Almost a year ago, my aunt started suffering back pains. She went to see the doctor and they told her it was a normal injury for someone who had been playing tennis for almost 30 years. They recommended that she do some therapy, but after a while she wasn't feeling better, so the doctors decided to do further tests. They did an x-ray and discovered an injury in her lungs, and at the time they thought that the injury was a strain in the muscles and tendons between her ribs, but after a few weeks of treatment, again her health wasn't getting any better. So finally, they decided to do a biopsy, and two weeks later, the results of the biopsy came back. It was stage 3 lung cancer.
Fai cousa dun ano, á miña tía comezou a doerlle o lombo. Foi ao médico e dixéronlle que era unha lesión común para alguén que xogou ao tennis durante case 30 anos. Recomendáronlle terapia, mais un tempo despois sentíase igual e decidiron facer máis probas. Fixo unha radiografía e descubriron unha lesión nos pulmóns que interpretaron como tensión nos músculos e tendóns entre as costelas, pero tras varias semanas de tratamento seguía igual. Á fin, decidiron facerlle unha biopsia e, dúas semanas despois, chegaron os resultados: cancro de pulmón de grao 3.
Her lifestyle was almost free of risk. She never smoked a cigarette, she never drank alcohol, and she had been playing sports for almost half her life. Perhaps, that is why it took them almost six months to get her properly diagnosed.
A súa forma de vida non podía ter relación, xa que nunca fumou, nunca bebeu alcol e fixo deporte case a metade da súa vida. Quizais por iso lles levou case seis meses facer unha diagnose correcta.
My story might be, unfortunately, familiar to most of you. One out of three people sitting in this audience will be diagnosed with some type of cancer, and one out of four will die because of it. Not only did that cancer diagnosis change the life of our family, but that process of going back and forth with new tests, different doctors describing symptoms, discarding diseases over and over, was stressful and frustrating, especially for my aunt. And that is the way cancer diagnosis has been done since the beginning of history. We have 21st-century medical treatments and drugs to treat cancer, but we still have 20th-century procedures and processes for diagnosis, if any.
Por desgraza, a miña historia pode resultarvos familiar. A 1 de cada 3 persoas deste público diagnosticaráselle algún tipo de cancro e 1 de cada 4 morrerá por isto. Non só a diagnose do cancro cambiou a vida da nosa familia, senón que o proceso de ir e vir con novas probas, médicos que describían síntomas, descartaban doenzas unha e outra vez, foi estresante e frustrante, sobre todo para miña tía. E así é como se diagnostica o cancro dende o comezo da historia. Temos tratamentos e fármacos do séc. XXI para tratar o cancro pero os métodos e procesos de diagnose son do XX, se é que hai algún.
Today, most of us have to wait for symptoms to indicate that something is wrong. Today, the majority of people still don't have access to early cancer detection methods, even though we know that catching cancer early is basically the closest thing we have to a silver bullet cure against it. We know that we can change this in our lifetime, and that is why my team and I have decided to begin this journey, this journey to try to make cancer detection at the early stages and monitoring the appropriate response at the molecular level easier, cheaper, smarter and more accessible than ever before.
Hoxe, a maioría temos que ter síntomas para saber que algo vai mal. Hoxe, a maioría non temos acceso a métodos de diagnose precoz do cancro, aínda sabendo que, coller o cancro cedo é basicamente o máis parecido a ter unha cura milagrosa. Sabemos que podemos cambialo e por iso o meu equipo e eu comezamos este traxecto para tratar de diagnosticar o cancro nas primeiras fases e dar coa mellor solución a nivel molecular dun xeito máis doado, económico, intelixente e máis accesible que nunca.
