Dr Soon-Shiong: The viral evolution of man behind pill to prevent Covid-19
SA-born Dr Patrick Soon-Shiong is a player in big pharma in the US. Now he has developed a pill to tackle Covid-19 and is back to kick-start Africa’s vaccine manufacturing capabilities, writes Paul Ash
For someone who has been fielding calls from Europe and SA in the early hours, Patrick Soon-Shiong shows no sign of fatigue when he logs on to the Zoom call at 6.30am Pacific time.
Clear-eyed, smiling, with a shock of greying hair, South Africa-born Soon-Shiong leans back in his office chair and smiles as a ray of Los Angeles sunshine streams into the room.
“I live in LA, as you can see,” he laughs. “It’s hot.”
A cup of coffee steams on the desk and, stage left, a sandwich from which he grabs a few quick bites in between answering questions with an accent that hovers somewhere between the US West Coast and SA.
“I am sorry about my drinking coffee,” he says. “I’ve been up since 6am but this is the only time I get to eat.”
He casually mentions that he has to shoot off to a meeting at the LA Times afterwards, a reminder that he is more than just a doctor, surgeon, entrepreneur and inventor but that he also owns two of America’s stalwart newspapers — the Times and the San Diego Union-Tribune, along with a share of the LA Lakers basketball team. While his motivation for buying the papers was to be “part of the voice”, his stake in the Lakers was done simply for love.
“I am a basketball fanatic,” he says. “When Magic Johnson came to me and said ‘would you like to buy my share?’ it was like a dream come true.”
He admits that owning the stake allowed him to “shoot around” with stars such as Kobe Bryant. “The Lakers was my outlet.”
The story goes that there were two South African guys of any importance in LA — and then Elon left, but the quip ignores an impressive CV. Soon-Shiong graduated fourth in his class of 189 students at Wits University’s medical school, carried out the first successful whole pancreas transplant at the University of California, Los Angeles and developed a type-1 diabetes treatment in which islets from a donor pancreas are transplanted to a patient to stimulate insulin production.
He invented Abraxane, a drug widely used in treating breast, lung and pancreatic cancer, and has since followed that with numerous patents — he says there are 500 or more — for treatments for various cancers and infectious diseases. He is also invested in a number of biotechnology and artificial intelligence start-ups including one that will produce bio-plastics made from waste scoured from the Earth’s oceans.
Soon-Shiong popped up on SA’s radar last week following the news that recently listed immunotherapy manufacturer ImmunityBio had formed a partnership with SA’s state-backed vaccine manufacturer Biovac to manufacture the US firm’s candidate Covid vaccine and other immunotherapy drugs.
The as-yet unnamed vaccine is undergoing parallel phase one clinical trials in Khayelitsha and in the US.
There is a lot riding on the trial. The candidate vaccine has a trick up its sleeve — not only does it trigger an immune response, it also hunts down the virus and kills it. Crucially, it will also be available in the form of a capsule, dramatically altering the vaccine distribution landscape.
My goal is ... to make the products in SA so that the country becomes the exporter of next-generation biologic drugs
The vaccine is the spearhead of Soon-Shiong’s dream to kick-start Africa’s vaccine manufacturing capabilities. His plan, of which Biovac will form a major part, is to turn SA into the Singapore of Africa.
“My goal is to build standards that would meet world standards such as in the US or Europe and make the products in SA so that the country becomes the exporter of next-generation biologic drugs for cancer and infectious diseases,” he says. “That’s not an impossible dream and I think it could be accomplished within five years.”
For him it will mean fulfilling a promise he made when he left the country in 1977, vowing to return within five years.
“That didn’t happen,” he says. “But now I’m ready to fulfil the promise.”
Medicine and the media
Soon-Shiong was born in Gqeberha in 1952, the fifth of eight children. His parents had fled to SA from China’s Guangdong province following the Japanese invasion of their homeland in 1937.
His parents owned a general dealership but his father was also a renowned herbalist who would make traditional Chinese medicine for people in the community.
In an article on ProudlyChineseSA, Soon-Shiong credits watching his father at work for developing his knowledge that the human body is able to heal itself.
The family did not have much but they were happy, he says.
“There wasn’t apartheid when [my parents] came to the country,” he says. “It was to me a happy time. We were poor but didn’t know we were poor, which is fine, and I was almost self-educated because it was very hard at the schools.”
It was here that he fell in love with newspapers. In the afternoons he would head to the offices of the Evening Post — the EP Herald’s evening edition.
“I would be at the printing press in Port Elizabeth, seven days a week, picking up newspapers, running them through the city, reading the first piece that came off the press. Newspapers were in my blood. I got educated through newspapers and books because there was no other way for me to teach myself — we couldn’t go to white schools.”
After qualifying as a doctor, he was offered a full-time post at the Johannesburg General Hospital.
“My very first patient refused to let me examine him,” he says. “And my professor, Bothwell, stood right next to me and said ‘Sir, if you don’t want this doctor examining you, you have to leave the hospital’. I diagnosed the reason for his infection — which they couldn’t figure out. After that the patient went around the hospital saying ‘that doctor ... make him examine you’.”
In 1976, the US offered an amnesty to all South African doctors so they wouldn’t have to write the usual exams to be able to practise medicine there.
“There was a shortage of doctors in the USA,” says Soon-Shiong. “All my friends literally took a Boeing 747 and left to make the amnesty and then came home.”
Soon-Shiong, however, stayed. “I said ‘I’m not gonna do that’,” he says. Instead, he turned down the Johannesburg General offer and went to work in the TB clinics in East London, where his wife, actress Michele Chan, grew up.
