Your Drugs are Average

[Music]

as we’re recording this is almost

christmas time

so i’m in the giving mood

who wants a new dress well to

all women watching this i’m gonna send

you a new versace dress

and for people wearing high glasses i’m

gonna send you the newest pair of tom 4

glasses

retail price 800

but let’s think also about our health so

who thinks that they might need any sort

of medication

between now and the day they die

well i go to colorado’s on that

but now that i’m saying it out loud yeah

it doesn’t sound like a great idea

actually

let me think so for the dress

i’m gonna take the average dress size

for a women

and this size is 16 for women in u.s

and 44 in europe yes

so i’m gonna ship to you a 16 or a 44

depending where you are and if that is

your

size oh you’re super lucky

if you’re above below yeah i’m really

sorry

but that’s the only solution i could

found

for eyeglasses people well i know that

you are getting more skeptical

so let’s say that the average people

are just slightly nearsighted so i’m

going to send you the tomfer glasses

for nearsighted people as soon as you

wear them

if you see all clicks are clear oh great

if not maybe you can send it to a friend

so as you can see averages do not work

and luckily we can always go to a shop

or we can go to a tailor if you want to

be fancy

and take the perfect dress for us or we

can go to an optician

and get the proper glasses

but what about the medication then

we all go to the doctor we all get

prescription

and it is all about us

how can i possibly trick you in finding

an average prescription

can i let’s see

let’s say that i’m going to the doctor

for a common disease

i’m taking a checkup and i get a

prescription with some pills to take

the prescription say it all it had my

name on it

the doctor’s name the dose

the the refilling everything so it was

all about me

well i was wrong

because while i was to the doctor’s

office thinking about my

own problem well the

deals that i have to take are actually

meant for

this guy a middle-aged white man

because from the moment in which a drug

is developed till is tested

his genetic traits are taken way more

into account than mine

and these does not happen only for me

it happens also if he goes to the doctor

middle-aged white men even if she goes

to the doctor

always the same guy and even sometimes

for them

middle-aged white men so to all

middle-aged white men watching these

we don’t want to blame you we just want

to acknowledge the fact

that the biggest part of the world

population does not fall

in that average i strongly believe

that medicine should be all about

inclusion

and precision not averages

we are all different by sex

age lifestyle genetic backgrounds

ethnicity

and all these factors makes us unique

those factors are also reflected into

our cells

from our hair our heart even our skin

so are are those factors taken into

account when developing drugs

not really because things like this

happens

an example when taking the pills that

the doctor prescribed me

me and all the women have

almost the double and i’m saying almost

to double of the risk to develop an

adverse drug reaction compared to men

if you’re lucky it can be a rash

but if not it can be also a drug-induced

liver toxicity

and let’s think about non-white people

well

a research report showed that among the

drugs approved

between 2018 and 2013

one over five of those drugs

actually change response depending on

your ethnicity

we need inclusion and precision not

averages

and this happens because women and

non-white people

are not represented enough in clinical

trials

in the early 16 there was a clinical

trial to check

if estrogen supplements would help in

preventing heart disease

well those supplements have been widely

prescribed

to women in post-menopause

the trial was run on 8341 men

and zero women so

you can imagine that from zero percent

we can just improve

so actually today women enroll in

cardiovascular

trials went from zero percent

to 38 percent in 2019

so definitely it’s a good step but we

need inclusion

and precision not averages

can we say the same for non-white people

well

there the situation is worse a recent

nature publication

showed the ethnicity party of the

participants in clinical trials

between 1997 and 2014.

well you can see from the graph the

majority

is all white and is even more

astonishing

if we compare with the u.s population in

those years

40 percent was non-white

and that percentage is gonna increase

and it will reach in 20 45

to 50 percent so more and more people

will get drugs that are not tested on

them

so here it is we need inclusion

and precision not averages and why you

keep on saying

inclusion and precision because right

now

we have a bad average inclusion can

bring us to

more accurate medicine a more inclusive

average but is always an average

and that’s totally fine and we should

strive for it

it is a common drug it is a common issue

but what about something more serious

so i want to ask to all

the listeners who know

someone that had a heart disease

or who knows someone who is going

right now through cancer

well i think that those people

don’t want any average treatment those

people

deserve a precise treatment and that’s

what i want to solve

so i’m a microelectronic engineer and

with two friends

we develop a tool that can have been

developing inclusive

and precise drug for all

and it is a computer chip like the one

that you have in your smartphone

in this chip biologists can insert

human cells and i’m underlining

human cells because it can be of a man

of a woman a different ethnicity so it

includes

us all i will show you how it works

so if you take the chip and you cut it

enough

you see two compartments in those two

compartments biologists will include

human cells let’s say that an example in

this case we want to create a heart

so the biologists insert the cells and

the chip

will nourish those cells through an

artificial blood vessel

and as in your body your heart is

beating

the chip will be will beat like an r2

in such a way that the the cells will

feel like in your body

and last but not least we can monitor

them

we can include electrodes and sensors to

get data out of them

so it’s like going to the doctor and

getting a checkup to your heart

so we call it the beauty of

microelectronics

this technology can be actually mass

produced

and it can be made as sexy vote for

whole

and i want to show you that is not

science fiction so here it is

here you have a happily beating art in

our chip

that is nourished through an artificial

blood vessel

this work has been done thanks to the

laden university medical center

those cells are coming from a patient

that choose to donate those cells

and this is about inclusion but we want

to push the boundary even further

we want precision so let’s go back

to the cancer patient every cancer

patient journey

always start by taking a sample of the

cancer

is called biopsy that biopsy is analyzed

by the clinicians

and a range of treatment is chosen

but is a range is a matter of trial and

error

so now let’s imagine to take a slice of

that biopsy

putting it on the chip and the chip

will nourish and keep it alive

for long enough to allow biologists to

test

this precise medicine for that patient

the precise treatment well that’s what

we want to achieve with the erasmus

medical center

it will take year but up to now we are

able to keep alive that cancer tissue

for two weeks so i hope in a future

in which individualized and personalized

treatment

will be available for all and so the

next time that you will go to the doctor

you will get your prescription it will

be all about you

and not only this guy