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