A pair of Harvard-trained American oncologists, backed by Hong Kong billionaire Li Ka-shing, are attempting to harness technology to revamp cancer care. They’re taking some of their earliest steps in China -- cancer’s ground zero.
China has the world’s largest number of cancer patients, yet specialized treatment is in such short supply that patients must often travel long distances to top hospitals, living in dilapidated housing for months for short oncologist visits.
That problem has begun drawing the attention of big name investors, and Li, one of Asia’s richest men, in 2015 became the first funder for the physicians’ startup, called Driver. Other investors joined, and now backed with $90 million, the firm is developing technology to give cancer patients more control over their care. It begins formally signing up patients in China and the U.S. this week, after a 17-month trial run with several hundred people.
The hope is to use technology to address a perennial problem at the heart of global oncology. Cancer drugs and experimental treatments have exploded, and $133 billion worldwide is spent on these medicines each year, according to researcher Iqvia Institute. Yet, patients often can’t find all the available options, except filtered through an overworked oncologist. Researchers, meanwhile, can’t always stay abreast of other studies -- sometimes even inside their own vast medical institutions.
Driver’s solution? The startup’s labs in San Francisco and Southern China analyze patient tumors, DNA and other medical records. Then an app shows patients the best treatments and clinical trials globally that match their specific tumors. Driver works in both countries. Yet, the information shortfalls it’s focused on are particularly visible in China: There are just 18 oncologists per 1 million people in China compared with 161 for the same number in the U.S., according to a paper in the Journal of Global Oncology.
“There is an air gap between knowledge and patients that has existed in cancer care since the 1850s,” said Driver co-founder Will Polkinghorn. “We want to close that space.”
Driver’s first major partnership has also appeared in China: The Beijing-based National Cancer Center, the central agency for cancer research through which 840,000 patients pass through annually. Next week, the NCC plans to officially announce its use of Driver’s platform to manage the more than 200 clinical trials it has running at any one time.
“Prior to Driver, we were managing this manually,” said the NCC’s clinical trial office director Li Ning. “It’s provided a systematic ability for researchers and doctors to recruit patients and keep track of trials going on within the institution.”
But for its biggest ambitions to be realized, Driver will needs large swaths of patients to sign up. The full service, including tumor and records processing, followed by treatment matching and curation, will have a $3,000 price tag, limiting access to affluent patients.
Driver’s Polkinghorn was a radiation oncologist at Memorial Sloan-Kettering, one of the biggest cancer treatments centers in the U.S., and his co-founder, Petros Giannikopoulos, was a pathologist at Harvard Medical School when they came up with the idea. Both were graduates from Harvard Medical School, but funding in Silicon Valley proved elusive. They found luck in Hong Kong, where they landed money from Horizons Ventures, a fund run by Li’s companion Solina Chau, and the primary channel of investment for his wealth.
Their board members now include gene-editing pioneer Jennifer Doudna and fashion designer and cancer advocate Tory Burch. They didn’t specify how much of the total $90 million came from Li and who the other investors are. Horizons Ventures in a statement said it had invested in Driver because of the rising need for a new platform to connect patients with novel therapies as cancer cases surge globally.
In the US, the government’s primary agency for cancer research, the National Cancer Institute, has signed up to be Driver’s partner, making information on its clinical trials available on the startup’s platform. It’s also validated Driver’s treatment matching system.
Matthew Brown, China director of NCI in Beijing, said the access to Chinese patients could facilitate cancer research. For example, he said, if Chinese users agreed for their scans to be uploaded anonymously to a global imaging database that would greatly expand scientists’ understanding of how certain cancers develop.
The vast patient body of China’s National Cancer Center could help draw users. NCC’s Li said that since its doctors were using Driver as an internal management tool, it was “possible” that they would recommend patients sign up for the app, although they aren’t obliged to do so. Driver is not charging the NCC for the use of its platform.
Not all patients — especially in China - may feel up to taking a more active role in treatment decisions.
“In Asia, decision-making can also be a lot more paternalistic as patients have the tendency to defer to and rely on the doctor,” said Joseph Kim, senior adviser in Clinical Development Innovation at Eli Lilly & Co.
In Miami, Jesus Loreto used Driver earlier this year to find options for prostate cancer that didn’t involve hormone treatments, which he worried might have side-effects. Driver curated a list of around nine trials that matched his requirements.
"My oncologist is good, but he would only recommend me trials at his institution, and he didn’t recommend new possibilities for me, like doing a liquid biopsy," said the 66-year-old former pharmaceutical executive.
Loreto said he didn’t end up enrolling in any trials as his condition remained stable. Still, "having access to Driver helped me fill the gaps in the information I wanted," he said.