Danny Hillis: Understanding cancer through proteomics

譯者: Joan Liu 審譯者: Wang-Ju Tsai

I admit that I'm a little bit nervous here

我承認我有一點點緊張，

because I'm going to say some radical things,

因為我要說一些極端的東西，

about how we should think about cancer differently,

談要如何以不同的角度看癌症，

to an audience that contains a lot of people

但在座有很多人

who know a lot more about cancer than I do.

卻比我還瞭解癌症。

But I will also contest that I'm not as nervous as I should be

但我也要說我其實沒有我應當的那麼緊張

because I'm pretty sure I'm right about this.

因為我很確定我是對的。

(Laughter)

（笑聲）

And that this, in fact, will be

而且這個，事實上，

the way that we treat cancer in the future.

會是我們未來治療癌症的方法。

In order to talk about cancer,

要談癌症，

I'm going to actually have to --

我們必須先談這個--

let me get the big slide here.

讓我用這張大投影片。

First, I'm going to try to give you a different perspective of genomics.

首先，我要讓你們從另一個角度看基因體。

I want to put it in perspective of the bigger picture

我想要以一個更廣的角度

of all the other things that are going on --

來看整件事情，

and then talk about something you haven't heard so much about, which is proteomics.

然後談一下你們沒那麼常聽到的東西，也就是蛋白質體學。

Having explained those,

解釋了這些後，

that will set up for what I think will be a different idea

我便可以談我認為和現今不同的

about how to go about treating cancer.

治療癌症的方式。

So let me start with genomics.

所以讓我從基因體講起。

It is the hot topic.

它是個熱門的話題。

It is the place where we're learning the most.

它是我們學到最多的地方。

This is the great frontier.

它是先驅。

But it has its limitations.

但它有它的極限。

And in particular, you've probably all heard the analogy

尤其是：你們可能聽過

that the genome is like the blueprint of your body,

基因就像是身體的藍圖。

and if that were only true, it would be great,

如果這是正確的，那就太好了，

but it's not.

但這不是正確的。

It's like the parts list of your body.

基因像是你身體組成表。

It doesn't say how things are connected,

它沒有解釋這中間如何串聯，

what causes what and so on.

什麼引起什麼之類的事。

So if I can make an analogy,

所以如果我要來比喻，

let's say that you were trying to tell the difference

想像你要分辨一個好餐廳、

between a good restaurant, a healthy restaurant

一個健康的餐廳

and a sick restaurant,

和一個壞餐廳，

and all you had was the list of ingredients

而且你所有的只是一張他們庫存的

that they had in their larder.

食材表。

So it might be that, if you went to a French restaurant

所以有可能是，你去一家法式餐廳

and you looked through it and you found

你發現他們只有人造黃油

they only had margarine and they didn't have butter,

沒有奶油，

you could say, "Ah, I see what's wrong with them.

你會說：「喔！我知道哪裡出錯了。

I can make them healthy."

我可以讓他們變健康。」

And there probably are special cases of that.

而且有可能有一些像那樣的特殊例子。

You could certainly tell the difference

你當然可以從他們食品室有的東西中

between a Chinese restaurant and a French restaurant

輕易分辨

by what they had in a larder.

中式餐廳和法式餐廳。

So the list of ingredients does tell you something,

所以食材表是能夠告訴你一些東西的，

and sometimes it tells you something that's wrong.

而且有時候會告訴你哪裡出問題了。

If they have tons of salt,

如果他們有很多鹽，

you might guess they're using too much salt, or something like that.

你可能會猜他們放太多鹽之類的。

But it's limited,

但知道的是有限的，

because really to know if it's a healthy restaurant,

因為要真正知道一家餐聽好壞，

you need to taste the food, you need to know what goes on in the kitchen,

你需要吃吃看他們做的食物，你需要知道廚房中發生了什麼事，

you need the product of all of those ingredients.