The number of Covid-19 vaccine jabs administered worldwide by March 23 (source: New York Times)
It was quickly apparent to the young doctor that SA did not have the technology it needed to beat the disease. “After three months I realised I was of no help to anybody because without technology or advanced systems of even diagnosing, I may be hurting the people I was trying to help.”
His plan was to head to Canada, learn the technologies and then return to SA to set up an institute. While in Canada, Soon-Shiong was recruited to the UCLA’s medical school. Then — because of the environment in LA, as he puts it without a hint of self-importance — he “invented stuff”.
“We lived the American Dream where I could build something out of nothing,” he says.
One of those inventions was Abraxane. He formed a company, Abraxis, to manufacture and market the drug.
But while Abraxane worked, he was worried about its terrible side-effects on patients.
“We needed to have a reduced killer-therapy programme,” he says. “What we’re doing to patients with these toxic chemicals is horrific. I saw the future was biologics. And I saw that the pharmaceutical companies were not going to go that way.”
In 2010, he sold Abraxis for $2.9bn. A great chunk of the proceeds from that sale was ploughed back into a new research and manufacturing institute in LA.
“I did an impossible thing — I found 40 acres in LA and built the equivalent of the National Cancer Institute, where we built science programmes and research programmes,” he says.
The company, known as Nantkwest, was one of the first to research the use of natural killer cells to fight cancers and infectious diseases, according to a report in Evaluate Advantage, a US medical intelligence provider.
The institute has nearly 4ha of manufacturing capacity. Soon-Shiong took a big gamble at the time because it was built before even launching a single drug for phase one clinical trials.
The most important quest, however, was to prove that what he believed was true — that the body’s own immune system in the form of natural killer cells and T-cells would change the way diseases are treated.
Natural killer cells are white blood cells that help the body fight tumours and infections. T-cells, meanwhile, attack specific antigens and as such are a critical part of the human immune system.
“If I was right,” says Soon-Shiong, “it would be morally wrong for me to be right and not have the product.”
As we talk, he pulls up a slide and points out three cells — a natural killer cell, a T-cell and a dendritic cell.
“That’s the cancer vaccine,” he says.
A few weeks ago, the company merged with immunotherapy firm ImmunityBio and went public.
Meanwhile, some of the drug trials have shown complete remission in pancreatic cancer and triple-level breast cancer, says Soon-Shiong.
Shuttling to Khayelitsha
On the basis of those results, Soon-Shiong figured it was time to keep his promise to return to SA and jump-start Africa’s vaccine manufacturing capability.
His vision is to create high-level jobs in SA and to identify scientists and clinicians to do the work.
Negotiations have been playing out over months — not so much an exercise in shuttle diplomacy as shuttle stealth — during the past couple of years.
He has visited Khayelitsha and Botswana, both places where his Stanford graduate and Princeton-fellow daughter was researching sanitation issues. “I spent time there with her quietly in Khayelitsha — and that’s why the trial is there.”
The delay ... is fortuitous because I want to go straight into the heart of the monster by going to SA and taking on these variants
Soon-Shiong makes a strong case for SA becoming completely self-sufficient in vaccine manufacture.
Making the substances of the drug requires growing vats of cells and linking genomic sequencing with modern vaccinology. The company’s cancer drugs — which will also be manufactured here — comprise trillions of cells grown out of the natural killer cells in a patient’s blood.
“We can take a natural killer cell and grow them off the shelf,” he says. “We could take this adenovirus and grow them in cells. That technology does not exist at all in SA.”
Adenoviruses are common viruses that cause such ailments as fevers, bronchitis, pneumonia and colds and are a critical component of the Covid-19 vaccines.
While one of the major obstacles to SA’s vaccine manufacturing hopes has been pharmaceutical companies’ reluctance to transfer that technology, another is scale.
Biovac was a fantastic medium-scale provider which could handle up to 30-million vials a year.
“We need scale of 1-billion vials,” he says.
For now, though, as the coronavirus pandemic roils the globe, most eyes will be on the firm’s vaccine trials.
The vaccine candidate will need to undergo phase two and three trials before it gets approved, as well as be tested against other vaccines. The company had already been working on an adenovirus drug to use in cancer patients and against Lassa fever when the pandemic hit and, by June 2020, the first dose of its Covid-19 vaccine was ready for testing.
But though the vaccine had been selected as one of the contenders in the US federal government’s “Operation Warp Speed” programme, it was not cleared for human trials until November 2020 — even though the company’s non-human primate tests, released in October, showed that the oral and subcutaneous administrations of the vaccine eradicated the virus.
Soon-Shiong blames the delay in what he calls “a dogma of vaccinology”.
“We were different,” he says.
While other vaccines work by generating antibodies only, ImmunityBio’s vaccine stimulates the same immune response and then goes on to kill the virus.
For Soon-Shiong, the delay has brought a silver lining. “It’s actually fortuitous because I want to go straight into the heart of the monster by going to SA and taking on these variants,” he says.
The candidate vaccine has been hailed as a potential game changer because it can be administered in the form of a pill or an injection. Whereas other vaccines have to be kept in cold storage, a vaccine in capsule form does not. “There’s a billion people who won’t get vaccinated if we rely on the cold chain,” says Soon-Shiong.
“If those billion people don’t get vaccinated and they get infected — especially in places where there’s HIV and immune-suppression — you will have continuous mutations because the viral evolution will cause this virus to find a way.”
Soon-Shiong has not yet figured out where he and his wife will live when they return to SA. He has no remaining family here but does not rule out the possibility of returning to his hometown.
He makes a decent attempt at pronouncing PE’s new name (“See, I can still do it,” he laughs) and then remarks that his considerable commitments mean he will probably be a citizen of the air, shuttling between SA and LA.
“I guess I’ll just follow the sun.”
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