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【TED】治疗胰腺癌的福音

 

By raising your hand, 在座各位 how many of you know at least one person on the screen? 知道至少一个屏幕中所示的人,请举手 Wow, it's almost a full house. 哇,基本上每个人都举手了 It's true, they are very famous in their fields. 没错,他们在各自的领域都十分有名 And do you know what all of them have in common? 你们知道他们有什么共同点吗? They all died of pancreatic cancer. 他们都死于胰腺癌 However, although it's very, very sad this news, 尽管这特别特别可悲 it's also thanks to their personal stories 但也正是由于他们的自身经历 that we have raised awareness of how lethal this disease can be. 让我们意识到胰腺癌有多致命 It's become the third cause of cancer deaths, 胰腺癌已成为癌症致死的第三大原因 and only eight percent of the patients will survive beyond five years. 病人的五年及以上存活率只有百分之八 That's a very tiny number, 这个比例是极小的 especially if you compare it with breast cancer, where the survival rate is almost 90 percent. 尤其是和存活率接近90%的乳腺癌相比 So it doesn't really come as a surprise that being diagnosed with pancreatic cancer 所以,被诊断得了胰腺癌 means facing an almost certain death sentence. 意味着几乎是被判了死刑这也就不足为怪了 What's shocking, though, is that in the last 40 years, 然而,让人震惊的是 this number hasn't changed a bit, 在过去的40年,这个数字一点都没有变 while much more progress has been made with other types of tumors. 而其它肿瘤的治疗已经有了长足进步 So how can we make pancreatic cancer treatment more effective? 那么我们该如何让胰腺癌治疗更有效呢? As a biomedical entrepreneur, 作为一名生物医学企业家 I like to work on problems that seem impossible, 我希望去解决那些看起来不可能解决的问题 understanding their limitations 了解那些问题的限制因素 and trying to find new, innovative solutions that can change their outcome. 并找到新的、创新的解决方案去改变结果 The first piece of bad news with pancreatic cancer 第一个关于胰腺癌的坏消息是 is that your pancreas is in the middle of your belly, literally. 胰腺正好位于腹部的中间位置 It's depicted in orange on the screen. 如屏幕上橙色部分所示 But you can barely see it 但是如果我不把胰腺前面的其它器官移开 until I remove all the other organs in front. 你几乎看不到它 It's also surrounded by many other vital organs, 而且它被很多其它重要的器官包围着 like the liver, the stomach, the bile duct. 譬如肝、胃、胆管 And the ability of the tumor to grow into those organs 肿瘤会扩散到这些器官 is the reason why pancreatic cancer 这也胰腺癌是最痛苦的肿瘤之一的原因 is one of the most painful tumor types. 另外,胰腺难以企及的位置 The hard-to-reach location also prevents the doctor from surgically removing it, 使得医生很难采取例行的治疗方式 as is routinely done for breast cancer, for example. 例如对肺癌,通过手术摘除肿瘤 So all of these reasons leave chemotherapy as the only option 上述各种原因 for the pancreatic cancer patient. 使得化疗成为了胰腺癌患者的唯一选择 This brings us to the second piece of bad news. 第二个坏消息是 Pancreatic cancer tumors have very few blood vessels. 胰腺癌肿瘤的血管极少 Why should we care about the blood vessel of a tumor? 为什么我们要关心肿瘤的血管呢? Let's think for a second how chemotherapy works. 让我们想想化疗的过程 The drug is injected in the vein 药物被注入静脉 and it navigates throughout the body until it reaches the tumor site. 然后流遍整个身体直到到达肿瘤处 It's like driving on a highway, trying to reach a destination. 这就像在高速路上行驶努力到达目的地一样 But what if your destination doesn't have an exit on the highway? 如果你的目的地在高速路上没有出口怎么办? You will never get there. 你将永远到不了目的地 And that's exactly the same problem for chemotherapy and pancreatic cancer. 对于化疗和胰腺癌来说也一样 The drugs navigate throughout all of your body. 