你需要食材的最終產物。

So if I look at a person

所以你如果看一個人，

and I look at a person's genome, it's the same thing.

看他的基因，這是相同的道理。

The part of the genome that we can read

我們看得懂的基因部份

is the list of ingredients.

就像是食材表。

And so indeed,

所以，

there are times when we can find ingredients

是有些時候我們可以看到

that [are] bad.

不好的食材。

Cystic fibrosis is an example of a disease

囊胞性纖維症就是一個

where you just have a bad ingredient and you have a disease,

你可以看組成就知道會有疾病，

and we can actually make a direct correspondence

且我們可以直接建立

between the ingredient and the disease.

這些組成和疾病的關連。

But most things, you really have to know what's going on in the kitchen,

但大部份時候，你需要知道在廚房發生了什麼事，

because, mostly, sick people used to be healthy people --

因為，大部份生病的人之前是健康的，

they have the same genome.

但他們有一樣的基因組。

So the genome really tells you much more

所以基因組只是告訴你

about predisposition.

預先的定位。

So what you can tell

所以你可以知道的是

is you can tell the difference between an Asian person and a European person

你可以從組成成分表中

by looking at their ingredients list.

看出亞州人和歐洲人的差別。

But you really for the most part can't tell the difference

但大部份的時候你沒有辦法看出

between a healthy person and a sick person --

一個健康的人和不健康的人的差別--

except in some of these special cases.

除了在很特殊的例子上。

So why all the big deal

既然如此，為什麼基因學

about genetics?

這麼重要？

Well first of all,

首先，

it's because we can read it, which is fantastic.

我們可以讀它，這很棒。

It is very useful in certain circumstances.

在某些情況下非常有用。

It's also the great theoretical triumph

它也是生物理論上

of biology.

非常重要的榮耀。

It's the one theory

這是一個生物學家們

that the biologists ever really got right.

一直想搞對的理論。

It's fundamental to Darwin

基因同時也是是達爾文

and Mendel and so on.

和孟德爾和其他人理論的基礎。

And so it's the one thing where they predicted a theoretical construct.

所以它是唯一一個他們預測且建構的理論。

So Mendel had this idea of a gene

孟德爾有點抽象地

as an abstract thing,

說明基因這個概念。

and Darwin built a whole theory

然後達爾文在這個基礎上

that depended on them existing,

建立了一整個理論。

and then Watson and Crick

然後華生和克力克

actually looked and found one.

真的去找且找到了基因。

So this happens in physics all the time.

這在物理學上常常發生。

You predict a black hole,

你預期會有黑洞，

and you look out the telescope and there it is, just like you said.

你去找然後透過望遠鏡去看，真的找到了。

But it rarely happens in biology.

但在生物上這很少發生。

So this great triumph -- it's so good,

所以這個大榮耀--重要到

there's almost a religious experience

幾乎成爲生物學上的

in biology.

信仰教條。

And Darwinian evolution

且達爾文演化論

is really the core theory.

就是核心理論。

So the other reason it's been very popular

另外一個讓基因這麼受喜愛的原因是

is because we can measure it, it's digital.

我們可以測量它。它是數位的。

And in fact,

事實上，

thanks to Kary Mullis,

感謝Kary Mullis，

you can basically measure your genome in your kitchen

你基本上只需要比你廚房再多一點用具

with a few extra ingredients.

就可以測量你的基因組。

So for instance, by measuring the genome,

舉例來說，透過測量基因組，

we've learned a lot about how we're related to other kinds of animals

我們從其間的相似性

by the closeness of our genome,

學到很多關於我們和其他動物的關係、

or how we're related to each other -- the family tree,

或是我們跟其他人的關係--像家族表，

or the tree of life.

或是生命表。

There's a huge amount of information about the genetics

僅僅只是比對基因間的相似情況，

just by comparing the genetic similarity.

