1 00:00:04,240 --> 00:00:06,840 "You have cancer." 2 00:00:08,680 --> 00:00:13,120 Sadly, about 40 percent of us will hear those three words within our lifetime, 3 00:00:13,840 --> 00:00:15,960 and half will not survive. 4 00:00:16,960 --> 00:00:20,816 This means that two out of five of your closest friends and relatives 5 00:00:20,840 --> 00:00:23,296 will be diagnosed with some form of cancer, 6 00:00:23,320 --> 00:00:24,800 and one will die. 7 00:00:27,280 --> 00:00:28,736 Beyond the physical hardships, 8 00:00:28,760 --> 00:00:31,936 roughly one-third of cancer survivors here in the US 9 00:00:31,960 --> 00:00:33,696 will go into debt from treatment. 10 00:00:33,720 --> 00:00:37,456 And they're at least two and a half times more likely to declare bankruptcy 11 00:00:37,480 --> 00:00:38,720 than those without cancer. 12 00:00:39,680 --> 00:00:42,056 This disease is pervasive. 13 00:00:42,080 --> 00:00:43,656 It's emotionally draining 14 00:00:43,680 --> 00:00:44,896 and, for many, 15 00:00:44,920 --> 00:00:46,320 financially destructive. 16 00:00:47,880 --> 00:00:51,440 But a cancer diagnosis doesn't have to be a death sentence. 17 00:00:51,920 --> 00:00:53,776 Finding cancer early, 18 00:00:53,800 --> 00:00:55,016 closer its genesis, 19 00:00:55,040 --> 00:00:58,656 is one of the critical factors to improving treatment options, 20 00:00:58,680 --> 00:01:00,656 reducing its emotional impact 21 00:01:00,680 --> 00:01:02,640 and minimizing financial burdens. 22 00:01:03,560 --> 00:01:04,775 Most importantly, 23 00:01:04,800 --> 00:01:06,056 finding cancer early -- 24 00:01:06,080 --> 00:01:08,976 which is one of the primary aims of my research -- 25 00:01:09,000 --> 00:01:11,160 greatly enhances your odds of survival. 26 00:01:12,120 --> 00:01:14,856 If we just look at the case of breast cancer for example, 27 00:01:14,880 --> 00:01:18,376 we find that those who are diagnosed and treated at stage one 28 00:01:18,400 --> 00:01:22,160 have a five-year survival rate of nearly 100 percent -- 29 00:01:22,760 --> 00:01:26,760 odds that decrease to just 22 percent if treated at stage four. 30 00:01:28,040 --> 00:01:32,000 And similar trends are found for colorectal and ovarian cancer. 31 00:01:34,000 --> 00:01:39,456 Now, we're all aware that an early diagnosis that is accurate 32 00:01:39,480 --> 00:01:41,600 is critical for survival. 33 00:01:43,600 --> 00:01:47,416 The problem is that many cancer diagnostic tools are invasive, 34 00:01:47,440 --> 00:01:48,656 costly, 35 00:01:48,680 --> 00:01:49,896 often inaccurate 36 00:01:49,920 --> 00:01:53,560 and they can take an agonizing amount of time to get the results back. 37 00:01:54,520 --> 00:01:56,936 Still worse, when it comes to some forms of cancer, 38 00:01:56,960 --> 00:02:01,256 such as ovarian, liver or pancreatic cancer, 39 00:02:01,280 --> 00:02:03,960 good screening methods simply don't exist, 40 00:02:04,880 --> 00:02:08,936 meaning that often people wait until physical symptoms surface, 41 00:02:08,960 --> 00:02:12,440 which are themselves already indicators of late-stage progression. 42 00:02:13,920 --> 00:02:17,496 Like a tornado strike in an area without an early warning system, 43 00:02:17,520 --> 00:02:19,416 there is no alarm to warn, 44 00:02:19,440 --> 00:02:22,296 for the danger is already at your doorstep 45 00:02:22,320 --> 00:02:25,360 when your odds of survival are greatly reduced. 46 00:02:27,400 --> 00:02:31,656 Having the convenience and accessibility of regular screening options 47 00:02:31,680 --> 00:02:37,016 that are affordable, noninvasive and could provide results much sooner, 48 00:02:37,040 --> 00:02:41,480 would provide us with a formidable weapon in the fight against cancer. 