[Applause]
hello good afternoon I actually want to
continue maybe on a workshop and on the
last thoughts you had just how the
humans will look like in 2080 4 and
actually what the future is and we don’t
really know but if we risen to one of
the Google’s visionary directors records
well actually we will reach soon the
point which is called singularity where
the human will be less intelligent than
a machine
machines will become more powerful and
more intelligent than we are he predicts
by 2045 so if this is true then many
hope that actually before when this
happened we will actually become
immortal and if we become immortal what
will happen whether we will have enough
space on earth whether we will have
enough food how the lines will look like
some of them think that actually we will
become a humanoids with a brain
connected to a cloud and we will stock
our information there and retry them to
think about things that we will get
empowered by different technology tools
to actually live forever maybe we will
look like a chips with adjust with the
face and everything else will become
less important I don’t really know what
I would like to tell you about today is
actually more about what binds me to
precision medicine what what is my
passion and my passion is more about
actually increasing quality of human
life and providing a better care to
people and that is for me what is a
precision medicine is about so before I
start speaking about precision medicine
I like to ask you one question did you
ever experience the situation you have a
terrible headache really terrible
headache and you forgot to take your
pill a painkiller
and you know people around you notice
something is wrong and they tell you oh
do you want a painkiller I have one and
they give you one and you say oh thanks
and you take it
five minutes passes ten minutes half an
hour or 45 minutes nothing happened your
headache is still there did you ever
have it well actually that happens very
very very often why because we’re giving
old old people the same drugs the same
dosing of drugs but actually 90% of the
registered drugs i effective only in 40%
of people so that’s the average for some
therapies situation is bit better for
instance antidepressant don’t work only
in 38 percent of people but for instance
anti-cancer drugs for many of them 75
percent of time are not efficient so
that’s what actually brought a question
of personalized medicine how do we know
that the treatment will be efficient and
why and how come that some people
respond well to the treatment
but the others actually just experienced
horrible secondary effects one thing I
want to share with you that actually
very rarely it’s spoken in a public is
the secondary adverse drug effects a
really serious health care problem today
do you have any idea how many people
actually died of adverse secondary
effects no well waho publishes every
year a statistics of most deadly
diseases and if you look well heart
diseases are still the worst they kill
around eight point eight million people
but then surprisingly in 2013 FDA
published a study saying that every year
around the world adverse drug effects
killed more people than diabetes than
car accidents and certain types of
cancer so that places adverse drug
effects to around fifth sixth most that
the disease on earth and yet we don’t
speak about so this for me represents
what the personalized medicine should be
about and actually we try to answer the
the questions how we can stratify
patients how we can find out for whom
treatment will be effective for whom it
will be effective but also will have
some adverse effect and for whom the
treatment will be completely ineffective
and based on this then decide who should
get the medication who should be maybe
examined whether the medication should
be given or not or who should not get
that medication but something else to
come to there actually humanity wait
long way and there were a few
technological revolutions that had to
happen first one was actually started
with discovery of DNA and actually just
in roughly 50 60 years we came to the
sequencing of human genome the first
human genome took more than 10 years to
be sequenced huge amount of money but
eventually in 2003 we got the full code
published so not that far away just 15
years ago what that brought us it’s a
nice image from another 10 conference by
Ricardo Sabatini that I invite you to
listen if you have time which actually
describes a human genome and what you
see here all these books is actually a
human code printed in a book so that’s
all our information that’s what we are
the set of books what is really
interesting is that with the sequencing
of human genome we learned many things
we confirm certain things that we knew
but we learn many surprising things so
one of these things that was confirmed
is that all our code contains only four
letters GA t and c we all composed our
DNA of just four letters we have three
billion letters in our genome but only
20,000 genes when I was the stood
I’ve been told that we have five times
more so that was a huge surprise we were
as simple as some much simpler
physically simpler organisms like flies
or insects and we always thought like
human beings that we might be superior
and have more genes than the others not