我們可以得到很多資訊。

Now of course, in medical application,

當然在醫學上

that is very useful

這是非常有用的，

because it's the same kind of information

因為醫生可以得到

that the doctor gets from your family medical history --

與瞭解家庭病史相同的資訊。

except probably,

事實上，

your genome knows much more about your medical history than you do.

你的基因比你還瞭解你的家庭病史。

And so by reading the genome,

所以利用解讀基因組，

we can find out much more about your family than you probably know.

我們可以瞭解更多你不知道的關於你的家庭的資訊。

And so we can discover things

我們可以發現一些

that probably you could have found

你如果看夠多你的親戚

by looking at enough of your relatives,

將可能會找到的資訊，

but they may be surprising.

但這些可能是驚人的。

I did the 23andMe thing

我做了「二十三和我」（基因檢測）的測驗，

and was very surprised to discover that I am fat and bald.

且驚人地發現我是又胖又禿頭的。

(Laughter)

（笑聲）

But sometimes you can learn much more useful things about that.

但有時候你會學到一些更有用的東西。

But mostly

但大部份時候

what you need to know, to find out if you're sick,

當你生病時你需要知道的

is not your predispositions,

不是你的體質，

but it's actually what's going on in your body right now.

而是現在在你身上發生了什麼事。

So to do that, what you really need to do,

要瞭解這個，你需要做的是

you need to look at the things

你需要看這些基因

that the genes are producing

製造的東西

and what's happening after the genetics,

和基因背後發生的事情。

and that's what proteomics is about.

而那正是蛋白質體學。

Just like genome mixes the study of all the genes,

就像基因體學是研究所有的基因

proteomics is the study of all the proteins.

蛋白質體學就是研究所有的蛋白質。

And the proteins are all of the little things in your body

蛋白質是所有在你身上

that are signaling between the cells --

在不同細胞間傳遞訊息的小東西。

actually, the machines that are operating --

而細胞則是體內工作的機器。

that's where the action is.

那是事情的發生地。

Basically, a human body

基本上，

is a conversation going on,

人體是一場正在進行的對話，

both within the cells and between the cells,

是正在細胞內和細胞間進行的對話，

and they're telling each other to grow and to die,

細胞互相告訴對方該生長還是死亡。

and when you're sick,

當你生病時，

something's gone wrong with that conversation.

這樣的對話出現問題。

And so the trick is --

所以訣竅是--

unfortunately, we don't have an easy way to measure these

不幸的，我們沒有像測量基因一樣

like we can measure the genome.

有個簡單的方式可以測量蛋白質。

So the problem is that measuring --

所以測量是個大問題--

if you try to measure all the proteins, it's a very elaborate process.

如果你試著測量所有的蛋白質，這是非常複雜的過程。

It requires hundreds of steps,

需要好幾百個步驟，

and it takes a long, long time.

而且需要花很久很久的時間。

And it matters how much of the protein it is.

而且蛋白質含量也有關係的

It could be very significant that a protein changed by 10 percent,

十分之一的含量差異可以有嚴重的影響，

so it's not a nice digital thing like DNA.

所以不是像DNA那樣有數位性的。

And basically our problem is somebody's in the middle

而且基本上我們的問題是

of this very long stage,

如果有人在一個很長的過程的中間，

they pause for just a moment,

他們停下來一下下，

and they leave something in an enzyme for a second,

且他們把東西留在生物酶中一秒鐘，

and all of a sudden all the measurements from then on

突然所有從那時後開始的測量值

don't work.

就都不對了。

And so then people get very inconsistent results

當他們這麼做時，

when they do it this way.

人們會得到非常不一致的結果。

People have tried very hard to do this.

有人很努力做這個。

I tried this a couple of times

我試了幾次，

and looked at this problem and gave up on it.

看了這個問題然後放棄。

I kept getting this call from this oncologist

我一直接到一個癌症學家的電話

named David Agus.