49 00:02:42,760 --> 00:02:45,816 An early warning would allow us to get out ahead of the disease 50 00:02:45,840 --> 00:02:48,576 instead of merely following in its relentless wake. 51 00:02:48,600 --> 00:02:50,576 And this is exactly what I've been doing. 52 00:02:50,600 --> 00:02:53,736 For the past three years, I've been developing technologies 53 00:02:53,760 --> 00:02:55,496 that could ultimately aid clinicians 54 00:02:55,520 --> 00:02:58,440 with rapid, early-stage cancer diagnostics. 55 00:02:58,920 --> 00:03:02,776 And I've been fueled by a deep scientific curiosity, 56 00:03:02,800 --> 00:03:05,320 and a passion to change these statistics. 57 00:03:06,880 --> 00:03:08,080 Last year however, 58 00:03:08,960 --> 00:03:10,720 this fight became much more personal 59 00:03:12,040 --> 00:03:14,360 when my wife was diagnosed with breast cancer. 60 00:03:15,560 --> 00:03:19,976 It was an experience that added a strong and unexpected emotional dimension 61 00:03:20,000 --> 00:03:21,200 to these efforts. 62 00:03:23,240 --> 00:03:26,520 I know firsthand how life-altering treatment can be, 63 00:03:27,520 --> 00:03:30,176 and I'm keenly aware of the emotional havoc 64 00:03:30,200 --> 00:03:32,656 that cancer can wreak on a family, 65 00:03:32,680 --> 00:03:35,080 which in our case included our two young daughters. 66 00:03:36,400 --> 00:03:39,536 Because we found it early during a routine mammogram, 67 00:03:39,560 --> 00:03:43,256 we were able to focus primarily on treatment options 68 00:03:43,280 --> 00:03:44,816 for the localized tumor, 69 00:03:44,840 --> 00:03:49,240 reaffirming to me how important an early diagnosis is. 70 00:03:50,960 --> 00:03:52,440 Unlike other forms of cancer, 71 00:03:53,400 --> 00:03:57,056 mammograms do offer an early-stage screening option for breast cancer. 72 00:03:57,080 --> 00:03:59,296 Still, not everyone has this done, 73 00:03:59,320 --> 00:04:00,906 or they may develop breast cancer 74 00:04:00,930 --> 00:04:04,050 before the middle age recommendation for having a mammogram. 75 00:04:05,560 --> 00:04:07,816 So, there's still a lot of room for improvement, 76 00:04:07,840 --> 00:04:10,096 even for cancers that do have screening options, 77 00:04:10,120 --> 00:04:12,960 and, of course, considerable benefits for those that don't. 78 00:04:13,680 --> 00:04:16,416 A key challenge then for cancer researchers 79 00:04:16,440 --> 00:04:17,736 is to develop methods 80 00:04:17,760 --> 00:04:21,296 that make regular screening for many types of cancers 81 00:04:21,320 --> 00:04:22,560 much more accessible. 82 00:04:23,920 --> 00:04:26,976 Imagine a scenario where during your regular checkup, 83 00:04:27,000 --> 00:04:30,776 your doctor can take a simple, noninvasive urine sample, 84 00:04:30,800 --> 00:04:32,040 or other liquid biopsy, 85 00:04:32,720 --> 00:04:36,244 and present you with the results before you even leave the doctor's office. 86 00:04:36,800 --> 00:04:40,336 Such a technology could dramatically reduce the number of people 87 00:04:40,360 --> 00:04:43,600 who slip through the net of an early-stage cancer diagnosis. 88 00:04:44,840 --> 00:04:47,656 My research team of engineers and biochemists 89 00:04:47,680 --> 00:04:49,720 is working on exactly this challenge. 90 00:04:50,320 --> 00:04:55,456 We're working on ways to frequently activate an early-stage cancer alarm 91 00:04:55,480 --> 00:04:59,816 by enabling regular screenings that would start when a person is healthy 92 00:04:59,840 --> 00:05:04,136 so that action could be taken to stop cancer the moment it emerges, 93 00:05:04,160 --> 00:05:06,840 and before it can progress beyond its infancy. 