Solomon Moshkevich and Perry Olshan Of Natera On The 5 Things Everyone Needs To Know About Cancer

An Interview With Savio P. Clemente

Perry: Be a loving partner. My wife was diagnosed with cancer and it was my job to love her unconditionally, in her most challenging moments of fear and discomfort.

Solomon: Love and laughter, together with good diet and exercise. Fighting cancer takes a huge amount of personal will power, so the patient needs to feel motivated and supported by her community.

Cancer is a horrible and terrifying disease. There is so much great information out there, but sometimes it is very difficult to filter out the noise. What causes cancer? Can it be prevented? How do you detect it? What are the odds of survival today? What are the different forms of cancer? What are the best treatments? And what is the best way to support someone impacted by cancer?

In this interview series called, “5 Things Everyone Needs To Know About Cancer” we are talking to experts about cancer such as oncologists, researchers, and medical directors to address these questions. As a part of this interview series, I had the pleasure of interviewing Solomon Moshkevich and Perry Olshan.

Solomon Moshkevich is responsible for strategy and execution across all aspects of Natera’s oncology business, as General Manager of Oncology. Since joining Natera in 2011, Solomon has built and led multiple teams including global marketing, business development, product management, medical and scientific affairs, and international sales; and he has played a leading role in the development, clinical validation and commercial success of all Natera’s cell-free DNA products including Panorama, Prospera, and Signatera. Solomon graduated summa cum laude from Columbia University with a B.A. in Economics and Mathematics and holds an M.B.A. from Stanford University. He lives in Menlo Park, CA with his wife and two children.

Perry Olshan leads the Oncology Medical Science Liaison team within the Medical Affairs group at Natera. Additionally, he’s responsible for numerous research initiatives within academic institutions, both within the US and Internationally. Prior to joining Natera, Perry had launched numerous products and built a number of Medical Affairs teams, while working for various biotech and pharmaceutical companies. Perry graduated from the Chicago School of Professional Psychology with a Ph.D. in Clinical Psychology, and holds an M.A. from Pepperdine University. He lives in San Francisco, CA with his wife and two children.

Thank you so much for joining us in this interview series! Before we dive into the main focus of our interview, our readers would love to “get to know you” a bit better. What or who inspired you to pursue your career? We’d love to hear the story.

Solomon: I always wanted to do something transformative in healthcare. In graduate school, I discovered genetics, and I realized that we were still in the early stages of a technological revolution that would help millions of people diagnose and fight disease, but would also create fascinating and challenging questions about ethics and humanity. That sounded pretty cool to me. I didn’t expect that the products and services developed by Natera would also have such a direct impact on my own family.

This is not easy work. What is your primary motivation and drive behind the work that you do?

Solomon: We have a core value at Natera, “There is a patient behind every sample.” Natera’s products have touched the lives of millions of people at critical moments, early in pregnancy, after a kidney transplant, or after a cancer diagnosis to inform treatment decisions. This is very satisfying. I also want to be the best version of myself, to be part of a winning team. I am lucky to have found both of these at Natera.

What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?

Perry: Some of the most interesting research initiatives that I’m working on at Natera include:

1. A prospective real world study within Colorectal Cancer measuring changes in treatment decisions and clinical outcomes based on the use of Signatera in patients with stage II and III colorectal cancer. The study will enroll at least 1,000 patients. Natera and its collaborators will collect clinical utility and outcomes data on enrolled patients for two years.
2. A prospective, multi-center clinical study examining the role of ctDNA in Immune checkpoint blockade treatment response monitoring. This study seeks to quantify the impact on treatment decisions and outcomes based on the results of Signatera residual disease test (MRD).

For the benefit of our readers, can you briefly let us know why you are an authority about the topic of Cancer?

Solomon: I am not a doctor, but I have the honor of leading a team of brilliant scientists, physicians, engineers and business people, who together are transforming how cancer is diagnosed and managed through a breakthrough diagnostic technology called Signatera, which can detect traces of cancer before it becomes visible with a CT scan or MRI.

Perry: By training I’m a Psychologist, which helps me understand the psychological toll that suffering from a devastating illness can have on an individual. However, I’m not an Oncologist and didn’t attend Medical school. I work with Oncologists on a daily basis and lead a team of pharmacists, nurses, surgeons, etc. that are all clinicians and have treated numerous types of Cancer. Additionally, I have the privilege of working at Natera, which has developed Signatera, a unique technology that can detect circulating tumor DNA (minimal traces of cancer in the bloodstream).

