Tuesday, July 16, 2019

For My Fellow Cancer Patients: There Are Many Bright New Stars In The Cancer-Treatment Universe

The cancer-treatment galaxy is brimming with breakthroughs
Dear fellow cancer patients and survivors: While it’s never a good time to be diagnosed with cancer, we are living in an exciting and unprecedentedly productive era for the advancement of new, novel cancer therapies -- both for newly diagnosed patients and those whose cancer has relapsed or is refractory.

There are currently more than 1,100 cancer treatments in clinical trials in the United States alone, according to the American Cancer Society (ACS), and there are many more promising new therapies in clinical trials and pharmaceutical company pipelines around the world, from Europe to China.

When I was first diagnosed with stage IV follicular non-Hodgkin’s lymphoma in late 1996, cancer death rates were at their highest in recorded history. But in the last two decades cancer death rates have declined 26 percent, leading to more than 2.3 million cancer deaths avoided, according to the ACS’s Cancer Facts and Figures 2018.

The primary reason fewer people are dying from cancer? New and better treatment options for patients, along with other factors such as smarter diets, better nutrition and healthier lifestyles.

Between 1988 and 2000, advancements in cancer treatments have saved 23 million years of life, according to the 2018 Cancer Chart Pack, PhRMA, which notes that since 1975, the chances that a cancer patient will live five years or more have increased by 41 percent across all cancers.

More and more cancer patients are surviving longer because scientists are finally gaining a real understanding of how this insidious disease works in the body and how they can leverage this knowledge.

New Discoveries Are Changing the Cancer Playbook

Exciting new discoveries being made in molecular and genomic research that shed new light on how your immune system works are changing the cancer treatment universe. As this happens, chemotherapies will slowly step aside and make room for less generally toxic, more effective options, as I wrote about recently at Healthline.

There is a variety of newly-discovered planets in the vast clinical cosmos, including NK (natural killer cells), which many are calling the next big thing in the treatment of cancer.

There are also such new stars as CAR-T cell immunotherapies, antibody-drug conjugates, immune checkpoint inhibitors, metabolic immunotherapies, oncolytic virus therapies, new-generation vaccines and so much more.

Granted, all this information can become a bit daunting for patients who are simply trying to choose the best treatment option. But in this age of precision medicine, with treatments becoming increasingly customized to fit the needs of each patient, treatment decisions for patients will in fact become easier for you to make.

The greater understanding of how cancer works will enable your oncologist to give you just what you need to treat your cancer. This will make your treatment decisions much simpler, as cancer inevitably becomes a chronic but largely treatable condition.

One of Cancer Research’s Brightest New Pioneers

Among the companies introducing new paradigms in cancer treatment is ImmunityBio, a leading late-stage immunotherapy company based in Los Angeles.

Dr. Patrick Soon-Shiong
Founded by Dr. Patrick Soon-Shiong, a surgeon, scientist, biotech entrepreneur, philanthropist and publisher, ImmunityBio is harnessing immunogenic cell death by orchestrating both the human body’s innate (NK) and adaptive (T Cell) immune systems via groundbreaking platforms.

Soon-Shiong explains that ImmunityBio has developed novel combinations of chemo-immune sensitizers, cell therapies, cytokines, vaccines, neoepitopes, and monoclonal antibody immunotherapies to orchestrate the NK and T Cell response for fighting cancer.

In an exclusive interview for The Reno Dispatch, Soon-Shiong shared with me this vision for the future of cancer treatment.

The impassioned pursuit of better treatment options for cancer patients began for Soon-Shiong in the early 2000’s, when he left UCLA to invent Abraxane, a so-called albumin nanoparticle chemotherapy for breast cancer treatment that was approved in 2005 for patients who’ve received certain other medicines for their cancer.

“What most oncologists did not fully grasp is that the purpose of developing this nanoparticle vehicle was the notion that, to win the war on cancer, the molecules needed to enter the heart of the tumor. That meant penetrating the tumor microenvironment,” Soon-Shiong explains.

While Abraxane accomplished that goal, Soon-Shiong says, administering high-dose chemotherapy was the incorrect approach.

“By 2010 my team and I decided to pursue our hypothesis that we are all endowed within our body’s immune system with the tools to fight cancer. All we needed to do was unlock this power,” he says.