94 00:05:08,640 --> 00:05:11,656 The silver bullet in this case are tiny vesicles, 95 00:05:11,680 --> 00:05:16,120 little escape pods regularly shed by cells called exosomes. 96 00:05:16,680 --> 00:05:19,416 Exosomes are important biomarkers 97 00:05:19,440 --> 00:05:22,720 that provide an early-warning system for the development of cancer. 98 00:05:23,720 --> 00:05:27,136 And because they're abundantly present in just about every bodily fluid, 99 00:05:27,160 --> 00:05:29,656 including blood, urine and saliva, 100 00:05:29,680 --> 00:05:33,880 they're extremely attractive for noninvasive liquid biopsies. 101 00:05:35,040 --> 00:05:36,616 There's just one problem. 102 00:05:36,640 --> 00:05:40,936 An automated system for rapidly sorting these important biomarkers 103 00:05:40,960 --> 00:05:42,560 is not currently available. 104 00:05:43,680 --> 00:05:46,976 We've created a technology that we call nano-DLD 105 00:05:47,000 --> 00:05:49,120 that is capable of precisely this: 106 00:05:49,920 --> 00:05:52,616 automated exosome isolation 107 00:05:52,640 --> 00:05:55,120 to aid rapid cancer diagnostics. 108 00:05:56,040 --> 00:05:59,576 Exosomes are the newest early-warning weapon, if you will, 109 00:05:59,600 --> 00:06:01,656 to emerge on the liquid biopsy front. 110 00:06:01,680 --> 00:06:03,976 And they're really, really small. 111 00:06:04,000 --> 00:06:07,520 They measure just 30 to 150 nanometers in diameter. 112 00:06:08,280 --> 00:06:09,576 This is so tiny 113 00:06:09,600 --> 00:06:13,240 that you could fit about a million of them into a single red blood cell. 114 00:06:13,800 --> 00:06:16,136 That's roughly the difference between a golf ball 115 00:06:16,160 --> 00:06:17,880 and a fine grain piece of sand. 116 00:06:18,920 --> 00:06:22,616 Once thought to be little bins for unwanted cellular waste, 117 00:06:22,640 --> 00:06:25,616 it has been found that cells actually communicate 118 00:06:25,640 --> 00:06:28,776 by producing and absorbing these exosomes 119 00:06:28,800 --> 00:06:31,176 which contain surface receptors, 120 00:06:31,200 --> 00:06:35,200 proteins and other genetic material collected from their cell of origin. 121 00:06:36,520 --> 00:06:39,176 When absorbed by a neighboring cell, 122 00:06:39,200 --> 00:06:43,016 exosomes release their contents into the receiving cell, 123 00:06:43,040 --> 00:06:46,256 and can set in motion fundamental changes in gene expression -- 124 00:06:46,280 --> 00:06:47,496 some good, 125 00:06:47,520 --> 00:06:49,256 and this is where cancer comes in, 126 00:06:49,280 --> 00:06:50,856 some bad. 127 00:06:50,880 --> 00:06:54,656 Because they are clothed in the material of the mother cell, 128 00:06:54,680 --> 00:06:56,616 and contain a sample of its environment, 129 00:06:56,640 --> 00:07:01,720 they provide a genetic snapshot of that cell's health and its origin. 130 00:07:03,200 --> 00:07:06,336 All of these qualities make exosomes invaluable messengers 131 00:07:06,360 --> 00:07:07,976 that potentially allow physicians 132 00:07:08,000 --> 00:07:10,920 to eavesdrop on your health at the cellular level. 133 00:07:12,080 --> 00:07:13,736 To catch cancer early, however, 134 00:07:13,760 --> 00:07:16,696 you have to frequently intercept these messages 135 00:07:16,720 --> 00:07:20,216 to determine when cancer-causing troublemakers within your body 136 00:07:20,240 --> 00:07:22,056 decide to start staging a coup, 137 00:07:22,080 --> 00:07:25,096 which is why regular screening is so critical 138 00:07:25,120 --> 00:07:27,960 and why we're developing technologies to make this possible. 