Ok, thank you for all of that. Let’s now shift to the main focus of our interview. Let’s start with some basic definitions so that we are all on the same page. What exactly is cancer?

Perry: Our body is made up of trillions of cells and Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. This uncontrolled growth of abnormal cells comes in all shapes and sizes. Each person’s cancer is as unique as their fingerprint, and just like no two fingerprints are exactly alike, no two tumors or treatment options are the same. Once these abnormal cells grow out of control, they start to have a negative impact on your normal, healthy cells — making it hard for the good ones to do their jobs.

It’s something that impacts us all in some way, shape or form. Whether you’re a survivor, a caregiver, or anything in between, you know that cancer can alter lives.

What causes cancer?

Perry: An elementary way of understanding what causes cancers is to understand that our cells grow and multiply through a process called “cell division” to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place. Sometimes this orderly process breaks down, and abnormal or damaged cells grow and multiply, when they shouldn’t. These cells may form tumors, which are lumps of tissue. These lumps of tissue can be cancerous or non-cancerous “benign”.

A closer look at genetics would be to understand how a person’s genes mutate, or have any changes in our genetic sequence. This mutation can develop after you’re born because of exposure to carcinogens identified in cigarette smoke, for example, or due to the effects of aging; or you can be born with a gene mutation that makes other cancerous mutations more likely, which is a hereditary predisposition.

Because some cancer risks may be hereditary, genetic testing can be an option for those who want to know more about their risk of developing cancer, why it might be common in their family, or want to inform treatment options following a cancer diagnosis. For instance, Natera’s Empower test tests up to 53 genes associated with risk for common hereditary cancers using blood or saliva samples.

What is the difference between the different forms of cancer?

Perry: There are more than 100 types of Cancer, these types of cancer are usually named for the organs or tissues where the cancer has formed. For example, Lung Cancer starts in the Lung, and Brain Cancer starts in the Brain. Also, Cancers may be described by the type of cells that formed them, such as Epithelial (major tissues in glands) Squamous (forms the surface of the skin). More generally, there are two types of cancer: one that can attack a specific organ or tissue and another that attacks something as broad as your blood cells. Some cancers can grow slowly over time and stay localized; while others can attack more rapidly and metastasize to other tissues in the body, falling into categorization somewhere between stage one and stage four — with four being the most severe.

I know that the next few questions are huge topics, but we’d love to hear your thoughts regardless. How can cancer be prevented?

Solomon: Cancer can be prevented by making healthy lifestyle choices including having a healthy diet, being physically active and protecting oneself from the sun to avoid risk of skin cancer. It’s also important to get the appropriate medical care by taking action early on and arming yourself with knowledge through genetic testing. Natera’s Empower test, for example, allows family members to proactively manage hereditary cancer risk through a simple blood test. And for patients who have already had cancer, Signatera can help detect cancer recurrence at its earliest, most treatable stage, identify someone’s treatment response to risk-reducing medications and surgeries, and inform surgical and therapeutic decisions.

How can one detect the main forms of cancer?

Solomon: Cancer can be detected via physical exam, lab tests, image testing and scans, and other preventative screenings. For patients previously diagnosed with cancer, new personalized blood tests, like Natera’s Signatera test, can detect miniscule traces of cancer with extremely high accuracy. These tiny particles of the disease can be left over following initial cancer treatment and signal remission.

Cancer used to almost be a death sentence, but it seems that it has changed today. What are the odds of surviving cancer today?

Perry: The technological advancements of today have altered the way that we look at and approach cancer as a society and in turn, have made the odds of beating cancer far greater than they have ever been.

For example, there have been recent advancements in immunotherapy or immuno-oncology, a type of treatment that uses the power of the body’s immune system to better target and eliminate cancer cells. In recent years, immunotherapies have been approved in the United States and elsewhere to treat various types of cancer, including specific advanced and metastatic cancers that may have spread from where they first started to nearby tissue, lymph nodes, or other parts of the body. Additionally, certain immunotherapies are available through clinical trials, which are sponsored by pharmaceutical companies and carefully controlled by regulations, and through closely monitored studies involving patient volunteers.

Immunotherapies have transformed the treatment of certain cancers and helped extend and save the lives of many patients. In the long term, immunotherapy holds the potential to treat all cancers by becoming more precise, individualized, and more effective than other types of therapy — and possibly with fewer side effects.

