Antibodies are the future of cancer treatment [PODCAST]

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“Since President Nixon declared war on cancer in 1971, and despite some great victories and many losses, there continues to be a never-ending battle in this long-fought war that seems never-ending. The convergence of great intellect and resources of academia and industry, fueled by continued entrepreneurship and investment funding into the biotechnology sector, despite the many risks of failure and expense, is one that is obvious to yield the greatest rewards to both prosperity and health. Ultimately, targeted therapies will improve lifespans and quality of life for cancer patients.”

Eugene Chan is a health care executive.

He shares his story and discusses his KevinMD article, “Cancer of the future: diagnosis, treatment, and impact on the health care system and patients.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. Today on the show, we have Eugene Chan. He’s a physician and health care executive. His KevinMD article is titled “Cancer of the future: diagnosis, treatment, and impact on the health care system and patients.” Eugene, welcome to the show.

Eugene Chan: Great, thanks for having me.

Kevin Pho: We’ll get into the article in a little bit. First off, share your story and journey to where you are today.

Eugene Chan: Sure. I grew up in New Jersey from reasonably humble beginnings and was raised by a family who were first-generation immigrants. My dad was a chemist, and my mom stayed at home, and we essentially had a reasonable childhood. It was not a very good school, but it was kind of surprising where I ended up, which is I was the first person from the school to go to Harvard. After that, I ended up at Harvard Medical School and kept on working hard.

Somewhere in between, at Harvard Medical School, I started this company, which essentially kicked off the $1,000 genome, and I completed medical school during this time as well. I was able to proceed with developing Abpro, which is now a health care biotech company focused on essentially curing cancer. I also have a diagnostic company called rHEALTH, which is focused on spaceflight diagnostics. And I’m here to talk to you about these exciting developments in cancer and also about the article as well.

Kevin Pho: All right, so before I get to the article, I’m interested in hearing more about that journey. A lot of physicians are interested in going perhaps into the biotech industry, going into more entrepreneurship. What kind of advice do you have, being a physician yourself, for these other doctors who also want to break into that field?

Eugene Chan: It’s a great way of making a patient impact, because ultimately you’re making a drug or therapeutic or diagnostic that impacts a lot of the patients that you would normally see in the hospital-type setting. You also get a bigger perspective in terms of the types of impacts that you might have. And so my best advice is just to go do it. There’s no path, so really just cut the course and jump right into it. The best is you learn from people who’ve done it before.

I think in my particular case, I was very lucky to have some wonderful mentors. Two particularly come to mind. One is Dr. Bob Langer, who’s an Institute Professor over at MIT, also the co-founder of Moderna. He’s also on the board of Abpro. Essentially, he showed me the ropes early on. He basically started a lot of biotech companies. The other mentor was Craig Venter, basically the first person to sequence the human genome, and he’s had tremendous success with Celera and obviously some other ventures afterward.

These guys basically showed me the ropes very, very early on, and those kinds of life skills have translated into the ability to do what I’m doing right now. So it’s been a pretty unique position to be in for me. But I think my general advice for other folks is you just have to go do it, and if you can, find some great mentors. There are a lot of people who are willing to help you out.

Kevin Pho: At what point in your medical journey did you realize that you were going to go into the biotech industry, and how did you go about finding those mentors?

Eugene Chan: So I was about three months into medical school when this happened to me. I was actually working on an idea for sequencing DNA back right as I was graduating from Harvard, and I was really looking for direction in terms of how to actually turn this thing into reality. Everyone around the community, and this is Harvard and MIT, so it was a pretty esteemed community where people have done this before, basically connected me with folks who were able to help out.

And so I think, generally, there are a few basic things. If people are available to help out and they want to help out, then you’ll get something that’s good out of it. That’s how I met Dr. Langer, very, very early on in my career. Since then, I’ve been able to build a good relationship with folks in biotech and create something that’s very interesting.

Kevin Pho: All right, let’s talk about your KevinMD article, titled “Cancer of the future: diagnosis, treatment, and impact on the health care system and patients.” Now, for those of you who get a chance to read your article, just walk my audience through it, and share the story of why you decided to write it.

