Patrick Y. Yang
Fighting Cancer with Precision Medicine
Instead of resting on his laurels and enjoying retirement life, biotech industry veteran Patrick Y. Yang has returned to the frontline to help Taiwan catch up with the world leaders in precision medicine.
Fighting Cancer with Precision MedicineBy Yi-ting Lin
From CommonWealth Magazine (vol. 636 )
Despite being an engineer by training, Patrick Y. Yang has spent most of his professional life in the biotech industry to become one of the handful of Taiwanese in the top management of a multinational biopharma company. When Yang retired as Global Head of Technical Operations for Hofmann-La Roche in 2013, his expertise became a hot commodity in the biotech industry. “Many people wouldn't let me retire,” chuckles Yang as he recalls his busy life as an industry consultant during the past four years.
Yang remains passionate about Taiwan’s biotech industry; he keeps making suggestions and incubating innovation. Earlier this year, he took the position of director with Taishan Investment and Management Co. Ltd. (台杉資本), a newly founded investment firm under the National Development Council. “There’s a host of things you can do,” remarks Yang.
In the middle of the year, he dropped another bombshell on the biopharmaceutical industry when taking the job of interim executive vice president at U.S. biopharma startup Juno Therapeutics. Again, Yang is in charge of technical operations, but this time he is focusing on the field of precision medicine.
Juno is a U.S. startup founded in 2013. Its product line focuses on immunotherapy based on two novel technologies - Chimeric Antigen Receptor (CAR) T cell technology and T Cell Receptor (TCR) technology to treat cancers. Although five patients died during clinical trials, Juno is in a tight race with three other pioneering pharma companies to bring CAR T-cell immunotherapy to market. These are Swiss pharma giant Novartis, which recently obtained approval from the U.S. Federal Drug Administration (FDA) for its CAR T-cell therapy, Kite Pharma Inc., which was just acquired by Gilead Sciences Inc. for US$11.9 billion, and Bluebird Bio Inc.
“This is a breakthrough development,” notes Yang. Immune cell therapy is the biggest change that the biotech industry has seen in three decades. Such treatment is more precise and has the potential to cure cancers, Yang explains.
What does Yang hope to change by joining Juno? “It’s not that I want to change anything; I am already history. It’s the young people who are important,” declares the 69-year-old pharma industry veteran.
“I hope to put the next generation on the right track and let them develop their potential. It amounts to helping the biotechnology of the next generation,” remarks Yang in outlining his mission to pass on his rich experience and promote talent and therapies.
However, while the whole world is raving about precision medicine, Taiwan’s biotech industry has been indecisive for the past three years, falling behind in the field of new-generation therapies. Yet Yang believes that “Taiwan’s biotechnology has no right to be pessimistic; we need to make greater efforts.”
How does the new face of the biotechnology he envisages look like? How can Taiwan jump on the precision medicine bandwagon? The following are excerpts from the interview:
The biotech industry has seen enormous changes in the past 30 years. From chemical pharmaceuticals to new biopharmaceuticals, and then breakthrough developments in recent years: Using human immune system therapy to treat difficult and complex diseases. CAR T-cell therapy, for instance, can probably cure cancers. This is no longer only a development but a movement. I am fortunate to be part of this movement.
CAR T-cell research has been done for more than 20 years, but there is often a wide gap between research and innovation.
Research can rely on the brains and efforts of an individual. Innovation requires a team, a goal, courage, wisdom, the power of execution, experience, capital, and not a little chutzpah as well. It takes experience to jump from research to innovation.
My joining Juno was meant to be. Their senior executives are old biotech industry acquaintances of mine who kept prodding me to join their team. I felt that the young people in their team had enthusiasm and energy but lacked some experience. I went through a lot of stormy times in the past 30-odd years and learned quite a lot. I would like to pass on these experiences and contribute to the fight against cancer.
Furthermore, immune cell therapy is different from conventional pharmaceuticals. The starting material for CAR T-cell therapy, for instance, is the blood of the patients. It is a make-to-order production method and not a pharmaceutical that is produced beforehand and kept in the warehouse. – The production process starts only after the physician has written a prescription: After blood has been drawn, the immune cells are separated and genetically engineered. Then the cells are cultivated until they have multiplied to several million, several hundred million. Then they are injected into the body, where they attack cancer cells.