139 00:07:29,120 --> 00:07:34,776 While the first exosome-based diagnostics emerged on the market just this year, 140 00:07:34,800 --> 00:07:38,080 they are not yet part of mainstream healthcare options. 141 00:07:39,320 --> 00:07:41,176 In addition to their recent emergence, 142 00:07:41,200 --> 00:07:44,656 another factor that's limiting their widespread adoption 143 00:07:44,680 --> 00:07:48,616 is that currently, no automated exosome isolation system exists 144 00:07:48,640 --> 00:07:51,840 to make regular screening economically accessible. 145 00:07:52,800 --> 00:07:55,536 The current gold standard for exosome isolation 146 00:07:55,560 --> 00:07:57,496 includes ultracentrifugation, 147 00:07:57,520 --> 00:08:00,776 a process requiring expensive laboratory equipment, 148 00:08:00,800 --> 00:08:02,056 a trained lab tech 149 00:08:02,080 --> 00:08:05,120 and about 30 hours of time to process a sample. 150 00:08:06,600 --> 00:08:11,256 We've come up with a different approach for achieving automated exosome isolation 151 00:08:11,280 --> 00:08:12,720 from a sample such as urine. 152 00:08:13,560 --> 00:08:17,816 We use a chip-based, continuous flow separation technique 153 00:08:17,840 --> 00:08:20,816 called deterministic lateral displacement. 154 00:08:20,840 --> 00:08:22,216 And we have done with it 155 00:08:22,240 --> 00:08:26,696 what the semiconductor industry has done so successfully for the past 50 years. 156 00:08:26,720 --> 00:08:28,776 We shrunk the dimensions of this technology 157 00:08:28,800 --> 00:08:31,440 from the micron scale to the true nanoscale. 158 00:08:32,720 --> 00:08:34,176 So how does it work? 159 00:08:34,200 --> 00:08:35,456 In a nutshell, 160 00:08:35,480 --> 00:08:39,456 a set of tiny pillars separated by nanoscopic gaps 161 00:08:39,480 --> 00:08:40,736 are arranged in such a way 162 00:08:40,760 --> 00:08:43,816 that the system divides the fluid into streamlines, 163 00:08:43,840 --> 00:08:47,216 with the larger cancer-related nanoparticles being separated 164 00:08:47,240 --> 00:08:51,136 through a process of redirection from the smaller, healthier ones, 165 00:08:51,160 --> 00:08:52,696 which can in contrast 166 00:08:52,720 --> 00:08:55,256 move around the pillars in a zigzag-type motion 167 00:08:55,280 --> 00:08:56,840 in the direction of fluid flow. 168 00:08:58,080 --> 00:09:02,080 The net result is a complete separation of these two particle populations. 169 00:09:03,440 --> 00:09:07,136 You can visualize this separation process 170 00:09:07,160 --> 00:09:11,016 similar to traffic on a highway that separates into two roads, 171 00:09:11,040 --> 00:09:14,496 with one road going into a low-clearance tunnel under a mountain, 172 00:09:14,520 --> 00:09:16,576 and the other road going around it. 173 00:09:16,600 --> 00:09:19,376 Here, smaller cars can go through the tunnel 174 00:09:19,400 --> 00:09:22,696 while larger trucks, carrying potentially hazardous material, 175 00:09:22,720 --> 00:09:24,480 are forced to take the detour route. 176 00:09:25,600 --> 00:09:29,696 Traffic is effectively separated by size and contents 177 00:09:29,720 --> 00:09:31,736 without impeding its flow. 178 00:09:31,760 --> 00:09:36,040 And this is exactly how our system works on a much, much smaller scale. 179 00:09:37,600 --> 00:09:41,456 The idea here is that the separation process for screening 180 00:09:41,480 --> 00:09:45,536 could be as simple as processing a sample of urine, blood or saliva, 181 00:09:45,560 --> 00:09:48,856 which is a near-term possibility within the next few years. 