他叫大維艾格斯。

And Applied Minds gets a lot of calls

在Applied Minds的人常常接到很多電話，

from people who want help with their problems,

來自於需要幫忙解決他們的問題的人，

and I didn't think this was a very likely one to call back,

而我不覺得這個是我會想要回電的人，

so I kept on giving him to the delay list.

所以我一直把他放到晚點再回的名單。

And then one day,

直到有一天，

I get a call from John Doerr, Bill Berkman

我接到約翰杜爾、比爾貝客門、

and Al Gore on the same day

高爾打來的電話，

saying return David Agus's phone call.

都叫我要回大衛艾格斯的電話。

(Laughter)

（笑聲）

So I was like, "Okay. This guy's at least resourceful."

所以我想「好吧，至少這個人人脈豐富。」

(Laughter)

（笑聲）

So we started talking,

所以我們開始談，

and he said, "I really need a better way to measure proteins."

然後他說：「我們很需要一個更好的測量蛋白質的方式。」

I'm like, "Looked at that. Been there.

我說：「我都看過了、做過了。

Not going to be easy."

一點都不容易。」

He's like, "No, no. I really need it.

他說：「不不，我真的很需要。

I mean, I see patients dying every day

我的意思是，我每天看到病人死亡

because we don't know what's going on inside of them.

因為我們不知道病人體內發生什麼事。

We have to have a window into this."

我們必須想個辦法。」

And he took me through

然後他給我看一些例子

specific examples of when he really needed it.

和為什麼他很需要這個技術。

And I realized, wow, this would really make a big difference,

然後我瞭解到，哇，如果我們做得到的話

if we could do it,

這會是很大的改變。

and so I said, "Well, let's look at it."

所以我說：「好，讓我們來看看。」

Applied Minds has enough play money

Applied Minds有一些閒錢

that we can go and just work on something

可以讓我們不需要跟任何人要錢獲取得許可

without getting anybody's funding or permission or anything.

就可以做些事情。

So we started playing around with this.

所以我們開始試試這件事情。

And as we did it, we realized this was the basic problem --

當我們在做的時候，我們瞭解到這是很基本的問題--

that taking the sip of coffee --

就像喝一口咖啡--

that there were humans doing this complicated process

就是有很多人在做這個複雜的事

and that what really needed to be done

但事實上我們需要的

was to automate this process like an assembly line

是自動化的流程

and build robots

然後建造機器人

that would measure proteomics.

來測量蛋白質體。

And so we did that,

所以我們這麼做了。

and working with David,

與大衛合作，

we made a little company called Applied Proteomics eventually,

我們創立了一個叫做「Applied Proteomics」的公司，

which makes this robotic assembly line,

專門建造這樣的機器流程線，

which, in a very consistent way, measures the protein.

這樣可以很穩定的測量蛋白質。

And I'll show you what that protein measurement looks like.

且我會給你們看蛋白質測量是怎麼做的。

Basically, what we do

基本上，我們做的是

is we take a drop of blood

我們從病人身上

out of a patient,

取一滴血，

and we sort out the proteins

然後我們將這滴血中的蛋白質

in the drop of blood

依照它們的

according to how much they weigh,

重量、

how slippery they are,

它們的光滑程度來分類，

and we arrange them in an image.

然後將它們放在一張圖上。

And so we can look at literally

然後我們可以同時

hundreds of thousands of features at once

看到這滴血當中

out of that drop of blood.

千百種的特色。

And we can take a different one tomorrow,

隔天我們可以取另一滴血，

and you will see your proteins tomorrow will be different --

然後你會發現你隔天的蛋白質是不一樣的--

they'll be different after you eat or after you sleep.

蛋白質在你吃過食物或睡過覺後都會不一樣。

They really tell us what's going on there.