only that we were a really surprised
because only 2% of human genome actually
encodes for proteins so everything else
there is to regulate and to respond to
environment and for many parts of the
genome we still don’t know the function
another very very surprising thing look
all these faces how they are different
we are all different yet if we look at
the genetics we are 99.9% identical if
you turn to your neighbor
you’re just 0.01% different how much is
that 3 million letters is that a lot 3
million letters it’s enough to make each
of us unique so that’s what is the
difference between us and these
differences these polymorphisms in
genetics are called polymorphisms
actually allowed us to identify but
associate certain variations to certain
phenotypes or expressions one of those
is for instance how we metabolize drugs
for this to be developed we needed 2nd
technology revolution which is actually
machine learning and you heard today a
lot of machine learning I just want to
say that machine learning also has each
good applications it’s not always just
the bad applications so it helped to
associate as I said certain variations
to certain outputs we heard a lot over
the last years about big data and
everybody speaks about big data and
importance of big data and collecting
data I’d like to tell you a small
anecdote that actually in my view we
don’t need a big data we need a smart
data especially in medicine
and it was a study that finally was
never published but it was done in New
York Hospital where they tried to study
the influence of a nutrition on the
physical characteristic nutrition of a
mother during the pregnancy on a
physical characteristics of a newborn
baby and they found the revolutionary
result that eating lots of rice actually
especially two three times per day
during the pregnancy will be associated
with a like higher likelihood that the
child will have a dark hair dark eyes of
the Oriental shape everybody was
astonished and then they look a little
bit deeper into data and they found out
well all the women all the pregnant
women for whom this was the case
actually came from Chinatown New York so
it’s not just about big data
it’s about smart data so what I want to
tell you is that you have a power to
influence on that if you go to hospital
somebody asks you I want to collect your
DNA
you should understand why it is for what
it should be used for what have really
the relevant data you should give and
not just share any data that you have
and the third revolution will come
certainly from connected objects we all
spoke about smartphones and about social
applications and social networks there
are many of these applications that
actually take your physical
characteristics how much you walk during
the day what do you eat all this is
actually gathered to be used in medical
studies
well what precision medicine can really
do today I can do lots of things it can
as I told you already now say for Vice
majority of drugs that are commonly used
whether you should take it or not what
is the dosage the
should be given how it should be
combined with the other drugs through
the algorithms that are developed you
can actually predict how person will
respond to a drug certain diseases can
be predicted people always speak about
cancer on purpose I don’t want to talk
about it for instance there is a
glaucoma a terrible disease that leads
to people lose their sight when they
older well you can actually predict who
is going to get glaucoma and you can
prevent it by a simple surgery
intervention where people will get
actually a small intervention on an
optical nerve and they would not develop
disease so precision medicine is all
about this it’s about preventing the
disease before it happens and it’s
actually something that existed long
time ago and Allison who is one of the
fathers of medicine who lived in the
10th century already said in his poem of
Medicine that medicine is actually art
of preserving health and eventually of
curing the disease that might occur in a
human body what is the impact of
precision medicine in general well there
are many impacts there is impact on a
clinical decision on a patient life on a
society on the industry on all of us I
give you an example we developed a tool
to actually predict who will develop
blood clots with contraceptive pills
it’s most widely used contraceptive
method in the world 100 million women
are using it and yet some women it’s
very rare one in 1,000 of users will
develop blood clots and why it is
important what is the impact of such a
tool precision medicine – so basically
with such a precision medicine tool you
can choose what is the most optimal
contraception for a woman you can choose
what is the best mode of the delivery
for the hormones for instance whether
it’s a oral or whether it’s a batch or
whether it’s something else
you can say what is the best
intervention moment the risk of blood
clotting increases with the age for
every single person on the earth so you
can see okay this is the threshold until
which we can go so maybe I can treat
this person and give that age and
another person for 10 years more and
another person shouldn’t get it at all
but you can actually decide upon a time
that is suitable for the treatment and
also you can know treatment responses
what is the effect of the patient well