182 00:09:48,880 --> 00:09:54,176 Ultimately, it could be used to isolate and detect target exosomes 183 00:09:54,200 --> 00:09:57,416 associated with a particular type of cancer, 184 00:09:57,440 --> 00:09:59,880 sensing and reporting their presence within minutes. 185 00:10:00,600 --> 00:10:03,800 This would make rapid diagnostics virtually painless. 186 00:10:04,720 --> 00:10:05,976 Broadly speaking, 187 00:10:06,000 --> 00:10:08,656 the ability to separate and enrich biomarkers 188 00:10:08,680 --> 00:10:11,400 with nanoscale precision in an automated way, 189 00:10:12,320 --> 00:10:15,776 opens the door to better understanding diseases such as cancer, 190 00:10:15,800 --> 00:10:19,776 with applications ranging from sample preparation to diagnostics, 191 00:10:19,800 --> 00:10:22,280 and from drug resistance monitoring to therapeutics. 192 00:10:23,440 --> 00:10:25,456 Even before my wife's bout with cancer, 193 00:10:25,480 --> 00:10:28,960 it was a dream of mine to facilitate the automation of this process -- 194 00:10:29,840 --> 00:10:32,776 to make regular screening more accessible, 195 00:10:32,800 --> 00:10:35,696 similar to the way Henry Ford made the automobile accessible 196 00:10:35,720 --> 00:10:37,296 to the general population 197 00:10:37,320 --> 00:10:39,576 through development of the assembly line. 198 00:10:39,600 --> 00:10:42,360 Automation is the key to accessibility. 199 00:10:44,280 --> 00:10:46,136 And in the spirit of the Hoover dream, 200 00:10:46,160 --> 00:10:49,056 "a chicken in every pot and a car in every garage," 201 00:10:49,080 --> 00:10:50,496 we're developing a technology 202 00:10:50,520 --> 00:10:54,336 that could ultimately place an early-warning cancer detection system 203 00:10:54,360 --> 00:10:55,560 in every home. 204 00:10:56,000 --> 00:10:58,056 This would allow every man, woman and child 205 00:10:58,080 --> 00:11:02,216 the opportunity to be regularly tested while they're still healthy, 206 00:11:02,240 --> 00:11:04,120 catching cancer when it first emerges. 207 00:11:05,400 --> 00:11:06,896 It is my hope and dream 208 00:11:06,920 --> 00:11:10,616 to help people around the world avoid the high costs -- 209 00:11:10,640 --> 00:11:13,176 physical, financial and emotional -- 210 00:11:13,200 --> 00:11:14,920 faced by today's cancer patients, 211 00:11:15,600 --> 00:11:17,920 hardships that I'm well acquainted with. 212 00:11:19,400 --> 00:11:23,776 I'm also happy to report that because we caught my wife's cancer early, 213 00:11:23,800 --> 00:11:25,456 her treatment was successful, 214 00:11:25,480 --> 00:11:27,736 and she is now, thankfully, cancer-free. 215 00:11:27,760 --> 00:11:29,960 (Applause) 216 00:11:36,160 --> 00:11:40,560 It is an outcome that I would like to see for everyone with a cancer diagnosis. 217 00:11:41,280 --> 00:11:43,336 With the work that my team has already done 218 00:11:43,360 --> 00:11:46,096 on separation of nanoscale biomarkers 219 00:11:46,120 --> 00:11:49,056 for rapid, early-stage cancer diagnostics, 220 00:11:49,080 --> 00:11:51,616 I am optimistic that within the next decade, 221 00:11:51,640 --> 00:11:54,216 this type of technology will be available, 222 00:11:54,240 --> 00:11:58,120 helping protect our friends, our family and future generations. 223 00:11:58,680 --> 00:12:02,576 Even if we are so unlucky as to be diagnosed with cancer, 224 00:12:02,600 --> 00:12:05,480 that early-stage alarm will provide a strong beacon of hope. 225 00:12:06,280 --> 00:12:07,496 Thank you. 226 00:12:07,520 --> 00:12:13,309 (Applause)