But since the cell state is different in every person, the treatment stages and effects also differ. Some people have older immune cells, so it takes four weeks to cultivate enough cells. But the patient might not be able to wait that long and will pass away. Or some people develop severe side effects after being injected with the pharmaceutical because the immune cells, which are like armed troops, might kill normal cells in a blood rage after they have killed the cancer cells.
Image: Ming-Tan Huang
Precision Medicine Requires Precise Engineers
If the entire course of treatment is supposed to succeed, the timing, therapy and dosage must be just right; “precision” is therefore very important, with “automated” technology being the basis. If genes are slowly engineered and cells cultivated in a manual process, it is impossible to produce large quantities, and the failure rate can be as high as 10 percent. Costs will also be high; the Novartis CAR T-cell treatment, for example, costs US$475,000.
Therefore, precision medicine requires precise production processes and precise engineers. That's where Taiwan, with its thriving technology industry, has a competitive edge in developing precision medicine.
Moreover, Taiwan has a great deal of committed, hard-working engineering talent with the ability to execute. My father prided himself on being an engineer (Yang’s late father, Yang Chin-tsung, was an electric power expert and served as Taipei City mayor from 1982 to 1985). It’s the same for me; although I am involved in the biotech industry, I have always been doing engineering, designing precise production processes. These are all Taiwan’s strengths.
However, the setbacks of the Taiwanese biotech industry in the past three years have undermined the investment climate. The biotech industry is staggering along, unable to move upward. Not many companies are investing in new-generation therapies. I am deeply worried. Yet Taiwan’s biotech industry has no right to be pessimistic; failure is normal, and continuing to fight is also normal. The most decisive aspects of the biotech battle are passion, speed and good faith. We must make greater efforts.
If Taiwan wants to develop precision medicine, the most crucial step is creating a precision medicine ecosphere, including upstream science and downstream engineering and manufacturing, and talent from scientists to startup entrepreneurs and engineers. We also need a good basic infrastructure, investment system and laws and regulations.
I particularly expect to see a necessary improvement in Taiwan’s environment and culture. To put it bluntly, while starting a business is to make money, profits must be made legally and reasonably.
That necessitates adequate control; the bad people must be caught, or else one bad apple spoils the whole barrel. But our current judicial and investment systems are still very crude when it comes to dealing with the biotech industry. If we don’t change them, no one will found new businesses, no one will take risks, and Taiwan will come to a standstill.
Talent is also important. There is quite a lot of talent inside several biotech or technical clusters in Taiwan, but for turning into a world-class biotech cluster, we still lack world-class universities. In Boston, for instance, there are schools like Harvard, Yale and MIT, which is conducive to constructive competition. But Taiwanese universities have failed to make progress in global rankings in recent years, whereas China is rising. We must make greater efforts.
Finally, I would like to encourage young Taiwanese who want to get involved in the biotech industry: Don’t be afraid of setbacks; having no setbacks means you have not truly done anything. On top of that, you also need to learn to communicate.
Aristotle once said there are three modes of persuasion: Ethos, pathos and logos. The strength of Taiwanese scientists is logos, or problem solving, but they lack pathos – the ability to persuade through consultation and negotiation. So even if you are doing the right thing, it won’t attain success if you fail to win support. Mastering communication so that doing the right thing becomes a common thing is not simple, but it is important.
Translated from the Chinese article by Susanne Ganz
Patrick Y. Yang
Current position: Juno Therapeutics executive vice president
Educational background: Undergraduate degree in engineering from National Chiao Tung University, graduate degree in electrical engineering from the University of Cincinnati (Ohio) and a doctorate degree in engineering from Ohio State University
Career: Worked for GE, Merck, Genentech executive vice president and Hoffmann-La Roche global head of technical operations.
The immune cell therapies that have become so hot in recent years mainly serve to fight cancers. For treatment, immune cells knowns as “T-cells” are separated from a patient’s blood, then genetically engineered and multiplied before they are reinjected into the patient’s body, where they identify and attack cancer cells.