this kind of problem for instance blood
clotting can happen very early girls of
16 can have it they stay disabled for
the rest of their life well if we can
avoid it we significantly impact of the
quality of their life also on the
compliance they might have to the
treatment to the therapy but that’s true
for any therapy with the precision
medicine if you speak about impact on
the society well if we have less less
blood clotting we will have less
healthcare burden so healthcare will
become cheaper as well quality of life
will increase there will be less absence
time of work so we can in general bring
quality to society also for the industry
it’s very interesting because industry
can improve development process can use
such a test to test ahead of putting on
the market to fill to say well this pill
is less dangerous so I’m gonna use that
one also it can in specific cases
improve for instance intellectual
property for the companies who can
narrow down the application of certain
drug and then have their IP extended
even if we can do today a lot with the
precision medicine there are still many
challenges and I just want to share some
with you clinical utility when we
develop such a tools one shouldn’t keep
in one shouldn’t
lose from from sight that it has to be a
useful tool clinically useful so that we
can actually bring better life better
quality of life better care to patients
costs they are still fairly expensive
treatments but the process is getting
down with the technology development and
hopefully one day precision medicine
should be accessible to every single
person on the earth understanding
probabilities that’s very important if
you don’t understand probabilities you
can’t match the expectations and I’d
like to come back to one of the talks we
listened this morning saying well if I
give my DNA then my genetic information
will be available to my insurance
company and my insurance company will
increase my do that I have to pay and
everybody gets scared of it but actually
you have to understand that no progress
will come if we don’t give anything if
we just are scared of everything so if
we scare people all the time about the
insurance then people will refuse for
instance a treatment that can increase
their quality of life or save their
lives
so everything actually for me is in
acceptance and to have acceptance we
have to have education everything is
about the education explaining to
everyone what it is really about what do
they give so that the people can
actually impact through their acts on
legal decisions and on the ethical
decisions thank you very much [Applause]
hello good afternoon I actually want to
continue maybe on a workshop and on the
last thoughts you had just how the
humans will look like in 2080 4 and
actually what the future is and we don’t
really know but if we risen to one of
the Google’s visionary directors records
well actually we will reach soon the
point which is called singularity where
the human will be less intelligent than
a machine
machines will become more powerful and
more intelligent than we are he predicts
by 2045 so if this is true then many
hope that actually before when this
happened we will actually become
immortal and if we become immortal what
will happen whether we will have enough
space on earth whether we will have
enough food how the lines will look like
some of them think that actually we will
become a humanoids with a brain
connected to a cloud and we will stock
our information there and retry them to
think about things that we will get
empowered by different technology tools
to actually live forever maybe we will
look like a chips with adjust with the
face and everything else will become
less important I don’t really know what
I would like to tell you about today is
actually more about what binds me to
precision medicine what what is my
passion and my passion is more about
actually increasing quality of human
life and providing a better care to
people and that is for me what is a
precision medicine is about so before I
start speaking about precision medicine
I like to ask you one question did you
ever experience the situation you have a
terrible headache really terrible
headache and you forgot to take your
pill a painkiller
and you know people around you notice
something is wrong and they tell you oh
do you want a painkiller I have one and
they give you one and you say oh thanks
and you take it
five minutes passes ten minutes half an
hour or 45 minutes nothing happened your
headache is still there did you ever
have it well actually that happens very
very very often why because we’re giving
old old people the same drugs the same
dosing of drugs but actually 90% of the
registered drugs i effective only in 40%
of people so that’s the average for some
therapies situation is bit better for
instance antidepressant don’t work only
in 38 percent of people but for instance
anti-cancer drugs for many of them 75
percent of time are not efficient so
that’s what actually brought a question
of personalized medicine how do we know
that the treatment will be efficient and
why and how come that some people
respond well to the treatment
but the others actually just experienced
horrible secondary effects one thing I
want to share with you that actually