他們真的告訴我們發生了什麼事。

And so this picture,

所以這張圖，

which looks like a big smudge to you,

對你們來說看起來像是一團大污點，

is actually the thing that got me really thrilled about this

但卻是讓我對這件事感到興奮的原因

and made me feel like we were on the right track.

而且讓我們覺得我們是往對的方向前進。

So if I zoom into that picture,

所以如果我們把這張圖放大，

I can just show you what it means.

我可以給你們看這是什麼意思。

We sort out the proteins -- from left to right

我們整理了這些蛋白質--從左至右

is the weight of the fragments that we're getting,

是這些片段的重量。

and from top to bottom is how slippery they are.

由上至下則是他們的光滑程度。

So we're zooming in here just to show you a little bit of it.

所以我們把他放大讓你們可以看清楚一些。

And so each of these lines

這邊每一條線

represents some signal that we're getting out of a piece of a protein.

就是我們在看一個蛋白質時得到的訊號。

And you can see how the lines occur

你們可以看到這些線是一群一群的

in these little groups of bump, bump, bump, bump, bump.

有蹦蹦蹦蹦蹦好幾條線。

And that's because we're measuring the weight so precisely that --

這是因為我們很精準的測量重量--

carbon comes in different isotopes,

碳有不同的同位素，

so if it has an extra neutron on it,

所以如果有多一個中子，

we actually measure it as a different chemical.

我們就會測出是不一樣的物質。

So we're actually measuring each isotope as a different one.

也就是說我們把每一個同位素當作不一樣的來測量。

And so that gives you an idea

所以這給你們一個

of how exquisitely sensitive this is.

這個測量有多精密的概念。

So seeing this picture

所以看這張圖

is sort of like getting to be Galileo

有點像伽利略

and looking at the stars

在看星星一樣，

and looking through the telescope for the first time,

就像他第一次透過望遠鏡看，

and suddenly you say, "Wow, it's way more complicated than we thought it was."

然後你突然說「哇！這比我們想像的複雜許多。」

But we can see that stuff out there

但我們可以看到這些東西

and actually see features of it.

而且知道他們的特色。

So this is the signature out of which we're trying to get patterns.

這就有點像是從各種簽名中找出規律。

So what we do with this

我們拿這些資訊做的是，

is, for example, we can look at two patients,

舉例來說，我們看兩個病人，

one that responded to a drug and one that didn't respond to a drug,

一個對某種藥有反應，另一個則沒反應。

and ask, "What's going on differently

然後問：「這兩者身體之間

inside of them?"

有什麼不同？」

And so we can make these measurements precisely enough

所以我們可以讓這樣的測驗夠精準到

that we can overlay two patients and look at the differences.

讓我們可以把兩個病人的資料疊在一起然後看出不同。

So here we have Alice in green

這裡綠色是愛莉絲

and Bob in red.

紅色是包伯。

We overlay them. This is actual data.

我們把他們倆疊在一起。這是實際的數據。

And you can see, mostly it overlaps and it's yellow,

你們可以看到，大部份相交呈黃色，

but there's some things that just Alice has

但有些是只有愛莉絲有，

and some things that just Bob has.

而有些只有包伯有。

And if we find a pattern of things

如果我們可以有類似的東西

of the responders to the drug,

來看對藥物有反應的人，

we see that in the blood,

我們可以看到血液中，

they have the condition

他們有一些特別的狀況

that allows them to respond to this drug.

讓他們可以對藥物有反應。

We might not even know what this protein is,

我們可能根本不知道這個蛋白質是什麼，

but we can see it's a marker

但我們可以看到

for the response to the disease.

是否會對疾病有影響。

So this already, I think,

所以到這裡，我認為已經

is tremendously useful in all kinds of medicine.

是在醫學上很有用的了。

But I think this is actually

但我覺得

just the beginning

這只是我們以後

of how we're going to treat cancer.

將如何治療癌症的開端。

So let me move to cancer.