Eugene Chan: So the whole point of the article is really to bring to light for patients that there are new ways of treating cancer, which are either ongoing or have happened, or things that you can tap into should you know someone, or be unfortunate enough to need cancer care. So I think the whole point of this is that there are things out there and tools out there which can help you treat cancer better than even five years ago.

Some of these things are immunomodulators, and this is basically where Abpro comes into play. This is a company that I’m involved with as a co-founder, to push some of this stuff forward. Anything that’s able to tap into your immune system and augment your immune system now has the potential capability of being able to fight cancer better than some of these old chemotherapy methods that have been out there for a very long time.

With the old chemotherapy methods, there’s the usual hair loss and being very sick and throwing up and all those things. That’s the cancer care that’s been around for quite some time. Cancer care doesn’t have to be like that, because now you have these much more targeted therapies, which essentially harness your body’s natural immunity, augment it, and now redirect the strength of your natural immunity to eliminate cancer and help you prolong life. It’s been pretty amazing, this whole revolution in immunotherapy.

And also what we’re doing is essentially taking the body’s natural immune cells and souping them up by telling them, “Hey, this is where the cancer cells are.” If you can turn on your natural immunity and destroy these cancer cells, then essentially you can eliminate these cancer cells in a very, very targeted manner without the toxicity that you typically see from chemotherapy.

Kevin Pho: Now, what kinds of cancer specifically do your drugs target?

Eugene Chan: So specifically, at the very forefront of our pipeline is a breast cancer therapeutic. This is kind of personal, because my mom had breast cancer just a few years ago, and she was able to fully recover. Luckily, it was diagnosed very, very early, and she was able to fully recover from it. But even watching this whole process of using existing drugs, it’s still reasonably limited. Even with the advances in treating breast cancer, and these are HER2-positive breast cancers, there’s still ample room to go in terms of where things can be.

And so even though my mom’s one of the lucky ones, there are some other folks who are less lucky. And so the whole premise of my work, as well as the team’s work, is how do we actually take these advances and really push them to the next level, where instead of prolonging life 18 months, which is really reasonably short in a person’s lifetime, how do we actually push it out to five years, to 10 years? That’s really where the next advances in cancer therapy need to be.

Kevin Pho: When it comes to these immunomodulating cancer therapies, where are we in the pipeline? Do we have completed products? Are we still in the investigational phases? Give us a sense of where we are in the pipeline.

Eugene Chan: So there are definitely very good drugs out there. PD-1, basically Keytruda, is a very good example, and these are some of the ones that are called checkpoint inhibitors, which basically target certain points in the regulation of cancer and growth cells. More recently, within the past few years, there have been cell therapies. For instance, now you can go in there and take out the person’s white blood cells, and you can modify them in ways and put them back in the person’s body, and then have these astounding effects where you can absolutely eliminate cancer.

Unfortunately, that particular therapy, it’s on the market, and it’s $2 million. So it’s really outside the reach of most ordinary individuals and ordinary insurance companies. And so that’s brought us to what we’re doing, which is we’re trying to take that same concept of taking these powerful cells called T cells and be able to use them to eliminate cancer. But we’re doing it by an infusion, versus having to take the cells out and having to re-engineer them.

And so the cost is going to be way down. Instead of $1 million or $2 million, now you’re in the regular realm of what standard chemotherapy costs or standard infusion costs. By doing that, especially now, you have the ability to essentially propagate this technology and make it scalable so that many more people can benefit from it.

Kevin Pho: So for those who aren’t familiar with the drug development timeline, give us a sense of the stages that you need to go through to bring a drug from the investigational phase to the market.

Eugene Chan: So it takes about a decade, and that’s what most people don’t realize. These things require a high level of rigor in order to be safe in a person’s body, particularly for some of these approaches harnessing your T cells, because you want to make sure, since these are very, very powerful systems that you’re dealing with, that these things are safe. So they don’t cause more harm than they’re intended to, and they have that therapeutic window, or that safety window, where you can eliminate cancer and at the same time not do damage to something else.