The context, of course, is that we're living at a time where technology is disrupting our present at exponential rates, and the biological realm is no exception. It is said today that biotech is advancing at least six times faster than the growth rate of the processing power of computers. But progress in biotech is not only being accelerated, it is also being democratized. Just as personal computers or the Internet or smartphones leveled the playing field for entrepreneurship, politics or education, recent advances have leveled it up for biotech progress as well, and that is allowing multidisciplinary teams like ours to try to tackle and look at these problems with new approaches.
Por suposto, o contexto é que estamos no tempo onde a tecnoloxía muda todo a un ritmo exponencial e o campo da bioloxía tamén. Parece que a biotecnoloxía está a avanzar cando menos seis veces máis rápido que a capacidade de procesamento dos ordenadores. O progreso en biotecnoloxía non só se acelera, senón que tamén se democratiza. Igual que os ordenadores, Internet ou os smartphones igualaron o campo de acción para o emprendemento, a política ou a educación, os últimos avances tamén fixeron que a biotecnoloxía progrese, o que permite que equipos multidisciplinares coma o noso traten de afrontar e ver estes problemas con novos enfoques.
We are a team of scientists and technologists from Chile, Panama, Mexico, Israel and Greece, and based on recent scientific discoveries, we believe that we have found a reliable and accurate way of detecting several types of cancer at the very early stages through a blood sample. We do it by detecting a set of very small molecules that circulate freely in our blood called microRNAs.
Somos científicos e tecnólogos de Chile, Panamá, México, Israel e Grecia, e en base a descubertas científicas recentes, cremos que atopamos unha forma fiable e precisa de detectar varios tipos de cancro nas fases iniciais a través do sangue. Detectamos unhas moléculas moi pequenas que circulan libremente no sangue que se chaman microARN.
To explain what microRNAs are and their important role in cancer, I need to start with proteins, because when cancer is present in our body, protein modification is observed in all cancerous cells. As you might know, proteins are large biological molecules that perform different functions within our body, like catalyzing metabolic reactions or responding to stimuli or replicating DNA, but before a protein is expressed or produced, relevant parts of its genetic code present in the DNA are copied into the messenger RNA, so this messenger RNA has instructions on how to build a specific protein, and potentially it can build hundreds of proteins, but the one that tells them when to build them and how many to build are microRNAs. So microRNAs are small molecules that regulate gene expression. Unlike DNA, which is mainly fixed, microRNAs can vary depending on internal and environmental conditions at any given time, telling us which genes are actively expressed at that particular moment. And that is what makes microRNAs such a promising biomarker for cancer, because as you know, cancer is a disease of altered gene expression. It is the uncontrolled regulation of genes. Another important thing to consider is that no two cancers are the same, but at the microRNA level, there are patterns. Several scientific studies have shown that abnormal microRNA expression levels varies and creates a unique, specific pattern for each type of cancer, even at the early stages, reflecting the progression of the disease, and whether it's responding to medication or in remission, making microRNAs a perfect, highly sensitive biomarker.
Para explicar o que son e a súa importancia no cancro, empezarei polas proteínas, xa que, cando temos cancro, estas modifícanse nas células cancerosas. Como xa saberedes, as proteínas son moléculas que realizan diferentes funcións no corpo, como catalizar as reaccións metabólicas, respostar aos estímulos ou replicar o ADN, pero antes de que isto suceda, partes relevantes do código xenético presentes no ADN, cópianse no ARN mensaxeiro e este ten instrucións para construír unha proteína específica e pode construír centos delas, pero os que dicen cando construílas e cantas construír son os microARN. Os microARN son pequenas moléculas que regulan a expresión xenética. A diferenza do ADN, que non soe variar, os microARN poden facelo dependendo do estado interno e do ambiente, comunicándonos que xenes se expresan dun xeito activo. E por iso os microARN son un biomarcador prometedor porque, como xa sabedes, o cancro é a doenza da expresión xénica alterada. A regulación xénica sen control. Outro dato importante é que non hai dous cancros iguais, pero no nivel dos microARN hai patróns. Varios estudos científicos demostraron que uns niveis de expresión de microARN anormais varían e crean un patrón único e concreto para cada tipo de cancro, mesmo nas primeiras fases, reflectindo o avance da doenza e se responde ao tratamento ou se remite, convertendo aos microARN nun biomarcador perfecto e moi sensible.