very rarely it’s spoken in a public is
the secondary adverse drug effects a
really serious health care problem today
do you have any idea how many people
actually died of adverse secondary
effects no well waho publishes every
year a statistics of most deadly
diseases and if you look well heart
diseases are still the worst they kill
around eight point eight million people
but then surprisingly in 2013 FDA
published a study saying that every year
around the world adverse drug effects
killed more people than diabetes than
car accidents and certain types of
cancer so that places adverse drug
effects to around fifth sixth most that
the disease on earth and yet we don’t
speak about so this for me represents
what the personalized medicine should be
about and actually we try to answer the
the questions how we can stratify
patients how we can find out for whom
treatment will be effective for whom it
will be effective but also will have
some adverse effect and for whom the
treatment will be completely ineffective
and based on this then decide who should
get the medication who should be maybe
examined whether the medication should
be given or not or who should not get
that medication but something else to
come to there actually humanity wait
long way and there were a few
technological revolutions that had to
happen first one was actually started
with discovery of DNA and actually just
in roughly 50 60 years we came to the
sequencing of human genome the first
human genome took more than 10 years to
be sequenced huge amount of money but
eventually in 2003 we got the full code
published so not that far away just 15
years ago what that brought us it’s a
nice image from another 10 conference by
Ricardo Sabatini that I invite you to
listen if you have time which actually
describes a human genome and what you
see here all these books is actually a
human code printed in a book so that’s
all our information that’s what we are
the set of books what is really
interesting is that with the sequencing
of human genome we learned many things
we confirm certain things that we knew
but we learn many surprising things so
one of these things that was confirmed
is that all our code contains only four
letters GA t and c we all composed our
DNA of just four letters we have three
billion letters in our genome but only
20,000 genes when I was the stood
I’ve been told that we have five times
more so that was a huge surprise we were
as simple as some much simpler
physically simpler organisms like flies
or insects and we always thought like
human beings that we might be superior
and have more genes than the others not
only that we were a really surprised
because only 2% of human genome actually
encodes for proteins so everything else
there is to regulate and to respond to
environment and for many parts of the
genome we still don’t know the function
another very very surprising thing look
all these faces how they are different
we are all different yet if we look at
the genetics we are 99.9% identical if
you turn to your neighbor
you’re just 0.01% different how much is
that 3 million letters is that a lot 3
million letters it’s enough to make each
of us unique so that’s what is the
difference between us and these
differences these polymorphisms in
genetics are called polymorphisms
actually allowed us to identify but
associate certain variations to certain
phenotypes or expressions one of those
is for instance how we metabolize drugs
for this to be developed we needed 2nd
technology revolution which is actually
machine learning and you heard today a
lot of machine learning I just want to
say that machine learning also has each
good applications it’s not always just
the bad applications so it helped to
associate as I said certain variations
to certain outputs we heard a lot over
the last years about big data and
everybody speaks about big data and
importance of big data and collecting
data I’d like to tell you a small
anecdote that actually in my view we
don’t need a big data we need a smart
data especially in medicine
and it was a study that finally was
never published but it was done in New
York Hospital where they tried to study
the influence of a nutrition on the
physical characteristic nutrition of a
mother during the pregnancy on a
physical characteristics of a newborn
baby and they found the revolutionary
result that eating lots of rice actually
especially two three times per day
during the pregnancy will be associated
with a like higher likelihood that the
child will have a dark hair dark eyes of
the Oriental shape everybody was
astonished and then they look a little
bit deeper into data and they found out
well all the women all the pregnant
women for whom this was the case
actually came from Chinatown New York so
it’s not just about big data
it’s about smart data so what I want to
tell you is that you have a power to
influence on that if you go to hospital
somebody asks you I want to collect your
DNA
you should understand why it is for what
it should be used for what have really
the relevant data you should give and
not just share any data that you have
and the third revolution will come
certainly from connected objects we all
spoke about smartphones and about social
applications and social networks there
are many of these applications that
actually take your physical
