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.
Prije skoro godinu dana, moju tetu su počeli mučiti bolovi u leđima. Otišla je kod doktora i rekao joj je da je to normalna ozljeda za nekoga tko igra tenis skoro pa 30 godina. Preporučili su joj određene terapije, ali i dalje se nije osjećala bolje, pa je doktor odlučio napraviti daljnja testiranja. Napravili su rendgen i otkrili ozljedu u njenim plućima, i tada su mislili da je ozljeda bila zbog napora mišića i tetiva između rebara, ali nakon nekoliko tjedana liječenja, njeno zdravlja nije postajalo bolje. Na kraju su se odlučili napraviti biopsiju i dva tjedna kasnije, došao je razultat biopsije. Imala je karcinom pluća trećeg stadija.
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.
Njen životni stil je skoro bio bez rizika. Nikada nije popušila cigaretu, nikada nije pila alkohol, i bavila se sportom skoro cijeli njen život. Možda je zbog toga trebalo skoro šest mjeseci da se postavi točna dijagnoza.
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.
Moja priča je možda, nažalost, poznata većini vas. Jednoj od tri osobe koje sjede u publici će biti dijagnosticira neka vrsta raka, a jedna od četiri će umrijeti od toga. Ne samo da je dijagnoza tog karcinoma promijenila život naše obitelji, već taj proces odlaska na nove testove, različiti doktori koji opisuju simptome, odbacuju druge bolesti opet nanovo, bilo je stresno i frustrirajuće, pogotovo za moju tetu. I to je način na koji se rak dijagnosticirao od početka povijesti. Imamo medicinske tretmane i lijekove 21-og stoljeća za liječenje raka, ali i dalje imamo procedure i načine 20-og stoljeća dijagnosticiranja 20-og stoljeća, ako i to.
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.
Danas, većina nas mora čekati pojavu simptoma koji pokazuju da nešto nije u redu. Danas, većina ljudi i dalje nema pristup metodama ranog otkrivanja karcinoma iako znamo da je rano hvatanje karcinoma zapravo najbliže što imamo sigurnom i brzom izliječenju. Znamo da to možemo promijeniti u našem životnom vijeku, i zato smo moj tim i ja odlučili započeti ovo putovanje, putovanje ka pokušaju da se detektiranje karcinoma u ranim stadijima, i nadgledanje prikladnih odgovora na molekularnoj razini, učini lakšim, jeftinijim, pametnijim i pristupačnijim no ikad prije.
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.
U biti, mi živimo u vremenu kada tehnologija mijenja sadašnjost eksponencijalnom brzinom, a biološka sfera nije isključena iz toga. Biotehnologija se razvija bar šest puta brže no razvitak snage kompjuterskog procesiranja. Ali napredak u biotehnologiji nije samo ubrzan, već je i demokratiziran. Isto kako osobna računala ili internet ili pametni telefoni izjednačavaju mogućnosti za poduzetništvo, politiku ili edukaciju, nedavni napredci su izjednačili i za biotehnološki progres također, i to dozvoljava multidisciplinarnim timovima poput našeg da se uhvate u koštac s ovim problemima s novim pristupima.
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.
Mi smo tim znanstvenika i tehničara iz Čilea, Paname, Meksika, Izraela i Grčke, i bazirano na nedavnim znanstvenim otkrićima, vjerujemo da smo pronašli pouzdan i točan način detektiranja nekoliko tipova karcinoma u vrlo ranom stadiju preko uzorka krvi. Radimo to detektirajući skup vrlo malih molekula koje slobodno cirkuliraju u našoj krvi, imena microRNA.
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.
Kako bi objasnio što su microRNA i njihovu važnu ulogu u raku, moram početi od proteina, jer kada je rak prisutan u našem tijelu, primijeti se modifikacija proteina u svim kancerogenim stanicama. Možda već i znate, proteini su velike biološke molekule koje obavljaju različite funkcije u našem tijelu, poput ubrzanja metaboličkih reakcija ili odgovora na stimulus ili repliciranja DNA, ali prije no što je protein izražen ili produciran, određeni dijelovi genetskog koda koji se nalazi u DNA se kopiraju na glasničku RNA i ta glasnička RNA ima upute kako izgraditi određeni protein, i potencijalno može izgraditi stotine proteina, ali ono što im govori kada ih izgraditi i koliko ih izgraditi su microRNA. MicroRNA su male molekule loje reguliraju ekspresiju gena. Nasuprot DNA, koja je nepromjenjiva, microRNA se mijenjaju ovisno o unutarnjim i okolišnim uvjetima u određenom vremenu, i govore nam koji geni se trebaju aktivno eksprimirati u određenom vremenu. I to je ono što microRNA čini obećavajućim biomarkerom za karcinom, jer kao što znate, karcinom je bolest promijenjene ekspresije gena. To je nekontrolirana regulacija gena. Bitno je i to da ne postoje dva ista karcinoma, ali na razini microRNA, postoje sličnosti. Nekoliko znanstvenih istraživanja su pokazala da razina abnormalne ekspresije microRNA varira i stvara jedinstveni određeni uzorak za svaku vrstu karcinoma, čak i u ranim stadijima, odgovarajući razvoju bolesti, i bilo da reagira na lijekove ili je u remisiji, microRNA je savršen, visoko osjetljiv biomarker.
