup from a blood sample and recommend the specific protein to be targeted by medications. That was based on an average calculation for the efficiency of the entire computing system. The actual time Soon-Shiong was targeting for a real patient, Herper noted, would be about 24 hours—still very quick. "Which raises the question: Why the unnecessary, counterproductive hyperbole?" Herper wrote. "How easy it could have been to instead take a bow for the hardware and the high-speed data connections he has built."
Legal controversies follow Soon-Shiong. He's been sued by employees and shareholders, with allegations of fraud; companies associated with him have been cited by the FDA for safety violations and making unsubstantiated medical claims.
Soon-Shiong's ambitions are huge and his rhetoric sometimes gets him in trouble. But given the success he's already achieved, he’s not likely to change his approach anytime soon.
Born in South Africa in 1952 to a healer who specialized in traditional Chinese herbal medicine, Soon-Shiong earned his medical degrees in Johannesburg and Vancouver. Shortly after joining UCLA Medical School in 1983, he directed the university’s pancreas transplant program and became famous for performing the first pancreas transplant on the West Coast. He's married to actress Michelle B. Chan (best known for her role in '80s series MacGyver), owns one of the largest homes in L.A., and purchased Magic Johnson's share of the L.A. Lakers.
In May, he invested $70.5 million in Tribune Publishing, the newspaper group that owns the Los Angeles Times and the Chicago Tribune. The deal includes Soon-Shiong giving Tribune access to 100 technology patents that the doctor says will allow more interactive and immersive experiences for readers. Details remain vague.
Soon-Shiong built his fortune by developing Abraxane, a reformulation of an existing chemotherapy treatment for breast cancer, paclitaxel (the generic form of Taxol). As explained in the original research paper, Soon-Shiong encapsulated paclitaxel in albumin, a common protein, making it more effective at penetrating the affected tissue. "When I launched Abraxane, they said Abraxane was just another Taxol generic," Soon-Shiong says of critics in the cancer field, adding that "they had no appreciation" for the mechanism it used to access cells. The commercial success of Abraxane helped make Soon-Shiong one of the richest people in his adopted hometown of Los Angeles. (Some estimates have him as the richest person.)
Though he speaks about disease as a battle or war, Soon-Shiong criticizes the scorched-earth practice of traditional high-dose chemotherapy. "My job over the next five years is to break that," he says. Despite his claim to be leading the charge, the truth is, over the past decade, the oncology community as a whole has already been moving away from heavy-dose chemo and towards-immune system-based treatments.
"Immunotherapy, after a long and difficult struggle over decades, has emerged as one of the most exciting developments in cancer in a long time," said Dr. Francis Collins, director of the National Institutes of Health in a briefing with reporters on the government's Cancer Moonshot back in January.
The latest criticism of Soon-Shiong is that he has fed on the publicity associated with federal government anticancer work. On January 11, the morning before Barack Obama's final State of the Union Address in which the president announced the government's National Cancer Moonshot, Soon-Shiong held a webcast with a group of powerful allies in the medical world to announce the private sector-led Cancer MoonShot 2020. (A press release had gone out the day before.) "This is very much what we call a 'do tank,'" Soon-Shiong said. "It’s not a think tank."
The initiative’s ambitious goal is to enroll 20,000 patients, covering 20 types of tumors, in clinical trials that lead to FDA-approved treatments by 2020—a blink of an eye in the slow, methodical world of medical research. Following the live webcast, Soon-Shiong released a multicam video of the event overlaid with inspirational background music. "The essence of the goal is to move something that would normally take five years, 10 years, 20 years, into a highly ambitious goal, having it done by 2020," Soon-Shiong says.
But the timing of Soon-Shiong's announcement rankled some, leading to claims that he intentionally scooped the president of the United States. At the very least, didn't he create confusion between the two similarly named efforts? "I had no idea what they were going to announce at the State of the Union," he says. In reference to MoonShot 2020, he adds, "All of that was planned one year in advance. We initiated this in 2014."
Soon-Shiong claims to have a close relationship with and to bear some influence on Vice President Biden, whom he first met while Biden was seeking advice for his son Beau during Beau's struggle with brain cancer. (He died in May 2015.) Soon-Shiong takes credit for introducing the "moonshot" concept to Biden months before the State of the Union address. And when he talks about this transaction, he is very specific about the details.
"By October, I gave [Biden] a white paper that talked about the moonshot," he told the audience in San Diego. "By November, he visited us, and by December, he invited me to present this entire program." The presentation took place on December 1, 2015, at Biden's residence at the U.S. Naval Observatory; Soon-Shiong invited many people who would become members of his private MoonShot 2020, including Independence Health Group CEO Dan Hilferty and Columbia University researcher Dr. Azra Raza.
Some supporters of MoonShot 2020 come from universities and research centers. Staff from government institutes such as Walter Reed Medical Center and the National Cancer Institute (NCI) have also attended meetings or released statements of support—but they did so strictly as individuals, not as official representatives of their respective institutions. "We're looking for people doing the work. This is not about a name thing," Soon-Shiong says. Still, according to the industry newsletter The Cancer Letter, government officials asked Soon-Shiong to take all mentions of federal agencies off the press release announcing his initiative.
The creation of Abraxane is the central element of Soon-Shiong's origin story: It provided the personal vindication and wherewithal for the doctor to build his anticancer empire and shoot for the moon.