药物流遍你的整个身体 They will reach healthy organs, 它们进入了健康器官 resulting in high toxic effect for the patients overall, 给病人整体带来很高的毒副作用 but very little will go to the tumor. 但是极少药物作用到肿瘤 Therefore, the efficacy is very limited. 因此治疗效果很有限 To me, it seems very counterintuitive to have a whole-body treatment to target a specific organ. 我认为,为了治疗某一个器官而对全身采取治疗是非常有悖常理的 However, in the last 40 years, 然而,在过去的40年里 a lot of money, research and effort have gone towards 大量的金钱、研究、努力被投入到 finding new, powerful drugs to treat pancreatic cancer, 找寻新的、药效更强的治疗胰腺癌的药物 but nothing has been done in changing the way we deliver them to the patient. 而对于改变治疗病人的手段却没有任何投入 So after two pieces of bad news, 说完两个坏消息 I'm going to give you good news, hopefully. 我想告诉你们一个好消息,希望是的 With a collaborator at MIT and the Massachusetts General Hospital in Boston, 通过麻省理工大学和位于波士顿的麻省总医院的合作研究 we have revolutionized the way we treat cancer 我们已经革新了治疗癌症的方式 by making localized drug delivery a reality. 使得定位给药成为现实 We are basically parachuting you on top of your destination, 总的来说就是,我们用降落伞将你在目的地上方直接投送出去 avoiding your having to drive all around the highway. 避免你得在高速路上七拐八拐 We have embedded the drug into devices that look like this one. 我们将药物嵌入类似这样的装置中 They are flexible enough that they can be folded to fit into the catheter, 它们极为柔软可以将它们折叠放入导管中 so the doctor can implant it directly on top of the tumor with minimally invasive surgery. 医生可以通过微创手术将它直接植入肿瘤上方 But they are solid enough that once they are positioned 同时这种装置又足够坚固 on top of the tumor, 一旦它们被放置到肿瘤上 they will act as a cage. 它们就像一个笼子 They will actually physically prevent the tumor from entering other organs, 通过物理方式阻止肿瘤进入到其它器官 controlling the metastasis. 从而控制癌细胞扩散 The devices are also biodegradable. 另外,这种装置是可生物降解的 That means that once in the body, 也就是说,一旦进入人体 they start dissolving, 它们就开始降解 delivering the drug only locally, slowly and more effectively 定点地、缓慢地释放药物 than what is done with the current whole-body treatment. 相比于目前的全身治疗方式这种给药方式更加有效 In pre-clinical study, we have demonstrated 临床前研究表明 that this localized approach 这种定位给药方式 is able to improve by 12 times the response to treatment. 可以提升12倍治疗效果 So we took a drug that is already known 我们使用某已知药物 and by just delivering it locally where it's needed the most, 将它定点放于最需要的部位 we allow a response that is 12 times more powerful, 使得治疗效果增强了12倍 reducing the systemic toxic effect. 并且减少了对身体系统的毒副作用 We are working relentlessly to bring this technology to the next level. 我们正致力于让这项技术更上一层楼 We are finalizing the pre-clinical testing 我们即将完成临床前测试 and the animal model required prior to asking the FDA for approval for clinical trials. 和向食品药品监督管理局申请临床试验前规定的动物实验 Currently, the majority of patients will die from pancreatic cancer. 目前,绝大部分胰腺癌患者都会死于此病 We are hoping that one day, 我们希望,有一天 we can reduce their pain, extend their life 我们可以减轻他们的痛苦,延长他们的生命 and potentially make pancreatic cancer a curable disease. 使胰腺癌成为一种可治愈的疾病 By rethinking the way we deliver the drug, 反思我们的给药方式 we don't only make it more powerful and less toxic, 我们不仅使其更有效、更小副作用 we are also opening the door to finding new innovative solutions 我们也为胰腺癌患者和更多其他患者 for almost all other impossible problems 所面临的各种不可能解决的问题 in pancreatic cancer patients and beyond. 打开了找寻革新解决方案的大门 Thank you very much. 谢谢大家

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