所以讓我談談癌症。

The thing about cancer --

關於癌症--

when I got into this,

當我剛開始接觸的時候，

I really knew nothing about it,

我事實上什麼都不知道。

but working with David Agus,

但跟大衛艾格斯合作，

I started watching how cancer was actually being treated

我開始觀察癌症治療，

and went to operations where it was being cut out.

還去看癌細胞移除手術。

And as I looked at it,

按照我的觀察，

to me it didn't make sense

對我來說我們治療癌症的方式

how we were approaching cancer,

是不合邏輯的。

and in order to make sense of it,

為了瞭解它，

I had to learn where did this come from.

我必須學這個是從何而來。

We're treating cancer almost like it's an infectious disease.

我們治療癌症的方式有點像是治療感染性疾病。

We're treating it as something that got inside of you

我們治療的方式像是一個外來物侵入，

that we have to kill.

且我們需要殺死這個外來物。

So this is the great paradigm.

所以這是標準範例。

This is another case

另一個

where a theoretical paradigm in biology really worked --

理論在生物學是對的的例子--

was the germ theory of disease.

就是細菌和疾病的關係。

So what doctors are mostly trained to do

所以大部分醫生的訓練

is diagnose --

就是去診斷

that is, put you into a category

也就是說把你放在某一個類別中

and apply a scientifically proven treatment

然後給你一個科學上證明為有用的

for that diagnosis --

治療方式。

and that works great for infectious diseases.

這對治療感染性疾病是很有用的。

So if we put you in the category

如果我們把你放在得到梅毒的類別，

of you've got syphilis, we can give you penicillin.

那麽我們就給你盤尼西林。

We know that that works.

我們知道這是有用的。

If you've got malaria, we give you quinine

如果你有瘧疾，我們給你奎寧，

or some derivative of it.

或它的一些衍生物。

And so that's the basic thing doctors are trained to do,

這基本上是醫生被訓練來做的事。

and it's miraculous

這在感染性疾病上

in the case of infectious disease --

有的效果--

how well it works.

是幾近神奇的。

And many people in this audience probably wouldn't be alive

而且如果醫生們不這麼做，

if doctors didn't do this.

在座很多人可能活不到現在。

But now let's apply that

但現在讓我們以同樣的方式

to systems diseases like cancer.

對待這個叫做癌症的疾病。

The problem is that, in cancer,

問題出在於，在癌症中，

there isn't something else

並沒有外來物

that's inside of you.

侵入人體。

It's you; you're broken.

是你自己，你有問題。

That conversation inside of you

那個你身體中的對話

got mixed up in some way.

出了問題。

So how do we diagnose that conversation?

所以我們要如何診斷這個對話？

Well, right now what we do is we divide it by part of the body --

目前我們根據身體部位把它劃分--

you know, where did it appear? --

你知道的，就是在哪裡發生--

and we put you in different categories

所以我們根據身體部位

according to the part of the body.

有不同的類別。

And then we do a clinical trial

然後我們有臨床試驗，

for a drug for lung cancer

有針對肺癌的藥的試驗，

and one for prostate cancer and one for breast cancer,

有另一個針對前列腺癌，然後另一個給乳癌，

and we treat these as if they're separate diseases

我們把他們看待成不同的疾病。

and that this way of dividing them

且這樣的分法

had something to do with what actually went wrong.

是基於發病表面的症狀。

And of course, it really doesn't have that much to do

但當然的，實情跟發病表面的症狀

with what went wrong

是沒有太大關係的。

because cancer is a failure of the system.

因為癌症是系統出問題。

And in fact, I think we're even wrong

事實上，我認為我們把癌症當作“一個東西”

when we talk about cancer as a thing.

這個看法本身就有問題。

I think this is the big mistake.

我認為那是個很大的錯誤。

I think cancer should not be a noun.

我認為癌症不該是名詞。

We should talk about cancering

我們應該把癌症當作動詞，

as something we do, not something we have.

