New science could turn some health systems into ‘dinosaurs’

Dr. Patrick Soon-Shiong is the founder and CEO of Culver City, Calif.-based NantHealth, which seeks to use big data to deliver personalized medicine. Last week, Allscripts Healthcare Solutions disclosed that it would pay $200 million for a 10% stake in NantHealth; Soon-Shiong said he plans a public stock offering by year-end. Soon-Shiong, who invented the blockbuster cancer drug Abraxane, founded drug companies Abraxis and American Pharmaceutical Partners, which he sold for a combined $9.1 billion. He also has served as global director of cancer services and bioinformatics at Providence Health & Services. Modern Healthcare reporter Beth Kutscher recently spoke with Soon-Shiong about how NantHealth will work with researchers, clinicians and payers to transform healthcare. This is an edited transcript.

Modern Healthcare: What does NantHealth do?

Dr. Patrick Soon-Shiong: NantHealth is creating a knowledge engine on behalf of the patient. If a patient is deathly ill, the best thing is to figure out the right treatment in the 21st century of molecular medicine. There was no infrastructure to capture big data in real time across the continuum for one single patient. So we set up this infrastructure to do that.

The patient is empowered because we now have discovered that cancer is a slew of rare diseases at the molecular level. The goal is to bring this breakthrough science to the delivery and payment sides. Then we have an opportunity to transform healthcare.

MH: Can you describe specifically how this will work?

Soon-Shiong: Let’s say you find out through whole genome sequencing that this patient with lung cancer had this molecular fingerprint and a drug was available and the patient was completely cured. The next week, you find a breast cancer patient who has the exact same molecular fingerprint. So the power of that single patient informed 5,000 breast cancer patients about the opportunity to treat them with that drug that’s been approved for a different indication.

This patient is unique in terms of the cancer. How do we find a treatment uniquely for that patient? That opportunity is here now, by being able to interrogate a patient’s molecular profile and find a unique antigen on the surface of the tumor cell of that patient. Then you have the ability to identify an antibody that might match that antigen and target that tumor.

MH: You believe we’re too focused on tissue and where (cancer) is in the body, as opposed to the molecular footprint?

Soon-Shiong: Yes. We should treat the biology, not the anatomy. The cancer doesn’t understand that it happens to be in the breast when the biological pathway is the same for the ovary, uterus, lung or brain. We’ve been stuck and happy that a treatment works in 20% of the patients. We need to transform our entire thinking to treat the biology, and get a 90% or 100% response.

The difficulty for the pharmaceutical industry is that the biology is so rare between different types. How does any one institution actually capture the patient with that same biology? With NantHealth, we’ve created the infrastructure to capture the biology of multiple rare diseases in real time so we can treat that biology.

MH: When did you first realize that the way we were treating cancer was wrong?

Soon-Shiong: When we developed Abraxane in 2001. Abraxane is paclitaxel. What we discovered is that by encoding it with an albumin drug, it interacts with a protein in the blood vessel called gp60 and that all tumors feed on this protein, regardless of tumor type. There was a dance of proteins and if we could dance with them, we could kill the tumor by having the tumor feed rather than starve.

MH: What do you mean by “a dance of proteins”?

Soon-Shiong: What drives the cell in both a normal state and in a disease state are proteins inside the cell. The proteins dance and talk to each other and cause the cell to either grow or die. In cancer, it’s not that the cells just grow; it’s that these proteins prevent the cells from dying. So the dance of proteins is changing all the time and we need to capture and find them. We want to drive that to an evidencebased decision-support system for doctors.

MH: How is your operating system progressing toward

“If a patient is deathly ill, the best thing is to figure out the right treatment in the 21st century of molecular medicine.”

sharing information with electronic health records?

Soon-Shiong: It’s launched across the country. The device connectivity is in 250 hospitals. It’s in 80% of the oncology practices. By next year, the decision-support engine is going to cover 40 million covered lives. It’s about to be launched throughout the National Health Service in the U.K.

MH: How is it changing the way clinicians operate?

Soon-Shiong: A patient diagnosed with breast cancer enters an oncology practice. The doctor goes on the system and finds there are a hundred protocols for breast cancer. The patient’s molecular profile is inserted. The data would rule out protocols in terms of overall survival and cost. The doctor chooses a protocol and the insurance company immediately adjudicates coverage. Then the patient enters a monitoring phase. A clinical trial engine then opens, and the patient knows by her location which clinical trial is available.

MH: Have insurers said they’ve saved money by using this?

Soon-Shiong: Many. Anthem Blue Cross has adopted this. It’s reimbursing the doctor $350 per patient per month over and above the standard reimbursement to use this system because it’s improving care and saving money.

MH: How are you partnering with companies such as Blackberry?

Soon-Shiong: With Blackberry, we will launch a cancer genome browser that every physician could access in real time. The other B2B piece we’re about to launch is called the NantTransporter. That takes genomic data from any sequencing machine. We stream that data to our supercomputer so that the bioinformatics and report could be put in the hands of the doctor that same day.

MH: What healthcare organizations will you be working with?

Soon-Shiong: You need the knowledge domain tied intimately to the delivery domain. While Providence has an excellent hospital delivery system, I have not yet seen any demonstration that it’s tied to the knowledge domain.

I’ve concluded I really need to work with organizations with in-depth knowledge of the bioinformatics and molecular medicine, as well as the hospital-based delivery system. So we will be moving on from Providence and looking for integrated health systems in California, Oregon and Washington. This is a very important decision for my wife and me as we start looking to see where we will put our active philanthropy. We want to commit $1 billion, with $100 million for each of the participating institutions.

MH: What’s your timeline?

Soon-Shiong: Now. We recently were in six cities in eight days. I’m looking in Nashville and Pittsburgh. I’m going back to Los Angeles and I’ll be discussing this with organizations there.

These organizations need to have leaders and scientists who understand 21st century science but also have the scale and capacity to manage clinical care with excellence. Science is moving so fast. Unless organizations tie clinical care to the movement of new science, they will become dinosaurs.