The Future of Early Cancer Detection? | Jorge Soto | TED Talks

136,008 views ・ 2014-10-15

TED


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00:12
Almost a year ago,
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my aunt started suffering back pains.
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She went to see the doctor
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and they told her it was a normal injury
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for someone who had been playing tennis
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for almost 30 years.
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They recommended that she do some therapy,
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but after a while she wasn't feeling better,
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so the doctors decided to do further tests.
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They did an x-ray
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and discovered an injury in her lungs,
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and at the time they thought that the injury
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was a strain in the muscles and tendons
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between her ribs,
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but after a few weeks of treatment,
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again her health wasn't getting any better.
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So finally, they decided to do a biopsy,
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and two weeks later,
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the results of the biopsy came back.
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It was stage 3 lung cancer.
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Her lifestyle was almost free of risk.
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She never smoked a cigarette,
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she never drank alcohol,
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and she had been playing sports
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for almost half her life.
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Perhaps, that is why it took them almost six months
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to get her properly diagnosed.
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My story might be, unfortunately,
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familiar to most of you.
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One out of three people sitting in this audience
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will be diagnosed with some type of cancer,
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and one out of four
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will die because of it.
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Not only did that cancer diagnosis
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change the life of our family,
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but that process of going
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back and forth with new tests,
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different doctors describing symptoms,
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discarding diseases over and over,
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was stressful and frustrating,
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especially for my aunt.
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And that is the way cancer diagnosis has been done
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since the beginning of history.
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We have 21st-century medical treatments and drugs
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to treat cancer,
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but we still have 20th-century procedures
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and processes for diagnosis, if any.
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Today, most of us have to wait for symptoms
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to indicate that something is wrong.
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Today, the majority of people still don't have access
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to early cancer detection methods,
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even though we know
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that catching cancer early
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is basically the closest thing we have
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to a silver bullet cure against it.
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We know that we can change this in our lifetime,
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and that is why my team and I
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have decided to begin this journey,
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this journey to try to make cancer detection
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at the early stages
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and monitoring the appropriate response at the molecular level
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easier, cheaper, smarter
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and more accessible than ever before.
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The context, of course,
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is that we're living at a time
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where technology is disrupting our present
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at exponential rates,
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and the biological realm is no exception.
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It is said today that biotech is advancing
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at least six times faster than the growth rate
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of the processing power of computers.
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But progress in biotech
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is not only being accelerated,
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it is also being democratized.
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Just as personal computers or the Internet
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or smartphones leveled the playing field
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for entrepreneurship, politics or education,
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recent advances have leveled it up for biotech progress as well,
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and that is allowing
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multidisciplinary teams like ours
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to try to tackle and look at these problems
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with new approaches.
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We are a team of scientists and technologists
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from Chile, Panama,
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Mexico, Israel and Greece,
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and based on recent scientific discoveries,
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we believe that we have found
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a reliable and accurate way
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of detecting several types of cancer
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at the very early stages through a blood sample.
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We do it by detecting a set of very small molecules
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that circulate freely in our blood
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called microRNAs.
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To explain what microRNAs are
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and their important role in cancer,
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I need to start with proteins,
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because when cancer is present in our body,
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protein modification is observed
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in all cancerous cells.
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As you might know,
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proteins are large biological molecules
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that perform different functions within our body,
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like catalyzing metabolic reactions
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or responding to stimuli
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or replicating DNA,
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but before a protein is expressed or produced,
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relevant parts of its genetic code
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present in the DNA
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are copied into the messenger RNA,
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so this messenger RNA
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has instructions on how to build a specific protein,
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and potentially it can build hundreds of proteins,
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but the one that tells them when to build them
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and how many to build
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are microRNAs.
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So microRNAs are small molecules
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that regulate gene expression.
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Unlike DNA, which is mainly fixed,
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microRNAs can vary depending on internal
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and environmental conditions at any given time,
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telling us which genes are actively expressed at that particular moment.
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And that is what makes microRNAs
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such a promising biomarker for cancer,
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because as you know,
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cancer is a disease of altered gene expression.
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It is the uncontrolled regulation of genes.
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Another important thing to consider
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is that no two cancers are the same,
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but at the microRNA level, there are patterns.
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Several scientific studies have shown
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that abnormal microRNA expression levels
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varies and creates a unique, specific pattern
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for each type of cancer,
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even at the early stages,