像是我們正在做，不是我們有。

And so those tumors,

且那些腫瘤，

those are symptoms of cancer.

是癌症的症狀。

And so your body is probably cancering all the time,

所以你的身體可能隨時都在癌症中。

but there are lots of systems in your body

但你的身體有很多系統，

that keep it under control.

會讓它在控制當中。

And so to give you an idea

所以要給你們一個

of an analogy of what I mean

我剛剛比喻的概念

by thinking of cancering as a verb,

想像癌症是個動詞，

imagine we didn't know anything about plumbing,

想像我們對配管系統完全不了解，

and the way that we talked about it,

還有我們談論的方式，

we'd come home and we'd find a leak in our kitchen

我們會回到家看到廚房漏水，

and we'd say, "Oh, my house has water."

我們會說：「喔，我的房子有水。」

We might divide it -- the plumber would say, "Well, where's the water?"

我們會把它分類--水電工會說：「水在哪裡？」

"Well, it's in the kitchen." "Oh, you must have kitchen water."

「在廚房裡。」「喔，你有廚房水。」

That's kind of the level at which it is.

有點像是這樣理解的。

"Kitchen water,

廚房水？

well, first of all, we'll go in there and we'll mop out a lot of it.

好，首先，我們要去那裡把水擦乾。

And then we know that if we sprinkle Drano around the kitchen,

然後我們知道如果在廚房撒Draino清潔劑

that helps.

會有幫助。

Whereas living room water,

如果是客廳水，

it's better to do tar on the roof."

可能要到屋頂上塗焦油有用。

And it sounds silly,

這聽起來很可笑，

but that's basically what we do.

但這基本上這就是我們現在的做法。

And I'm not saying you shouldn't mop up your water if you have cancer,

我不是說當你有癌症的時候你不該把水清乾淨。

but I'm saying that's not really the problem;

我是說它不是真正的問題；

that's the symptom of the problem.

那只是問題的症狀。

What we really need to get at

我們需要修理的

is the process that's going on,

是整個過程，

and that's happening at the level

而那是在蛋白質的層面上

of the proteonomic actions,

決定的。

happening at the level of why is your body not healing itself

要去瞭解為什麼你的身體不能像以往一樣

in the way that it normally does?

修復自己？

Because normally, your body is dealing with this problem all the time.

因為平常你的身體隨時都在處理各種問題。

So your house is dealing with leaks all the time,

所以你的房子也一直都在處理漏水。

but it's fixing them. It's draining them out and so on.

是去解決這個問題，是將水排出系統外。

So what we need

所以我們需要的

is to have a causative model

是一個整個過程

of what's actually going on,

因果關係的模型。

and proteomics actually gives us

蛋白質體學可以給我們

the ability to build a model like that.

做這樣的模型的能力。

David got me invited

大衛邀請我

to give a talk at National Cancer Institute

到國家癌症學院演講

and Anna Barker was there.

安娜芭克也在那。

And so I gave this talk

我在那演了講

and said, "Why don't you guys do this?"

問說：「為什麼你們不這麼做？」

And Anna said,

安娜說：「

"Because nobody within cancer

因為在癌症中的人

would look at it this way.

不會這樣看這件事。

But what we're going to do, is we're going to create a program

但我們要做的是，我們要創造一個計畫

for people outside the field of cancer

讓癌症領域外的人

to get together with doctors

可以和真正

who really know about cancer

瞭解癌症的醫生合作，

and work out different programs of research."

然後做出不同的研究方向。」

So David and I applied to this program

所以大維和我申請了這個計畫

and created a consortium

且在南加大

at USC

創造了一個聯合會，

where we've got some of the best oncologists in the world

在那我們有世界上最好的癌症學家，

and some of the best biologists in the world,

一些世界上頂尖的生物學家，

from Cold Spring Harbor,

從冷泉港，

Stanford, Austin --

從史丹佛，從奧斯丁--

I won't even go through and name all the places --

我不列舉全部的地方--

to have a research project

這些人一起做這個研究計畫

that will last for five years

花五年的時間，

where we're really going to try to build a model of cancer like this.