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.
Naime, problem s microRNA je taj da ne možemo koristiti postojeću tehnologiju baziranu na DNA kako bismo ih pouzdano detektirali, jer oni su vrlo kratki dijelovi nukleotida, mnogo manji od DNA. I također, sve microRNA su veoma slične jedna drugoj, s vrlo malim razlikama. Zamislite pokušaj razlikovanja dvije molekule, vrlo slične, vrlo male.
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.
Vjerujemo da smo pronašli način za to, i ovo je prvi put da ovo pokazujemo u javnosti. Dozvolite da vam demonstriram. Zamislite da sljedeći put kada idete kod doktora i napravite normalno testiranje krvi, laboratorijski tehničar ekstrahira RNA, što je vrlo jednostavno danas, i stavi ju u standardne jažice poput ovih. Svaka od ovih jažica ima određenu biokemiju koju dodijelimo, koja traži specifičnu microRNA, i djeluje poput zamke koja se zatvara jedino kada je microRNA prisutna u uzorku, a kada se zatvori, svijetli zelenom bojom, Da bi pokrenuli reakciju, stavite jažice u uređaj poput ovoga, a zatim možete staviti svoj pametni telefon na njega. Možemo li usmjeriti kameru ovdje da možete vidjeti moj zaslon. Smartphone je povezano računalo, a također je i kamera, dovoljno dobra za ovu svrhu. Pametni telefon fotografira, i kada reakcija završi, poslat će fotografije u našu online bazu podataka na obradu i interpretaciju. Cijeli proces traje oko 60 minuta, ali kada proces završi, jažice koje sjaje su pozitivne na određenu microRNA i analiziraju se ovisno o tome koliko puno i brzo sjaje. I onda, kada je proces gotov, dogodi se ovo. Ovaj graf prikazuje određene microRNA prisutne u uzorku i kako su reagirali tijekom vremena. Onda, ako uzmemo ove specifične obrasce microRNA uzorka ove osobe i usporedimo ih s postojećom znanstvenom dokumentacijom koja povezuje uzorke microRNA s određenom bolesti, ovako izgleda karcinom gušterače. Unutra je pravi uzorak gdje smo upravo detektirali karcinom gušterače.
(Applause)
(Pljesak)
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.
Također bitno kod ovog pristupa je prikupljanje i obrada podataka u oblaku, tako da dobijemo rezultate u stvarnom vremenu i analiziramo ih sa kontekstualnim informacijama. Ako želimo bolje razumjeti i odgonetnuti bolesti poput karcinoma, moramo ih prestati tretirati kao akutne, izolirane epizode i uzeti u obzir i mjeriti sve što kroz dulji period utječe na naše zdravlje. Cijela platforma je prototip u izradi. Koristi najnovije spoznaje molekularne biologije, jeftini, 3D printani uređaj, i znanost o podatcima kako bi se uhvatilo u koštac s najvećim izazovom čovječanstva. Vjerujemo da bi rano otkrivanje raka trebalo biti demokratizirano, sve ovo košta bar 50 puta manje no trenutno dostupne metode i znamo da nam društvo može pomoći još više to ubrzati, pa ćemo učiniti dizajn uređaja javno dostupnim.
(Applause)
(Pljesak)
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.
Želim vrlo jasno reći da smo mi u ranim stadijima, ali zasad smo uspješno identificirali microRNA uzorke za karcinom gušterače, pluća dojki i jetre. I trenutno, provodimo kliničko istraživanje u suradnji s NJemačkim centrom za istraživanje raka s dvjesto žena o karcinomu dojke.
(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.
(Pljesak) Ovo je jedini neinvazivni, točan i povoljan test koji ima potencijal dramatično promijeniti procedure i dijagnostike raka rađene dosad. Zbog toga što tražimo uzorke microRNA u vašoj krvi u određenom vremenu, ne morate znati koji rak tražite. Ne morate imati ikakvih simptoma. Samo vam je potreban mililitar krvi i relativno jednostavan set alata.
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.
Danas, detekcija raka se odvija uglavnom kada se pojave simptomi. To jest, kod 3. ili 4. stadija i vjerujem da je to prekasno. Preskupo je za naše obitelji. Preskupo je za čovječanstvo. Ne možemo izgubiti rat protiv raka. Ne košta nas samo milijarde dolara već nas košta i ljudi koje volimo. Danas, moja teta, bori se hrabro i prolazi kroz sve to s vrlo pozitivnim stavom. No ipak, želim da ovakve borbe postanu rijetkost. Želim vidjeti dan kada se rak tretira lako jer je to rutinska dijagnostika u vrlo ranim stadijima, i siguran sam da u vrlo bliskoj budućnosti, zbog ovog i drugih otkrića koje vidimo svaki dan u životnoj znanosti, način na koji vidimo karcinome će se drastično promjeniti. Dat će nam šansu ranog detektiranja, boljeg razumijevanja i pronalaska lijeka.
Thank you very much.
Hvala vam puno.
(Applause)
(Pljesak)