characteristics how much you walk during
the day what do you eat all this is
actually gathered to be used in medical
studies
well what precision medicine can really
do today I can do lots of things it can
as I told you already now say for Vice
majority of drugs that are commonly used
whether you should take it or not what
is the dosage the
should be given how it should be
combined with the other drugs through
the algorithms that are developed you
can actually predict how person will
respond to a drug certain diseases can
be predicted people always speak about
cancer on purpose I don’t want to talk
about it for instance there is a
glaucoma a terrible disease that leads
to people lose their sight when they
older well you can actually predict who
is going to get glaucoma and you can
prevent it by a simple surgery
intervention where people will get
actually a small intervention on an
optical nerve and they would not develop
disease so precision medicine is all
about this it’s about preventing the
disease before it happens and it’s
actually something that existed long
time ago and Allison who is one of the
fathers of medicine who lived in the
10th century already said in his poem of
Medicine that medicine is actually art
of preserving health and eventually of
curing the disease that might occur in a
human body what is the impact of
precision medicine in general well there
are many impacts there is impact on a
clinical decision on a patient life on a
society on the industry on all of us I
give you an example we developed a tool
to actually predict who will develop
blood clots with contraceptive pills
it’s most widely used contraceptive
method in the world 100 million women
are using it and yet some women it’s
very rare one in 1,000 of users will
develop blood clots and why it is
important what is the impact of such a
tool precision medicine – so basically
with such a precision medicine tool you
can choose what is the most optimal
contraception for a woman you can choose
what is the best mode of the delivery
for the hormones for instance whether
it’s a oral or whether it’s a batch or
whether it’s something else
you can say what is the best
intervention moment the risk of blood
clotting increases with the age for
every single person on the earth so you
can see okay this is the threshold until
which we can go so maybe I can treat
this person and give that age and
another person for 10 years more and
another person shouldn’t get it at all
but you can actually decide upon a time
that is suitable for the treatment and
also you can know treatment responses
what is the effect of the patient well
this kind of problem for instance blood
clotting can happen very early girls of
16 can have it they stay disabled for
the rest of their life well if we can
avoid it we significantly impact of the
quality of their life also on the
compliance they might have to the
treatment to the therapy but that’s true
for any therapy with the precision
medicine if you speak about impact on
the society well if we have less less
blood clotting we will have less
healthcare burden so healthcare will
become cheaper as well quality of life
will increase there will be less absence
time of work so we can in general bring
quality to society also for the industry
it’s very interesting because industry
can improve development process can use
such a test to test ahead of putting on
the market to fill to say well this pill
is less dangerous so I’m gonna use that
one also it can in specific cases
improve for instance intellectual
property for the companies who can
narrow down the application of certain
drug and then have their IP extended
even if we can do today a lot with the
precision medicine there are still many
challenges and I just want to share some
with you clinical utility when we
develop such a tools one shouldn’t keep
in one shouldn’t
lose from from sight that it has to be a
useful tool clinically useful so that we
can actually bring better life better
quality of life better care to patients
costs they are still fairly expensive
treatments but the process is getting
down with the technology development and
hopefully one day precision medicine
should be accessible to every single
person on the earth understanding
probabilities that’s very important if
you don’t understand probabilities you
can’t match the expectations and I’d
like to come back to one of the talks we
listened this morning saying well if I
give my DNA then my genetic information
will be available to my insurance
company and my insurance company will
increase my do that I have to pay and
everybody gets scared of it but actually
you have to understand that no progress
will come if we don’t give anything if
we just are scared of everything so if
we scare people all the time about the
insurance then people will refuse for
instance a treatment that can increase
their quality of life or save their
lives
so everything actually for me is in
acceptance and to have acceptance we
have to have education everything is
about the education explaining to
everyone what it is really about what do
they give so that the people can
actually impact through their acts on
legal decisions and on the ethical
decisions thank you very much [Applause]
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