我們要試著去建造一個癌症模型。

We're doing it in mice first,

我們從老鼠開始。

and we will kill a lot of mice

在這個過程中

in the process of doing this,

我們會犧牲很多老鼠，

but they will die for a good cause.

但他們的犧牲會是有用的。

And we will actually try to get to the point

且我們要試著達到一個

where we have a predictive model

可以預測的模型，

where we can understand,

我們可以瞭解

when cancer happens,

什麼時候癌症會發生，

what's actually happening in there

事實上發生了什麼事，

and which treatment will treat that cancer.

和什麼樣的治療方法可以治療癌症。

So let me just end with giving you a little picture

讓我給你一個我認為

of what I think cancer treatment will be like in the future.

未來癌症治療的方向。

So I think eventually,

我認為總有一天，

once we have one of these models for people,

當我們有針對人類的模型後，

which we'll get eventually --

我們有一天會做到的--

I mean, our group won't get all the way there --

我的意思是，我們這個團隊不會一直做到那--

but eventually we'll have a very good computer model --

但總有一天我們會有一個很棒的電腦模型--

sort of like a global climate model for weather.

有點像是世界天氣模型那樣。

It has lots of different information

這系統有很多不同的訊息，

about what's the process going on in this proteomic conversation

可以提供在不同層面蛋白質的對話中

on many different scales.

發生的事情。

And so we will simulate

所以我們可以

in that model

針對特定的模型

for your particular cancer --

來跑這樣的模擬--

and this also will be for ALS,

且這也可以幫助ALS（脊椎硬化症）

or any kind of system neurodegenerative diseases,

或其他任何一種神經退化性疾病，

things like that --

像是這一類的事--

we will simulate

我們可以特別為你

specifically you,

來作模擬，

not just a generic person,

不只是一般不特定的人，

but what's actually going on inside you.

而是在你體內發生的事。

And in that simulation, what we could do

在這樣的模擬中，

is design for you specifically

我們可以特別為你設計

a sequence of treatments,

一系列的治療，

and it might be very gentle treatments, very small amounts of drugs.

這有可能是很簡單的治療，很少量的藥物。

It might be things like, don't eat that day,

有可能是，那天不要吃東西，

or give them a little chemotherapy,

或是給他們一點點化療，

maybe a little radiation.

或一點點放射線治療。

Of course, we'll do surgery sometimes and so on.

當然，有時候我們也會開刀或做一些其他的事。

But design a program of treatments specifically for you

但完全針對你來設計的治療，

and help your body

來幫助你的身體

guide back to health --

回到健康的狀態--

guide your body back to health.

引導你回到健康。

Because your body will do most of the work of fixing it

因為你的身體會做大部份的修理動作，

if we just sort of prop it up in the ways that are wrong.

我們只是需要把錯誤的地方稍微修正一下。

We put it in the equivalent of splints.

我們把它放在矯正器中。

And so your body basically has lots and lots of mechanisms

所以你的身體基本上有很多可以

for fixing cancer,

治療癌症的方法，

and we just have to prop those up in the right way

我們只是要把它引導到正確的方向

and get them to do the job.

讓它們做這個工作。

And so I believe that this will be the way

所以我相信這會是

that cancer will be treated in the future.

未來治療癌症的方法。

It's going to require a lot of work,

這會需要很多努力，

a lot of research.

很多研究。

There will be many teams like our team

會有很多像我們這樣的團隊

that work on this.

來研究這個。

But I think eventually,

但我認為最後，

we will design for everybody

我們可以針對每一個人設計

a custom treatment for cancer.

專屬個人的癌症療法。

So thank you very much.

謝謝大家。

(Applause)

（掌聲）