The FDA's approval of Abraxane in 2005 allowed Soon-Shiong to fund a complex multibillion-dollar web of companies under the umbrella group NantWorks that target the entire cancer-care life cycle—including computing and artificial intelligence used to collect and analyze medical data. NantWorks also branches into other areas, like managing patient electronic health records. NantWorks even owns a sound studio near its headquarters in Culver City, where neighbors include Sony Pictures. According to the company website:
NantWorks is a convergence of next-generation machine vision, object and voice recognition technologies, ultra-low power semiconductors, supercomputing, and advanced networks for the purpose of bringing the digital revolution to health care, commerce, and digital entertainment to an entirely new level.
Even the company name is multifaceted and hard to pin down. "'Nant' is nantan, which is the Native American that speaks for the people," Soon-Shiong explains. "'Nant' could be nanotechnology, 'Nant' could be neural network. 'Nant' is new approaches to neoepitope therapy." The goal is to make Nant the "Bell Labs of health care," he says, referencing the great research institution founded by AT&T in 1925 and now part of Alcatel-Lucent.
The NantWorks accounting is complex, with money moving back and forth between entities. For instance, In 2010, Soon-Shiong sold Abraxis BioScience (the maker of Abraxane) for $2.9 billion to Celgene. (Soon-Shiong was the largest individual shareholder in both companies, according to Forbes.) Then in 2014, Celgene put money back into NantWorks by investing $25 million in NantHealth and $75 million in NantBioScience, a Soon-Shiong company developing more chemotherapies. Health care IT company Allscripts purchased a 10% equity stake in NantHealth for $200 million in cash, while Soon-Shiong invested $100 million in Allscripts. (Meanwhile, a Celgene lobbyist is reportedly on Trump's transition team.)
One of NantHealth's projects is GPS Cancer, a reading of a patient's genome (DNA), transcriptome (RNA), and proteome (proteins) to develop targeted treatments for specific tumors. "So it's like a target, right?" he says. "GPS-ing your cancer." That's expensive, up to $50,000 per patient, but according to Soon-Shiong, in the long run, it's a cheaper treatment if the technique can someday cure the patient's cancer, when more advanced chemo- and immunotherapies become available.
Independence Blue Cross was the first health insurance provider to cover GPS Cancer, which Soon-Shiong says was the trigger for formally launching MoonShot 2020. (Other insurance carriers have since come aboard, such as South Dakota-based Sanford Health Plan.) There are links between these entities: An affiliate of Independence was a minority owner of NaviNet, which provides a portal linking physicians and insurance providers. NantHealth purchased NaviNet in January.
As if dominating cancer care weren't ambitious enough, NantHealth also aims to transform electronic health record keeping with software that collects and consolidates data from hospital devices like vital signs monitors and dialysis machines. Another offering gathers data from blood pressure cuffs and other home-care machines. The company promises that another product, NantOS, "will bring together the clinical, financial, operational, and environmental data to identify and solve complex health care problems such as quality, cost, and outcomes at a health system level, hospital level, service line level, physician level, and the patient level."
NantHealth went public in June of this year for a valuation of about $1.5 billion. In July, Soon-Shiong's NantKwest, which is dedicated to activating the immune system's "natural killer" cells to fight cancer, had a public offering valued at $2.6 billion. In an interview with Bloomberg, Soon-Shiong said that he had two more IPOs in the pipeline for other companies in the Nant umbrella: NantBioscience and diagnostic company NantOmics.
Soon-Shiong's recent IPOs provide a glimpse into the discord that follows him and his businesses. The Securities and Exchange Commission filing for NantHealth made quick mention of a whistleblower lawsuit. Two fired executives, Stephanie Davidson and William Lynch, filed a wrongful termination suit alleging that they were let go for calling attention to shortcomings and fraudulent activities, including the violation of health privacy requirements. Fast Company's calls to their attorney, Mitchel L. Feldman, have not been returned.
Meanwhile, NantKwest was hit in June with a class-action lawsuit from investors. Plaintiffs say the company made false and misleading financial statements, in part due to high stock-based awards given to Soon-Shiong.
In July 2015, NantHealth parted ways with its first customer, Providence Health and Services, where Soon-Shiong also served as global director of cancer services and bioinformatics. In an announcement, he said the 27-hospital system’s leadership "is not ready to blur science and clinical practice."
Controversies are nothing new for Soon-Shiong, and they haven't slowed him down. In 2006, he received a warning letter from the FDA that called out "significant" deficiencies at the Abraxis Bioscience manufacturing facility in Illinois that led to microbiological contamination. The letter also chastised Soon-Shiong's slow response to remedy the problem.
None of this seems to have hurt his lucrative 2010 sale of Abraxis to Celgene, after which controversy continued. In 2011, the FDA cautioned Celgene against making several unsubstantiated claims about Abraxane at an oncology conference. These included the assertion that Abraxane could treat other forms of cancer, such as non-small-cell lung cancer, for which it had not yet been approved. In 2012, the FDA did approve Abraxane for lung cancer treatment, vindicating the company's optimistic claims. (It also won approval for pancreatic cancer in 2013.)
Abraxane could be a metaphor to describe Soon-Shiong's unconventional, sometimes confrontational, approach to both medicine and business. The doctor gives off a whiff of impatience with the world around him. Critics didn't understand the Abraxane breakthrough, he says, but they were proved wrong. Celgene started to brag about new uses of Abraxane before it had all the evidence in place, but ultimately, the FDA came around. Likewise, employees and shareholders have faulted Soon-Shiong's recent startups, but he's propelled the companies to multibillion-dollar valuations. There are parallels with the president-elect, who was continually underestimated over the past 18 months, right up to election night. Now it's time to see if each man can deliver the results he has promised.
With additional reporting by Christina Farr.