Welcome to tech Stuff. This is the story, and today I'm here with Cara Price. Hey os Hey, Cara. This week's story is one that is quite personal to me, and it has to do with the technology that we use to detect and treat cancer.
You know, I think cancer is unfortunately one of those things that many people have confronted. Even if you have never received a cancer diagnosis, many people have watched loved ones struggle to overcome the disease.
That's right, and my parents separated when I was very very young one. In fact, my parents are sort lived in different countries, so I was often shuttling around between them in the company of a nanny who was essentially a third parent, and she unfortunately got with breast cancer that was detected too late. She had a double mistectomy, but the cancer already metastasized and she died. And it's one of the great sadnesses of my life.
In fact, I'm sorry to hear that, you know, it's unfortunately an all too common story.
Absolutely. So I got connected with this guy called Andre Zor a few months ago, and he's a biochemist and also the co founder of a company called Loomis cell which is a company that's changing how cancer surgeries are performed. So I was pretty intrigued.
So can you just explain to me what is wrong with the way that surgeries are being done now?
Well, I was pretty surprised to hear from andre that cancer surgery isn't as precise as perhaps we might imagine or hope. He says that there's actually a fair amount of art to the science of detecting and then removing tumors in surgery.
I think it's one of those dirty secrets in medicine that people don't really realize. Cancer surgery is extraordinarily imprecise, and even the best surgeons in the world will miss cancer because, contrary to common perception, cancer cells are really not that.
Different from normal tissue.
It's very difficult to tell in real time during a surgery, with everything going on, where does the tumorand and the healthy tissue start.
In fact, Andrei told me that the best cancer surgeons are considered the best because they're so good at detecting where the cancerous tissue ends and where the healthy tissue begins. This is through a process called palpating, which is basically a fancy way of saying feeling out by touch, the difference between healthy cells and cancerus cells.
I've been there, and I've tried, and I can't feel a damn thing. It's not something that the untrained fingers are able to detect. But all of the world's best surgeons is able to tell whether there's cancer left behind by pile paiding around where the primary tumor was and deciding in real time whether more tissue needs to be
taken out or not. But most cancer surgeries are imperfect, and on average, if we look at all cancer surgeries, thirty to forty percent of the time, thirty to forty percent of the time there will be cancer left behind, not on purpose, unintentionally.
That seems like a high percentage.
Yeah, I mean, of course, is not to say that cancer surgery is ineffective. Alongside drugs, these procedures have saved millions of lives in the past few decades. Andrew thinks we can do better and save more lives, and so he set out to solve this problem, and his company has now created a technology to more precisely detect cancerous tissue. It's called Loomis cell, and so far it's being used to treat breast cancer patients. But Andre doesn't want to
stop at just one type of cancer. He wants to treat them all, and he has a deeply personal reason to do so. He told me that he watched one of the women who he loved most in his life, a woman he grew up with, suffer from an unsuccessful avarian cancer treatment. Andre tells it best, So here's the rest of our conversation. And I've lived through the tragedy of an unsuccessful cancer treatment, and so of you, and I'm wondering if you could tell that story.
It was one of those incredibly sad stories that her cancer was called relatively late. It was a varian cancer, and he was a varian cancer that had metastasized to.
What we call the peroneal cavity.
That is the cavity where all the reproductive organs of the women are, as well as several other Bible ord And there is really no way to identify where cancer has metastasized in the peritoneal cavity other than palpating around and trying to figure out where the cancer is. And unfortunately, more often than not, they failed. The vast majority of times they failed.
What was the name of the friend that you lost.
Her name was Monica.
If I remember from our last conversation, though, you really lived through the journey with Monic current and you may have promised to her, I think before she passed away.
Yeah, it was one of these things that you never forget, you know, we went through this journey together.
She was in Mexico at the time I was here in Boston, and so.
Because I was privileged to work with a lot of top physicians in the field, I was able to put her in contact with some of the best doctors in the varian cancer and you know, the incredible team at MD Anderson was able to extend her life by almost nine months, which is unheard of or a stage four over a cancer patient. She had just had a baby, Emilia,
who unfortunately grew up not knowing his mom. Her doctor, David at m D Anderson said, look, we're at the end of the line here, We're done here, and she needs to find peace on the fact that she fought with all her will, but it's time for her to let go. And so I flew to Mexico City and the whole family was there and we're talking, and you know, she was making jokes, and then at some point we were left alone and she said, I don't understand the
why why aren't we doing better? Why is in the field doing something that will give women like me who just gave birth to beautiful, healthy baby, the opportunity to leave longer to do something with our lives. Why why aren't you doing more? And I said, well, you know, it's a combination of factors where she's like, look, I don't want to hear you have to promise me, and I did that you're going to do everything in your power, everything you can to make sure this doesn't ever happen
again to another woman. That when a woman gets diagnosed with a variant cancer, breast cancer, correctal cancer, whatever it may be, and they tell her that she needs to go to surgery, that they're not going to tell her at the end of the surgery what they told me, which is there's some cancer left behind and you have weeks to leave. You have to promise me that you're going to do everything in your power and you're not going to rest until you have figured out a solution
to this. And I did. I, you know, held her hand in mind, and I said, I promise you.
