Fuck cancer. Every year in the United States, nearly 1.75 million new cases of cancer are diagnosed and over 600,000 succumb to the disease. The National Cancer Institute estimates that there are over 15 million cancer survivors living today and that nearly 40% of Americans will be touched by it in their lifetime. Given that human toll — the sheer magnitude of both victims and survivors — it really wasn’t hyperbole when President Nixon declared war on cancer in 1971, or when Siddhartha Mukherjee crowned cancer the “emperor of all maladies.” Despite meaningful advances in preventing, diagnosing, and treating the disease, cancer continues to devastate humankind, remaining the second leading cause of death worldwide and claiming nearly 10 million lives around the globe last year alone.
Cancer is, in its most simplistic explanation, a disease of DNA. Genetic mutations, the scrambling of the As, Cs, Gs and Ts that make up the molecular language of DNA, introduce “bugs” into the genetic code and alter the operating instructions of cells to enable them to run amok. In 2000, Douglas Hanahan and Robert Weinberg published their seminal work describing the “hallmarks of cancer,” or the common traits that cells acquire on their path from normal to cancerous: out-of-control growth (slamming on the accelerator and ripping out the brakes); immortality (evading the immune system and other mechanisms that kill, and producing infinite generations of descendants); and the ability to hijack the body to grow and spread (secure blood flow and invade other tissues in order to migrate and metastasize). In short, as cancer cells accumulate more mutations over time, they essentially become genetically-enabled runaway trains.
Stopping these trains has become the lifework of many a brilliant mind. Cancer is an incredibly complex area of biology. Hanahan and Weinberg’s hallmarks are just one example of all the work that has been done and continues to be pursued in order to better elucidate the mechanisms and machinations by which it furthers its own grim agenda. Recently, the rise of new technologies has given us new intel and armaments to use against the disease. DNA sequencing technology, for example, has given us the ability to sequence tumors to both categorize disease based on its genetic mutation (vs. its tissue of origin) and also to develop highly-targeted therapies. Artificial intelligence is increasingly used to help unravel some of the mysteries of biology that have eluded human understanding. Among other things, we’ve learned that there are key genetic drivers that propel a cancer — helping it to acquire and sustain its hallmarks — and that these drivers can be targeted and exploited by therapeutics. In other words, if done well, we can use the very factors from which the cancer derives its strength as a strategy for defeating it. Achilles isn’t invincible if you know where to aim your shot.
If fighting cancer is a war, seasoned veterans who can synthesize the latest knowledge and wield the most cutting edge tools will be critical to turning the tide. Jonathan Lim, physician-turned-serial-entrepreneur, has led and founded four biotechnology start-up companies over his career. His last company, Ignyta, developed precision medicines guided by diagnostic analysis of specific tumor mutations for the treatment of rare cancers and was recently acquired by Roche for $1.7 billion. Jonathan’s very next act was to launch Erasca, a next-generation precision oncology company guided by the audacious (and more artfully articulated) mission to erase cancer. The company is keeping its war plans close to the vest for now, but those plans entail targeting those essential biological drivers of the disease — and it is making early but astounding progress. Jonathan has recruited several of his fellow veterans for Erasca, including Chief Business Officer Gary Yeung, previously of Genentech and Guardant, and Vice President of Biology Robert Shoemaker, an Ignyta and Illumina alumnus. This deep bench of scientific and executive expertise is augmented by a proprietary AI-enabled discovery platform, dubbed OPRA™, that will enable them to develop unique insights and novel strategies for attacking core drivers of cancer. We believe this combination of cancer biology expertise, successful drug discovery and development track record, and access to cutting-edge computational capabilities will bring Erasca closer to our highest collective ambition against disease: cures.
I’m proud to support Erasca in this fight with an investment from the a16z bio fund. Let’s erase cancer!