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.
Pre oko godinu dana, moja tetka je počela da oseća bol u leđima. Otišla je kod lekara gde su joj rekli da je to uobičajena povreda za nekoga ko je igrao tenis skoro 30 godina. Preporučili su joj terapiju, ali posle nekog vremena nije se osećala bolje pa su lekari odlučili da urade druge testove. Uradili su rendgen i otkrili povredu u njenim plućima, za koju su tada smatrali da je istegnuće mišića i tetiva između njenih rebara. Ali nakon nekoliko nedelja lečenja, i dalje nije bilo napretka. Stoga su odlučili da urade biopsiju i posle dve nedelje, dobili smo rezultate. Imala je rak pluća u trećem stadijumu.
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.
Uglavnom je vodila zdrav način života. Nikada nije pušila, nikada nije pila alkohol, i skoro polovinu života se bavila sportom. Možda im je zbog toga trebalo skoro šest meseci za tačnu dijagnozu.
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 verovatno, nažalost, poznata većini vas. Jednoj od tri osobe koje sede u publici biće dijagnostikovana neka vrsta raka, i jedna od četiri će od toga umreti. Dijagnoza raka nije samo promenila život naše porodice, već je zbog tog procesa stalnog testiranja, različitih lekara i opisa simptoma kao i odbacivanja dijagnoza iznova i iznova bio stresan i frustrirajući, posebno za moju tetku. To je način na koji se radi dijagnoza raka od početka istorije. Imamo savremene medicinske metode i lekove za lečenje raka, ali su procedure i procesi za dijagnozu raka zastareli, ako uopšte i postoje.
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 da čeka na pojavu simptoma da bi se utvrdilo da nešto nije u redu. Većina ljudi danas, nema pristup metodima ranog otkrivanja raka, iako znamo da je rano otkrivanje raka najbliža stvar koju imamo efikasnom leku protiv raka. Znamo da ovo možemo da uradimo za života, i zato smo moj tim i ja odlučili da započnemo ovo putovanje, putovanje koje je pokušaj da otkrivanje raka u ranim stadijumima i posmatranje odgovarajućih indikatora na molekularnom nivou bude lakše, jeftinije, pametnije i dostupnije više nego ikad.
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 kontekstu, živimo u vremenu u kojem tehnologija veoma brzo menja našu sadašnjost, i oblast biologije nije izuzetak. Kažu da biotehnologija danas napreduje bar šest puta brže od stope rasta moći obrade računara. Napredak u biotehnologiji je ne samo ubrzan, već i demokratizovan. Dok su lični računari, internet ili pametni telefoni izjednačili mogućnosti u preduzetništvu, politici ili obrazovanju, skorašnji pomak je isto ovo uradio za napredak biotehnologije. To je omogućavanje multidisciplinarnim timovima kao što je naš da se pozabave i sagledaju ove probleme drugačijim 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 naučnika i tehnologa iz Čilea, Paname, Meksika, Izraela i Grčke, i na osnovu nedavnih naučnih otkrića mislimo da smo pronašli pouzdan i tačan način otkrivanja više tipova raka u ranim stadijumima preko uzorka krvi. Ovo smo postigli otkrivanjem grupe veoma sitnih molekula koji se slobodno kreću u krvotoku i nazivaju se mikroRNK.
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 bismo objasnili šta je mikroRNK i njenu značajnu ulogu za rak moram da krenem od proteina, jer kad je rak prisutan u našem telu posmatra se modifikacija proteina u svim kancerogenim ćelijama. Kao što već možda znate, proteini su veliki biološki molekuli koji obavljaju različite funkcije unutar tela kao što je katalizacija metaboličkih reakcija, reagovanje na nadražaje ili replikacija DNK, ali pre ekspresije i stvaranja proteina bitni delovi genetičkog koda koji su prisutni u DNK se kopiraju u transportnu RNK, kako bi transportna RNK imala instrukcije za građenje odeđenog proteina i mogla da izgradi stotine proteina ali ona koja govori kad da ih grade i koliko je mikroRNK. MikroRNK se sastoji od malih molekula koji regulišu ekspresiju gena. Za razliku od DNK, koja je uglavnom nepromenljiva, mikroRNK može da varira bilo kad u zavisnosti od unutrašnjih i spoljašnjih uslova, i govori nam koji geni aktivno učestvuju u ekspresiji u tom trenu. Zato je mikroRNK tako obećavajući biomarker za rak, jer kao što znate, rak je bolest promenjene ekspresije gena. Ono je nekontrolisana regulacija gena. Još jedna bitna stvar za razmatranje je da nijedna dva raka nisu ista, ali na nivou mikroRNK, postoje šabloni. Nekoliko naučnih istraživanja su pokazala da nivo abnormalne ekspresije mikroRNK varira i stvara jedinstveni i specifični šablon za svaki tip raka, čak i u ranim stadijumima, i time prikazuje napredak bolesti i da li reaguje na lečenje ili je u remisiji, što čini mikroRNK savršenim, vrlo osetljivim biomarkerom.
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.