I will do that.
She passed away a few weeks later. We didn't discuss this ever again, and you know, it was kind of stuck in the back of my mind for a couple of years. So I was like, Okay, well I made this promise. And then you know, I met my co founder David. He had just lost his wife to breast cancer, and I saw the opportunity to partner up with.
Somebody who was as heart and as deeply.
Moved by the fact that we can do better by these women, that we can't do better by their families, and you know, we have the power to do something to change it.
And so that's how a fifteen year journey started.
Fifteen years almost to the date. Let's talk about what is loumicell, What does it do, how does it work.
What we know is that if you catch cancer early, surgery can be curative if you get all the cancer cells out, But most cancer surgeries are imperfect. When you do a breast conserving surgery, the problem is that thirty to forty percent of the time, the surgeon will inadvertently
leave cancer cells behind. So what loomicell does, for the first time in history is it gives the surgeons a guideline, a signal where they are able to identify in real time during the surgery whether there are cancer cells left behind or not. How well, you get a Nobel Price winner and you get a couple of really smart people from MIT, and you define the problem. And that's what
people from MIT do. They go and solve problems, right, And so in this case, Munjigu Weendi, Jorge Ferreer and David Leif they sort of joined me in this journey and said, all right, well, we need something that is extraordinarily safe, inexpensive that can be injected before surgery and will give surgeons the ability to make cancer cells illuminate, be fluorescent under normal light.
Only it's purple light.
And so the surgeon will switch off the big lamp that you see on the ceiling on the operating room, and the device that we use has purple light coming out of it, and when it hits the cells that are cancers, those cells fluores back and can be detected and displayed on the screen so the surgeon can take action immediately. The way it works at the molecular level is proteins have a function, and if you can tailor
protein function you can make some real magic happen. And so what we do is we take advantage of a protein that is abundant in cancer cells. It's a protein that cancer cells use to cut tissue that is surrounding the tumor. One of the most important features of cancer is that it destroys its environment so that it can grow.
Otherwise it just doesn't grow right.
And so we detect that protein by providing it something too cut. And when it cuts that substrate that we provide, that's when light happens. Think about one of those little sticks that you use, a glow stick, right that when you crack it, it emits light. Well, the same but at a molecular level. When you crack this little mini glow stick, and the only way to crack it is by a protein that is primarily expressed in cancer cells, it gives you a luminous signal.
So you're injecting a substance into the patients, which you know that the cancer will destroy. When it destroys the substance, it emits this light, which is visible under purple light. Correct well, and where are you on delivering on that promise?
So we were incredibly fortunate that the FDA approved this product last year. Hospitals started using it in the first quarter of this year, and it's being used now at several hospitals across the US.
Stanford was the first adopter.
There are three surgeons at Stanford that are essentially doing every single cancer surgery that they do using the Loomi cell technology.
Breast cancer surgery or beyond breast cancer.
Breast cancer.
At this point, of course, the journey will continue for a long time because I'm not going to rest until we are successful in a varian cancer.
Ovarian cancer.
Unfortunately, in the list of difficult cancers to treat, ovarian cancer is kind of at the top of one of the hardest ones to treat, right up there next to brain cancer and so on. And so right now there's trials on going on sophageal called recto prostate cancer and so on, and eventually we will get two complicated things
like brain cancer and varian cancer. But to know that patients are going in big academic cancer centers like Stanford and relatively small regional hospitals like Baker in Florida, and patients are going in there and they're leaving the surgery room and the doctor is saying we got it all. And when they say we got it all, before they had a seventy percent certainty that they got it all based on our clinical data. Now they have like a ninety eight percent.
Certainty that they did in fact get it on.
What did it feel like to watch the technology being deployed for the first time?
You know, you can never get over the loss, especially the loss of somebody as incredible, as beautiful, as full of energy and love and life as Monica was. There's nothing that will ever substitute for having her around. There's nothing that will fill that hole. But to fulfill a promise that it's made under those conditions is one of the most gratifying things that you can do in life, right, because it's not an empty promise. This is not going
to benefit hurt, It's not going to benefit me. It's going to benefit hopefully millions of people.