However, the problem with microRNAs is that we cannot use existing DNA-based technology to detect them in a reliable way, because they are very short sequences of nucleotides, much smaller than DNA. And also, all microRNAs are very similar to each other, with just tiny differences. So imagine trying to differentiate two molecules, extremely similar, extremely small.
Con todo, o problema cos microARN é que non se pode usar a tecnoloxía baseada no ADN para detectalo dun xeito fiable, por ser secuencias moi curtas de nucleótidos, moito máis pequenas que o ADN. Tamén porque os microARN parécense moito, teñen diferenzas minúsculas. É como diferenciar dúas moléculas, extremadamente similares e pequenas.
We believe that we have found a way to do so, and this is the first time that we've shown it in public. Let me do a demonstration. Imagine that next time you go to your doctor and do your next standard blood test, a lab technician extracts a total RNA, which is quite simple today, and puts it in a standard 96-well plate like this one. Each well of these plates has specific biochemistry that we assign, that is looking for a specific microRNA, acting like a trap that closes only when the microRNA is present in the sample, and when it does, it will shine with green color. To run the reaction, you put the plate inside a device like this one, and then you can put your smartphone on top of it. If we can have a camera here so you can see my screen. A smartphone is a connected computer and it's also a camera, good enough for our purpose. The smartphone is taking pictures, and when the reaction is over, it will send the pictures to our online database for processing and interpretation. This entire process lasts around 60 minutes, but when the process is over, wells that shine are matched with the specific microRNAs and analyzed in terms of how much and how fast they shine. And then, when this entire process is over, this is what happens. This chart is showing the specific microRNAs present in this sample and how they reacted over time. Then, if we take this specific pattern of microRNA of this person's samples and compare it with existing scientific documentation that correlates microRNA patterns with a specific presence of a disease, this is how pancreatic cancer looks like. This inside is a real sample where we just detected pancreatic cancer.
Cremos ter atopado a forma de facelo e ides ser os primeiros en coñecela. Vouvos facer unha mostra. Imaxinade a próxima vez que ides ao médico para facer unha análise de sangue e vos extraen unha mostra total de ARN, bastante sinxelo hoxe en día, e póñena nunha placa de 96 cuncas. A cada cunca destas placas asignámoslle un bioquímico concreto que busca un microARN concreto e actúa como unha trampa que se pecha só cando o microARN está na mostra, e cando isto sucede, ten un brillo verde. Para que reaccione, métela nun dispositivo coma este e colocas o teu smartphone sobre el. Podedes colocar a cámara aquí para que vexades a pantalla? O smartphone é un ordenador conectado e tamén é unha cámara, dabondo para o noso propósito. O smartphone tira fotos e cando a reacción remate, enviará as fotos á base de datos en liña para procesalas e interpretalas. Este proceso dura uns 60 minutos pero cando remata, emparella as que brillan cos microARN e analízaos en termos de canto e como de rápido brillan. Cando este proceso remata, isto é o que acontece: a gráfica amosa os microARN específicos presentes nesta mostra e como reaccionaron co tempo. Se este patrón específico de microARN das mostras desta persoa comparámolo coa documentación dos patróns de microARN da presenza específica dunha doenza, así veremos o cancro de páncreas. Aquí dentro temos unha mostra real na que detectamos cancro de páncreas.
(Applause)
(Aplausos)
Another important aspect of this approach is the gathering and mining of data in the cloud, so we can get results in real time and analyze them with our contextual information. If we want to better understand and decode diseases like cancer, we need to stop treating them as acute, isolated episodes, and consider and measure everything that affects our health on a permanent basis. This entire platform is a working prototype. It uses state-of-the-art molecular biology, a low-cost, 3D-printed device, and data science to try to tackle one of humanity's toughest challenges. Since we believe early cancer detection should really be democratized, this entire solution costs at least 50 times less than current available methods, and we know that the community can help us accelerate this even more, so we're making the design of the device open-source.
