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It was a Sunday afternoon
back in April of this year.

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My phone was ringing,

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I picked it up.

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The voice said, "It's Rebecca.

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I'm just calling to invite you

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to my funeral."

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I said, "Rebecca,
what are you talking about?"

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She said, "Joy, as my friend,
you have to let me go.

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It's my time."

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The next day, she was dead.

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Rebecca was 31 years old when she died.

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She had an eight-year struggle
with breast cancer.

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It came back three times.

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I failed her.

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The scientific community failed her.

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And the medical community failed her.

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And she's not the only one.

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Every five seconds,

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someone dies of cancer.

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Today, we medical
researchers are committed

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to having Rebecca and people like her

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be one of the last patients that we fail.

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The US government alone has spent
over 100 billion on cancer research

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since the 1970s,

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with limited progress
in regards to patient survival,

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especially for certain types
of very aggressive cancers.

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So we need a change because, clearly,

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what we've been doing so far
has not been working.

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And what we do in medicine
is to send out firefighters,

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because cancer is like a big fire.

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And these firefighters
are the cancer drugs.

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But we're sending them out
without a fire truck --

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so without transportation, without ladders

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and without emergency equipment.

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And over 99 percent of these firefighters
never make it to the fire.

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Over 99 percent of cancer drugs
never make it to the tumor

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because they lack transportation and tools

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to take them to the location
they're aiming for.

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Turns out, it really is all about
location, location, location.

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(Laughter)

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So we need a fire truck
to get to the right location.

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And I'm here to tell you
that nanoparticles are the fire trucks.

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We can load cancer drugs
inside nanoparticles,

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and nanoparticles
can function as the carrier

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and necessary equipment

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to bring the cancer drugs
to the heart of the tumor.

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So what are nanoparticles,

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and what does it really mean
to be nano-sized?

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Well, there are many different
types of nanoparticles

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made out of various materials,

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such as metal-based nanoparticles

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or fat-based nanoparticles.

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But to really illustrate
what it means to be nano-sized,

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I took one of my hair strands

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and placed it under the microscope.

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Now, I have very thin hair,

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so my hair is approximately
40,000 nanometers in diameter.

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So this means, if we take
400 of our nanoparticles

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and we stack them on top of each other,

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we get the thickness
of a single hair strand.

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I lead a nanoparticle laboratory
to fight cancer and other diseases

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at Mayo Clinic here in Jacksonville.

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And at Mayo Clinic,

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we really have the tools
to make a difference for patients,

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thanks to the generous donations
and grants to fund our research.

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And so, how do these nanoparticles
manage to transport cancer drugs

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to the tumor?

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Well, they have an extensive toolbox.

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Cancer drugs without nanoparticles
are quickly washed out of the body

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through the kidneys

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because they're so small.

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So it's like water going through a sieve.

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And so they don't really have time
to reach the tumor.

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Here we see an illustration of this.

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We have the firefighters,
the cancer drugs.

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They're circulating in the blood,

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but they're quickly
washed out of the body

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and they don't really end up
inside the tumor.

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But if we put these cancer drugs
inside nanoparticles,

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they will not get washed out by the body

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because the nanoparticles are too big.

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And they will continue
to circulate in the blood,

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giving them more time to find the tumor.

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And here we see the cancer drug,
the firefighters,

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inside the fire truck, the nanoparticles.

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They're circulating in the blood,

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they don't get washed out

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and they actually end up
reaching the tumor.

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And so what other tools
do nanoparticles have?

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Well, they can protect cancer drugs
from getting destroyed inside the body.

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There are certain very important
but sensitive drugs

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that are easily degraded
by enzymes in the blood.

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So unless they have
this nanoparticle protection,

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they will not be able to function.

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Another nanoparticle tool
are these surface extensions

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that are like tiny hands with fingers
that grab on to the tumor

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and fit exactly onto it,

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so that when the nanoparticles
are circulating,

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they can attach onto the cancer cells,

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buying the cancer drugs
more time to do their job.

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And these are just some of the many tools
that nanoparticles can have.

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And today,

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we have more than 10 clinically approved
nanoparticles for cancer

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that are given to patients
all over the world.

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Yet, we have patients,
like Rebecca, who die.

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So what are the major
challenges and limitations

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with currently approved nanoparticles?

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Well, a major challenge is the liver,

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because the liver is the body's
filtration system,

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and the liver recognizes
and destroys foreign objects,

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such as viruses, bacteria
and also nanoparticles.

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And the immune cells in the liver
eat the nanoparticles,

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preventing them from reaching the tumor.

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And here we see an illustration
where the kidney is no longer a problem,

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but these fire trucks, the nanoparticles,

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get stuck in the liver

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and, actually, less of them
end up reaching the tumor.

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So a future strategy
to improve nanoparticles

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is to temporarily disarm
the immune cells in the liver.

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So how do we disarm these cells?

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Well, we looked at drugs
that were already clinically approved

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for other indications

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to see if any of them
could stop the immune cells

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from eating the nanoparticles.

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And unexpectedly,
in one of our preclinical studies,

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we found that a 70-year-old malaria drug

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was able to stop the immune cells
from internalizing the nanoparticles

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so that they could escape the liver

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and continue their journey
to their goal, the tumor.

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And here we see the illustration
of blocking the liver.

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The nanoparticles don't go there,

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and they instead end up in the tumor.

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So, sometimes, unexpected connections
are made in science

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that lead to new solutions.

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Another strategy
for preventing nanoparticles

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from getting stuck in the liver

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is to use the body's own nanoparticles.

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Yes -- surprise, surprise.

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You, and you and you, and all of us
have a lot of nanoparticles

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circulating in our bodies.

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And because they're part of our bodies,

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the liver is less likely
to label them as foreign.

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And these biological nanoparticles
can be found in the saliva,

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in the blood, in the urine,
in pancreatic juice.

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And we can collect them from the body

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and use them as fire trucks
for cancer drugs.

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And in this case,

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the immune cells in the liver
are less likely to eat

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the biological nanoparticles.

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So we're using
a Trojan-horse-based concept

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to fool the liver.

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And here we see
the biological nanoparticles

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circulating in the blood.

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They don't get recognized by the liver,

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and they end up in the tumor.

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And in the future,

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we want to exploit
nature's own nanoparticles

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for cancer drug delivery,

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to reduce side effects and save lives

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by preventing the cancer drugs
from being in the wrong location.

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However, a major problem has been:

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How do we isolate these biological
nanoparticles in large quantities

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without damaging them?

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My lab has developed
an efficient method for doing this.

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We can process large quantities
of liquids from the body

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to produce a highly concentrated,
high-quality formulation

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of biological nanoparticles.

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And these nanoparticles
are not yet in clinical use,

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because it takes an average of 12 years

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to get something from the lab

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to your medicine cabinet.

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And this is the type of challenge
that requires teamwork

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from scientists and physicians,

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who dedicate their lives to this battle.

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And we keep going,
thanks to inspiration from patients.

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And I believe that if we keep working
on these nanomedicines,

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we will be able to reduce harm
to healthy organs,

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improve quality of life

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and save future patients.

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I like to imagine

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that if these treatments
had been available for Rebecca,

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that call from her

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could have been an invitation

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not to her funeral,

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but her wedding.

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Thank you.

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(Applause)