And so being able to speed this process up is the goal of most of these biotech companies and executives. You’ll hear a lot from many different pharma leaders: How do we make this thing shorter and faster, and how do we get the drugs out there? And I think to some extent the FDA has actually listened over the course of the past few years, and so now there are expedited pathways for breakthrough therapies. You’ve seen the speed at which the vaccines have come out. So I think there’s a desire and impetus to do it safely, but also to speed it up. I think part of it is regulation, but the other part is also really just making sure you go through the ropes to run the clinical trials with enough people and patients to see the kind of benefit and safety profile that it needs to see.

Kevin Pho: So specifically with these immunomodulating cancer therapies in general, historically, what’s the success rate for these therapies coming to market?

Eugene Chan: So it depends on the cancer. I think with the original immunotherapies, and this is not the cell-based therapies, but things like Keytruda, you’re looking at prolonging life by about 18 months or something like that. There are also small molecules; these are for non-small cell lung cancer, and some of these other therapies are in the same ballpark. And then with cell therapy, now you’re talking about some of these things where you’re talking complete remissions and complete cures, unheard of, unheard of.

And so for us, I think the next step, again, as I mentioned, is if we can take that 18-month extension, and let’s say our next goal is to have something that’s cheap enough that you can administer it to a lot of patients, and you can extend life to five years or 10 years. It doesn’t have to be complete remission. That would be amazing if we can do it for breast cancer, pancreatic cancer, some of these more challenging cancers, which people right now have difficulties developing therapies for. So I think that’s where we are.

People hear about this war on cancer, and I think most recently, the White House was kicking off something to essentially have a second war on cancer. I think there’s still a lot of room to go. On one hand, people think, “Hey, we’re done.” That would be very naive. On the other hand, I think the reality is we’ve done a lot, and we have all these new drugs, but they’re not good enough. And that’s what we’re focused on, really to push the boundary of what’s possible.

Kevin Pho: We’re talking to Eugene Chan. He’s a physician and health care executive. His KevinMD article, which we’re talking about today, is titled “Cancer of the future: diagnosis, treatment, and impact on the health care system and patients.” Eugene, what are some of the trends in cancer therapy that we have to look forward to in the next couple of years, especially for me as a primary care physician, and all the other oncologists that are out there? What do we have to look forward to?

Eugene Chan: Yeah, so I think there are definitely some of these new tools that are coming out. But other than that, I think there’s also this whole patient aspect, which needs to be considered. A lot of times, I think you see in the medical world a pretty strong opinion that it’s go, go, go all the time, really trying to push the boundaries of care onto the patient. But I think a lot of times, in terms of providing whole health, you have to be able to look at the patient. You have to be able to look at the patient’s social needs and family needs and determine what’s best for the patient.

And so with some of these more convenient therapies, which might be administered outside the hospital, sometimes not having too many trips to the hospital is a good thing for the patient. If you’re able to take these things out and let the person enjoy, or take advantage of, what their life could be, with this kind of prolonging of life outside the hospital, not being in the hospital, taking blood draws and X-rays and CT scans, I think that’s a better way of caring for cancer patients. Because ultimately they get that benefit of, “Hey, I’m actually living my life. I’m not just a patient,” right? And they basically realize, “Hey, there are still things I can do, and I can tap into. I can see family and all this other stuff.”

And I think being able to juggle that balance as a doctor is hard, because you want your patients to be good patients. You want to have them all the time. You want to be able to be there and guide them. But sometimes, being able to strike that good balance is what being a good doctor is about.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Eugene Chan: Yeah, I think the big thing here is there are folks like us, like myself, who are very committed to taking our medical knowledge and pushing the boundaries of health care and these advances in the treatment of cancer. And we’re doing it for patients. Ultimately, we went to med school because the crux of what we want to do is to help patients. And being able to get these therapies into your hands is something that, really, really, every day, we wake up, we go there, and we want to make happen. Collectively, as a biotech industry, everyone’s doing it, so we get these wonderful advances.

And always stay tuned in terms of clinical trials, what the latest is out there that might actually help with what you might have. I think that’s the message, because there may be something out there that could help you that you haven’t looked into yet.

Kevin Pho: Eugene, thank you so much for sharing your time and insight, and thanks again for being on the show.

Eugene Chan: Great, thank you so much.

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