The natural killer cell, the T cell, and the dendritic cell all needed to act in an orchestrated fashion to mount what Soon-Shiong has coined as “quantum oncotherapeutics” to induce immunogenic cell death and a memory T cell.

“Went Stealth” for Close to a Decade

Soon-Shiong and his scientific team “went stealth now for close to a decade” to develop first-in-class technologies to orchestrate activation of the NK and T cell.

“We believe that by 2020 we will demonstrate the validity of this hypothesis that ‘the human body is the pharmaceutical factory of the future’," he says. “We hope to demonstrate that durable complete responses are achievable without high-dose chemotherapy through controlled clinical trials across multiple tumor types.”

Soon-Shiong says he and his team of researchers will soon present what he believes are “seminal discoveries in genomics, transcriptomics and neoepitope identification through our artificial intelligent supercomputing platform — findings we have taken a decade to uncover.”

He further explains, “We have now translated these insights into immunotherapies beyond checkpoints in clinical trials in patients with bladder cancer, triple negative breast cancer, head and neck cancer, pancreatic cancer, colon cancer and lymphomas.”

ImmunityBio will be presenting data resulting from these trials in the next quarter and in 2020, says Soon-Shiong, who launched NantKwest to develop off-the-shelf Natural Killer cells and has now developed the platform of haNK and cD19 and PDL1 t-haNK cells. 

Yes, some of this sounds pretty complicated, but it's not as unfathomable as it sounds. If you want to learn more about how all this works, if you really want to take a deep dive, feel free to email me, and I will try to explain it to you. And most of these terms are Google-able.

Soon-Shion explains, “These ‘living drugs in a bag’ have been combined with the portfolio of immunotherapy molecules at ImmunityBio, and together these first-in-class technologies drive synergies of the innate and adaptive systems."

ImmunityBio’s Broad Cancer Portfolio

Soon-Shiong says that ImmunityBio has amassed a portfolio of biological molecules spanning albumin-linked chemotherapeutic, peptide, fusion protein, cytokine, monoclonal antibody, adenovirus and yeast vaccine therapies.

This platform of immunotherapy technologies has enabled the company to achieve a late-stage clinical pipeline addressing both the innate (activated macrophage and natural killer cell) and the adaptive immune system (dendritic, CD4 and CD8 killer T cells).

The ImmunityBio pipeline is comprised of more than 40 immunological assets, he says, with 13 first-in-human immunotherapy molecules in active Phase 1, 2 and 3 patient clinical trials.

Soon-Shiong says the company is actively enrolling patients in late-stage trials with three molecules across 17 indications in solid-tumor cancers and blood cancers.

ImmunityBio’s goal, Soon-Shiong says, is to employ a broad portfolio of biological molecules that will enable it to activate endogenous NK and CD8+ T cells, and in combination with Soon-Shiong’s company NantKwest’s off-the-shelf NK cells, develop a T-cell memory cancer vaccine to combat multiple tumor types.

And this will all be done, he says, without the use of high-dose chemotherapy.

As I noted above, we are living in a very exciting time for the advancement of new cancer treatments. I’ll be watching ImmunityBio’s progress with particular interest over the coming months and years. 

Stay tuned, fellow patients and survivors. 

Tuesday, June 11, 2019

Smokey Robinson, Paul McCartney, Willie Nelson: Baby Boomer-Era Music Legends Still Rocking in Their 70s and 80s!

When Smokey "King of Motown" Robinson hits the Corona Grandstand Stage as part of the Toyota Summer Concert Series at the San Diego County (Del Mar) Fair this Saturday night, June 15, I wonder how many people in the audience will know, or care, that he recently celebrated his 79th birthday.

Smokey, who’s performed since he formed a doo-wop group in high school in 1955, is on a lengthy US tour and shows no signs of slowing. By all accounts he still has boundless energy and remains the consummate showman. He doesn't short-change audiences, even at his, uh, advanced age. He still treats every gig as if it were that fateful first audition for Motown founder Barry Gordy in 1957. 

A Detroit native , of course, Smokey, who met Gordy before Motown even existed, can’t hit all the nigh notes any more. But he still has that inimitably smooth high tenor. He's got nothing left to prove, and I’m pretty sure he doesn't need the money. 

But he still thrives on bringing joy to others. I've seen this charming musical genius numerous times in concert over the years, but the most memorable performance for me came about a decade ago at a makeshift "theater" in the parking lot of a Southern California casino that will remain nameless because the venue was so bad. 