Outro aspecto importante é que reúne e extrae os datos na nube, así temos resultados en tempo real e analizámolos en contexto. Se queremos entender mellor e descodificar estas doenzas, hai que deixar de tratalas como graves e illadas, para considerar e medir todo o que afecta a nosa saúde. A plataforma é un prototipo. Emprega bioloxía molecular de vangarda, un dispositivo de baixo custo impreso en 3D e datos científicos para abordar un dos retos máis difíciles. Como cremos que a detección precoz debería democratizarse, esta solución custa case un 50% menos que os métodos que temos na actualidade e a comunidade pode axudarnos a aceleralo máis, así que deseñamos o dispositivo en código aberto.
(Applause)
(Aplausos)
Let me say very clearly that we are at the very early stages, but so far, we have been able to successfully identify the microRNA pattern of pancreatic cancer, lung cancer, breast cancer and hepatic cancer. And currently, we're doing a clinical trial in collaboration with the German Cancer Research Center with 200 women for breast cancer.
Permitídeme dicir claramente que estamos nas primeiras etapas, pero puidemos identificar con éxito os patróns de microARN de cancro de páncreas, de pulmón, de mama e de fígado. Estamos a traballar nun ensaio clínico en colaboración co Centro Alemán de Investigación Oncolóxica con 200 mulleres con cancro de mama.
(Applause) This is the single non-invasive, accurate and affordable test that has the potential to dramatically change how cancer procedures and diagnostics have been done. Since we're looking for the microRNA patterns in your blood at any given time, you don't need to know which cancer you're looking for. You don't need to have any symptoms. You only need one milliliter of blood and a relatively simple array of tools.
(Aplausos) Esta é a única proba non invasiva, precisa e económica que posibilita un cambio radical nos métodos e diagnoses que se fan ata o momento. Como buscamos patróns de microARN no sangue nun momento dado, non é preciso saber que cancro buscas. Non é preciso ter ningún síntoma. Só é preciso un mililitro de sangue e unhas ferramentas relativamente simples.
Today, cancer detection happens mainly when symptoms appear. That is, at stage 3 or 4, and I believe that is too late. It is too expensive for our families. It is too expensive for humanity. We cannot lose the war against cancer. It not only costs us billions of dollars, but it also costs us the people we love. Today, my aunt, she's fighting bravely and going through this process with a very positive attitude. However, I want fights like this to become very rare. I want to see the day when cancer is treated easily because it can be routinely diagnosed at the very early stages, and I'm certain that in the very near future, because of this and other breakthroughs that we are seeing every day in the life sciences, the way we see cancer will radically change. It will give us the chance of detecting it early, understanding it better, and finding a cure.
Hoxe, adoita detectarse o cancro cando aparecen os síntomas. É dicir, no grao 3 ou 4 e creo que é demasiado tarde. É demasiado caro para as nosas familias. É demasiado caro para a humanidade. Non podemos perder contra o cancro. Cústanos miles de millóns de dólares, pero tamén nos custa a nosa xente. Hoxe, miña tía loita valerosamente e segue o proceso moi positiva. Con todo, quero que este tipo de loitas sexan moi pouco frecuentes. Desexo que chegue o día no que sexa doado tratar o cancro porque se detecta sistematicamente nas primeiras fases e estou seguro de que moi pronto, grazas a este avance e a outros que vemos nas ciencias biolóxicas, a nosa perspectiva cara o cancro cambiará dun xeito radical. Daranos a oportunidade de detectalo cedo, de entendelo mellor e de descubrir unha cura.
Thank you very much.
Moitas grazas.
(Applause)
(Aplausos)