Problem sa mikroRNK je što ne možemo koristiti postojeću tehnologiju koja je zasnovana na DNK kako bismo ih otkrili na pouzdan način, zato što su one veoma kratki nizovi nukleotida mnogo manji od DNK. Takođe, sve mikroRNK su međusobno jako slične, sa jako malim razlikama. Zamislite da treba da razlikujete dva izuzetno slična i veoma mala molekula.
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.
Mislimo da smo pronašli način da to uradimo, i ovo je prvi put da ga prikazujemo u javnosti. Demonstriraću vam. Zamislite da sledeći put kad odete kod lekara i uradite vašu standardnu analizu krvi, laborant izoluje totalnu RNK, nešto što je veoma jednostavno danas, i stavi je u mikroploču sa 96 determinacija, kao što je ova. Svaka determinacija ovih ploča sadrži biohemiju koju smo mi odredili, koja traži određenu mikroRNK i ponaša se kao zamka koja se zatvara tek onda kad je mikroRNK prisutna u uzorku, u tom trenutku, zasvetli zelenom bojom. Da bi pokrenuli reakciju ploču stavite u uređaj kao što je ovaj, a zatim na vrh i svoj pametni telefon. Nek kamera zumira ovde kako biste videli moj ekran. Pametan telefon je umrežen računar ali i fotoaparat, dovoljno dobar za naše namere. Telefon fotografiše, i kada se reakcija završi, poslaće slike u našu bazu podataka na internetu radi obrade i tumačenja podataka. Ceo proces traje otprilike 60 minuta, ali kada se završi, determinacije koje sijaju poklapaju se sa određenim mikroRNK i analiziraju se u pogledu toga koliko su i koliko brzo zasijale. Kada se ceo taj proces završi, ovo se desi. Tabela pokazuje određene mikroRNK prisutne u uzorku i njihovu reakciju tokom vremena. Ako uzmemo ovaj određeni šablon mikroRNK iz uzorka ove osobe i uporedimo ga sa postojećom naučnom dokumentacijom koja povezuje šablone mikroRNK sa prisutnošću određene bolesti, ovako izgleda rak pankreasa. Unutra je pravi uzorak gde smo upravo otkrili rak pankreasa.
(Applause)
(Aplauz)
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.
Još jedan važan aspekat ovog pristupa je skupljanje i skadištenje informacija u oblaku kako bismo dobili rezultate u realnom vremenu i onda ih analizirali sa postojećom dokumentacijom. Ako hoćemo bolje da razumemo i dekodiramo bolesti kao što je rak moramo prestati da ih tretiramo kao akutne, izolovane slučajeve i uzmemo u obzir i izmerimo sve što trajno utiče na naše zdravlje. Cela ova platforma je radni prototip. Koristi najsavremeniju molekularnu biologiju, jeftini uređaj za štampanje u 3D-u i nauku o podacima kako bi pokušala da pobedi jedan od najvećih izazova za čovečanstvo. Zato što mislimo da rano otkrivanje raka treba da bude demokratizovano, celo ovo rešenje košta bar 50 puta manje od trenutno dostupnih metoda, i znamo da nam zajednica može pomoći da ovo ubrzamo, te je dizajn ovog uređaja otvorenog tipa.
(Applause)
(Aplauz)
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.
Hoću samo da naznačim da smo tek u ranim fazama, ali za sad smo uspeli da uspešno identifikujemo šablon mikroRNK raka pankreasa, raka pluća, raka dojke i raka jetre. Trenutno obavljamo kliničko ispitivanje u saradnji sa Nemačkim centrom za istaživanje raka sa 200 žena, za rak 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.
(Aplauz) Ovo je jedini neinvanzivni tačan i pristupačan test koji ima potencijal da drastično promeni način na koji se rade procedure i dijagnoze raka. Zato što tražimo šablone mikroRNK u vašoj krvi u bilo kom trenutku, nema potrebe da znate koji rak tražite. Ne morate da imate nikakve simptome. Treba vam samo mililitar krvi i prilično jednostavan izbor instrumenata.
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 se dijagnoza raka radi uglavnom kada se pojave simptomi. Odnosno u 3. ili 4. stadijumu, i mislim da je tada prekasno. Preskupo je za naše porodice. Preskupo je za čovečanstvo. Ne smemo da izgubimo rat protiv raka. Ne samo da nas košta milijarde dolara, već i ljudi koje volimo. Moja tetka se hrabro bori i prolazi kroz ovaj proces sa veoma pozitivnim stavom. Ali ja hoću da ovakve bitke postanu jako retke. Hoću da dočekam dan kada se rak lako leči jer se rutiniski može dijagnostikovati u dosta ranim stadijumima, i siguran sam da će se u veoma bliskoj budućnosti zbog ovoga i drugih otkrića koje vidimo svakog dana u naukama života, naš pogled na rak drastično promeniti. Imaćemo priliku da ga otkrijemo rano, bolje razumemo, i pronađemo lek.
Thank you very much.
Hvala vam mnogo.
(Applause)
(Aplauz)