It was a dark and stormy night – literally - and while the show was sold out, fewer than half of the folks who bought a ticket showed up. But we Smokey loyalists weren't about to let some chilly, damp air get in the way of enjoying the man that Bob Dylan once called America's "greatest living poet." 

And Smokey did not disappoint. Undaunted by the harsh conditions, Robinson hit the stage sans umbrella but wearing a big smile and we roared our approval.

Smokey could have greeted the half-empty "theater" with a short, by-the-numbers show. But instead of perfunctory, he was extraordinary. He clearly saw the place as half-full, not half-empty, and gave a masterful, joyous performance that lasted nearly two hours. He rewarded us for showing up, and we gave the love right back.

There's a sweetness and warmth in Robinson the performer. Sure, he has a star's ego. He was after all a record company executive for many years. He's just as tough as his voice is soft. But even under the weight of worldwide fame and great wealth, Robinson's heart never shrank.

It was an intimate affair in which the crowd and the performer established a rare if drenched bond. Everyone was soaked but happy. We all knew we'd been a part of something special.

Robinson is truly old-school. He gives the fans what they want. And that helps explain his staying power so many decades after his Motown heyday. Robinson is responsible for far too many classic songs to sing them all in concert. But you're pretty much guaranteed to hear “I Second That Emotion, “You've Really Got a Hold on Me,” “Ooo Baby Baby,” “The Tears of a Clown” and “Cruisin'.” 

I hope he sings a few of those lost gems, too, like “Quiet Storm” and “Baby, Baby Don’t Cry,” but we shall see.

You also might hear “Just to See Her,” the Grammy-winning tune written by my buddy Lou Pardini, a gifted singer-songwriter-keyboardist who is now in the band Chicago. And you may hear some of the classics Robinson wrote for other artists such as The Temptations’ “Get Ready” and “My Girl.”

Smokey Isn't Alone

The grandstand is expected to be filled with graying, nostalgia-hungry boomers. Maybe it's not such a drag getting old! In fact, Smokey will be joined on national tours this summer by a whole bunch of baby boomer-era rock and roll legends, who continue to defy Father Time and are still performing into their 70s and even 80s.

For example: A week after Smokey performs in Del Mar, Beatles legend Paul McCartney arrives at Downtown San Diego’s Petco Park on his world tour. When he plays Petco, Paul will have just celebrated his 76th birthday.

Mick Jagger, 75, gave us all a scare with his recent heart surgery, but is reportedly healthy again and preparing for the Rolling Stones' upcoming re-scheduled No Filter world tour.

The three original members of Chicago, including Robert Lamm, 74, are still touring 52 years after they played their first gig in Chicago and will be appearing at Harrah’s Resort SoCal in September. 

Jon Anderson, 74, lead singer of the band Yes, is still touring both solo and in his configuration of the classical-rock band and recently performed at Humphrey’s.

Justin Hayward, 72, lead singer of the Moody Blues, is currently on another solo tour that comes to the Belly Up in Solana Beach in August.

Steven Tyler, 71, and his Aerosmith mates are also on another US tour. 

Pete Townshend,and Roger Daltrey, founding members of The Who, are 74 and 75, respectively, and are still (thankfully) performing and stating, with a straight face, “I hope I die before I get old.” They’ll be performing at Viejas Arena in October.

Southern rock great Charlie Daniels, 82, is presently on a nationwide concert trek still singing and playing his fiddle. 

Then there’s the great granddaddy of them all, country music legend Willie Nelson, who is happily on the road again this summer at the age of 86.

What gives Willie and these other troupers the energy to continue the grueling national and global summer concert tours into old age? And how long can they keep rocking? 

Some cynics, mostly those in Generations X, Y and Z, undoubtedly think these old geezers should pack up their microphones and Cialis, go home and give the younger artists a brighter spotlight and a little more concert revenue. 

But these older acts not only provide the soundtrack to our lives, they also inspire us when they appear on stage in their advanced years and still bring it musically. And most of them can.

These rockers, many of whom lived the life of excess over the decades, are now ironically role models for good health. Their positive habits on the road - good food, exercise, sleep, little or no drugs — help explain their longevity. 

While these artists will all eventually meet up with their mortality, that's a tomorrow worry. For now, these aging artists still have a lot of living and rocking to do. As Neil Young, now 73, says, "It's better to burn out than it is to rust."