Who who get the news that they have cancer and that they need to have surgery. That is unique.
And while it doesn't make up for the loss of somebody that you love, the fact that you got fifteen years worth of disappointments and failure and restarts and falling down having to get up again, because you have this energy that is propelled by the problems that you made. I don't think that there's any other motivation that is as strong as that. It is that kind of energy that's like I can't quit. I don't have the right to quit ever.
Zooming out a little bit to the wider field of technology and cancer, I mean, you laid it out, I think very well. Which is better detection allows for earlier intervention? Obviously? You know nowadays in the US, one and eight women are expected to be diagnosed with breast cancer at some point in their lives, but the mortality rate has been in steady decline. Where are we on the bigger picture
of beating cancer? I mean where there was an article in the New York And not too long ago about how detection is getting better but doesn't necessarily mean better outcomes. There's a lot of excitement around you know, AI, personalized drugs. You know, taking a step back, what is the state of the nation, of the wider field of technology's ability to kill cancer?
You're right to take a wider view, right, We're going to live longer.
And most mechanical things we will be able to fix, including the heart, which at the end is a mechanical pump. So cancer is the ultimate frontier if we continue to improve our health as a society or be sitting the US notwithstanding because that's a problem. But you know, if you look at the rest of the world, people are living longer and longer, and cancer is becoming the primary cause of death, and so at some point we have to address this in a much more efficient manner than
we are today. We have some wonderful drugs, and I'm not against drugs at all. In fact, some cancers there's nothing you can do surgery wise, and you have to use drugs. So we are making significant advances and eventually we will find drugs that are highly specific that are going to be able to target cancer cells in ways that we couldn't imagine ten years ago without the side
effects that we used to have with raw chemotherapy. But I believe and I think most physicians will agree that surgery will remain the front line way to deal with cancer for the simple fact that if you have to kill cancer cells, it's better to kill less cells, and the more you can get out of the body, the less cells you have to kill later on. And if you can ensure that you didn't leave any cells in the primary tumor site, then you're going to be better off.
And there's no question about that. So my prediction is we will see cancer quote unquote end within our lifetimes.
That's a big prediction.
I think it's going to happen.
I think our understanding of biology, the biology of cancer over the next forty years is going to get us to the point where we can address cancer very very effectively through a combination of surgery and incredibly targeted therapies.
How big a role do you think lo Miiselle could play in that.
I think lou Miisell will become the center of care for cancer surgery for all cancers. I do believe that we do. In the US, we do about a million to two million cancer surgeries every single year. That's across all cancers. Breast cancer is one of the highest ones, with three hundred thousand surgeries a year. I would say that this year we're probably going to do a couple of thousand surgeries, and then that is going.
To grow pretty quickly from there. So right now we.
Are in either full use or testing at about a dozen hospitals in the US. We expect to be in about twenty to thirty hospitals by the end of the year, and the projection for the following years to be at.
About one hundred health centers across the United States.
And if lou Misselle doesn't become the standard of care for cancer surgery, why will that be What would have happened, would have.
Gone wrong, because somebody will come up with a better solution and that will.
Be a happy day. Technology is only as good as technology is good. Right. We all used to use AOL At.
One point, I still have a Yahue email account, and I may be one of the only ones left. And then technology got better and everybody moved to something else, and that's entirely fine.
That's what we want. We want to create ever rising bars.
So that people get over them. We don't create barriers so that people can't get over them. We create barriers so that stronger will.
Prevail after the break. How Andrea is working to improve another industry, our food system.
Stay with us.
I'd have to know a bit more about you and what brought you to the field of biotechnology.
You know, I grew up in Mexico City, not really knowing what I wanted to do.
With my life.
I always thought I wanted to be a doctor. I had the opportunity, after finishing college in Mexico to come to Boston and become.
A part of M I. T. And Harvard, which.
Opened up an entire new universe of of what could be done with biology. Very early on, I got interested in a very specialized field, which is how proteins, which of course are the building blocks of nature, how their structure relates to their funk. And it opened up a brand new universe to me that I was just not aware of that. You know, all these little, tiny, microscopic machines regulate everything that happens in nature in an incredibly
powerful way. And so the more I learned about that microscopic biological world, the more.
I wanted to know.
And then, of course, you know, I learned that they could be used to cure disease, which is what I wanted to do all my life. You know, growing up in a lower middle class household, my mom was teacher,
my dad worked in construction. You know, you're kind of wondering what am I going to do with my life, And there was always this desire to try to help other people, and I really didn't know how, and so this universe that opened up before my eyes gave me an opportunity to say, if I can figure out some of this very unique processes that happen in our bodies at a microscopic level, I could help cure disease. I could help make a better life for people. And that was just incredible.