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reflecting the progression of the disease,
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and whether it's responding to medication
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or in remission,
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making microRNAs a perfect,
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highly sensitive biomarker.
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However, the problem with microRNAs
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is that we cannot use existing DNA-based technology
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to detect them in a reliable way,
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because they are very short sequences of nucleotides,
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much smaller than DNA.
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And also, all microRNAs are very similar to each other,
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with just tiny differences.
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So imagine trying to differentiate two molecules,
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extremely similar, extremely small.
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We believe that we have found a way to do so,
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and this is the first time that we've shown it in public.
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Let me do a demonstration.
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Imagine that next time you go to your doctor
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and do your next standard blood test,
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a lab technician extracts a total RNA,
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which is quite simple today,
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and puts it in a standard 96-well plate like this one.
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Each well of these plates
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has specific biochemistry that we assign,
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that is looking for a specific microRNA,
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acting like a trap that closes
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only when the microRNA is present in the sample,
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and when it does, it will shine with green color.
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To run the reaction,
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you put the plate inside a device like this one,
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and then you can put your smartphone on top of it.
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If we can have a camera here
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so you can see my screen.
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A smartphone is a connected computer
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and it's also a camera,
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good enough for our purpose.
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The smartphone is taking pictures,
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and when the reaction is over,
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it will send the pictures
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to our online database for processing
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and interpretation.
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This entire process lasts around 60 minutes,
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but when the process is over,
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wells that shine are matched with the specific microRNAs
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and analyzed in terms of how much and how fast
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they shine.
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And then, when this entire process is over,
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this is what happens.
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This chart is showing the specific microRNAs
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present in this sample
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and how they reacted over time.
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Then, if we take this specific pattern of microRNA
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of this person's samples
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and compare it with existing scientific documentation
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that correlates microRNA patterns
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with a specific presence of a disease,
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this is how pancreatic cancer looks like.
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This inside is a real sample
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where we just detected pancreatic cancer.
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(Applause)
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Another important aspect of this approach
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is the gathering and mining of data in the cloud,
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so we can get results in real time
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and analyze them with our contextual information.
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If we want to better understand
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and decode diseases like cancer,
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we need to stop treating them
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as acute, isolated episodes,
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and consider and measure everything
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that affects our health on a permanent basis.
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This entire platform is a working prototype.
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It uses state-of-the-art molecular biology,
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a low-cost, 3D-printed device,
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and data science
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to try to tackle one of humanity's toughest challenges.
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Since we believe early cancer detection
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should really be democratized,
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this entire solution costs at least 50 times less
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than current available methods,
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and we know that the community can help us
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accelerate this even more,
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so we're making the design of the device
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open-source.
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(Applause)
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Let me say very clearly
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that we are at the very early stages,
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but so far, we have been able
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to successfully identify the microRNA pattern
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of pancreatic cancer, lung cancer,
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breast cancer and hepatic cancer.
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And currently, we're doing a clinical trial
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in collaboration with the German Cancer Research Center
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with 200 women for breast cancer.
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(Applause)
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This is the single non-invasive,
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accurate and affordable test
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that has the potential to dramatically change
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how cancer procedures and diagnostics
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have been done.
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Since we're looking for the microRNA patterns
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in your blood at any given time,
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you don't need to know which cancer you're looking for.
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You don't need to have any symptoms.
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You only need one milliliter of blood
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and a relatively simple array of tools.
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Today, cancer detection happens mainly
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when symptoms appear.
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That is, at stage 3 or 4,
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and I believe that is too late.
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It is too expensive for our families.
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It is too expensive for humanity.
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We cannot lose the war against cancer.
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It not only costs us billions of dollars,
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but it also costs us the people we love.
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Today, my aunt, she's fighting bravely
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and going through this process with a very positive attitude.
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However, I want fights like this
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to become very rare.
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I want to see the day
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when cancer is treated easily
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because it can be routinely diagnosed
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at the very early stages,
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and I'm certain
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that in the very near future,
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because of this
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and other breakthroughs that we are seeing
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every day in the life sciences,
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the way we see cancer
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will radically change.
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It will give us the chance of detecting it early,
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understanding it better,
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and finding a cure.
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Thank you very much.
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(Applause)
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