Approximately 43.6 percent of cancer patients are eligible for immunotherapy, and in the U.S., more than 200,000 are currently undergoing immunotherapy treatment for cancer. However, despite being such a revolutionary and widely used treatment, less than 20 percent of eligible patients will actually respond. Signatera, a new personalized cancer-monitoring test, can help determine — earlier than traditional tests — whether a patient is responding to immune checkpoint inhibitors, a type of immunotherapy, by assessing the changes in levels of circulating tumor DNA (ctDNA) throughout treatments. This helps patients to know if their treatment is or is not working and what the next step of their cancer journey may be.

Can you share some of the new cutting-edge treatments for cancer that have recently emerged? What new cancer treatment innovations are you most excited to see come to fruition in the near future?

Solomon: The biggest change in cancer treatment over the past decade has been the emergence of immune checkpoint inhibitors, aka immunotherapy. This amazing class of drugs unlocks the potential of one’s own immune system to fight cancer. Many patients have benefited significantly from immunotherapy, either by itself or in combination with other treatments.

Now researchers are exploring the next frontier in immunotherapies, including personalized cancer vaccines. These hold a lot of promise, but they are mostly still undergoing clinical trials.

Healing usually takes place between doctor visits. What have you found to be most beneficial to assist a patient to heal?

Solomon: Love and laughter, together with good diet and exercise. Fighting cancer takes a huge amount of personal will power, so the patient needs to feel motivated and supported by her community.

From your experience, what are a few of the best ways to support a loved one, friend, or colleague who is impacted by cancer?

Solomon: I can say from my own experience as a caregiver: when my friends would ask me, “Is there anything I can do to help?” I would respond, “Thank you so much. There is one thing: keep checking in, but please don’t be upset if I am unresponsive.”

What are a few of the biggest misconceptions and myths out there about fighting cancer that you would like to dispel?

Solomon: Cancer is a tough disease. There is rarely a silver bullet. Find a great team of physicians, ask lots of questions, and put your trust in them.

Thank you so much for all of that. Here is the main question of our interview. Based on your experiences and knowledge, what are your “5 Things Everyone Needs To Know About Cancer? Please share a story or example for each.

Perry:

1. It’s important to recognize that cancer recurrence does not proceed step-wise. If you get cancer at stage 1 and later the same cancer comes back, it’s not then stage 2, and if it comes back again, it’s not then stage 3, and so on. When you are diagnosed with an early-stage cancer (for instance, stage 1), if that cancer comes back and spreads. you have metastatic (stage 4) disease.
2. Cancer is not always a death sentence, particularly with the progress made in recent decades.
3. It’s important to remember that cancer survivors often experience emotional, social, and financial challenges as a result of their cancer diagnosis and treatment. This doesn’t dismiss the intense physical discomfort that patients experience.
4. It’s critical to find your support system when you’re diagnosed with cancer, don’t let shame or embarrassment win. Reach out to friends and family. Don’t forget that there are patient advocacy groups that exist to help you.
5. Be a loving partner. My wife was diagnosed with cancer and it was my job to love her unconditionally, in her most challenging moments of fear and discomfort.

How can our readers further follow your work online?

Solomon and Perry: Please visit www.natera.com to learn more about the work we’re doing to revolutionize cancer care.

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.

About The Interviewer: Savio P. Clemente helps cancer survivors overcome the confusion and gain the clarity needed to get busy living in mind, body, and spirit. He inspires health and wellness seekers to find meaning in the “why” and to cultivate resilience in their mindset. Savio is a Board Certified wellness coach (NBC-HWC, ACC), stage 3 cancer survivor, podcaster, writer, and founder of The Human Resolve LLC.

Savio pens a weekly newsletter at thehumanresolve.com where he delves into secrets from living smarter to feeding your “three brains” — head 🧠, heart 💓, and gut 🤰 — in hopes of connecting the dots to those sticky parts in our nature that matter.

He has been featured on Fox News, and has collaborated with Food Network, WW, Bloomberg, Amazon, and Facebook. His mission is to offer clients, listeners, and viewers alike tangible takeaways in living a truly healthy, wealthy, and wise lifestyle.

Savio lives in the suburbs of Westchester County, New York and continues to follow his boundless curiosity. He hopes to one day live out a childhood fantasy and explore outer space.