When green Light Biosciences, your other company, was publicly listed, you talked about having two missions in life. One was quote the ability to provide solutions for healthcare, which we've discussed. The other was to grow food sustainably and cleanly, which we haven't discussed yet. This also begins with a personal story.
Yeah, and that personal story is a lot cuter because of course nobody died, but it also involves My favorite person in the world was my son Alex. And Alex had something that you know, I think a lot of parents will relate to, which was Alex didn't need a lot and he was super thin and losing weight, and a lot of the things that we would feed him would make him sick, and we were just like racking our brain trying to figure out what the hell was going on. Like one of the only things he would
eat was bananas. He would eat bananas all day long. And I remember my mom being like, let me bananas is you know, when have you ever seen a you know, a sickly gorilla and only it is bananas.
They don't only eat bananas or whatever. But you know, it made sense because bananas are protected.
They have this incredibly strong peel that protects them from basically everything that is outside. And so one of the things that would make Alex really sick, for example, would be strawberries, and we couldn't figure out why. My wife, who is not a scientist, eventually figure it out that it wasn't the strawberry itself, or the salary or the carrot or whatever, it was whatever chemical leftovers where on that particular food. Chemical synthetic pesticides were the.
Biggest s culprit.
There were others, like some of the colorings would make him fairly anxious, but what would make him really sick would be And we later identified a class of insecticides called organo phosphates.
Of phosphates.
If you google or akin of phosphates, they're nerve agents. Most famous or kind of phosphate of all times sarrying gas. So here's human wisdom in full display for you. We take a nerve agent that was used to kill people, millions of people, okay, and we chemically modify it, and we to solve it in water and dilute.
It down, and then we spray it on.
The same foods that we're going to feed our kids. And so what I discovered is that we use thousands of chemicals, none of which are particularly safe or specific or bio degradeable or clean, and that if we don't use them, by the way, we would lose seventy to eighty percent of our food. So it's all like we have an option. So a lot of people will tell you, ah, it just short, all should just go organic.
Okay, Well, then we're going to need another eight planets to.
Feed the soon to be ten billion people that we have on this planet, and there's no room for that.
In fact, thirty to twenty.
Percent of our food gets destroyed on the farm before we have an ability to harvest it. That's an insane number. It's billions of metric tons of food that get destroyed by pests because we cannot control them with the chemicals we.
Have, because they've become resistant.
Because most of the bogs have become resistant to the chemicals we have, and so there came another impossible idea, right, which is, okay, well, let's replace those chemicals with something that is here's a list of stuff that we have to come up with. First of all, cheap, because you know, farmers are the engine or society. They already don't make enough money. We can't give them something that's going to be three times the price of what they're paying today.
That's just not going to work. So it's got to be inexpensive. It's got to be potent, because they're not going to sacrifice their yield. In fact, it has to be more potent than the chemicals they're using today so that they can recover more of their food.
But it has to be one hundred percent safe.
It cannot affect the environment, It can't affect beneficial insects, can't affect pollinators, it cannot affect obviously human health, and it cannot accumulate in our food because otherwise it'll end up in our kids.
And so, you know, that's the list of things that we had to come up with.
And it's kind of interesting when you put a list of features that is that impossible you eliminate a lot of things really really quickly, and the only thing that was left was this wonder molecule called right on nucleic acid RNA. And so it turned out that RNA was at that point we thought would be, and now we have proved that it is the solution to a lot of those problems.
RNA has become famous since the COVID pandemic as something that you can inject to in a sense, change the DNA of an organism, in our case humans. Is that is that a fair assessment?
Incorrect? Okay? The messenger on a Vaccines do not change the DNA. First.
Now, RNA acts in two ways, right the way in which we all know, which is the way we learn in high school, which is our DNA gets transcribed into RNA, So the RNA is a faithful copy of the DNA. That RNA then gets read by a ribosome and it gets translated into a protein. That's the machinery of the body. DNA goes to RNA, RNA goes to proteins. That's what
we learn in high school. What we didn't learn in high school is that there's another function of RNA, which is a function of interference, and that means that there are RNAs, they're called small interfering RNAs whose job is actually to silence down some of the messenger RNAs that are not needed. So why is that, Well, imagine that your body says I have too much of this messenger RNA, that I don't need it.
I don't need more.
Insulin or more growth RM or more cortisol or whatever it.
Is that your body is producing at the time.
And so what your body does is then it produces this small interfering RNase to suppress the excess messenger RNA that is out there so that you don't end up with an overproduction of a protein.
So now you can take that tool that is natural. It's nature. We're using nature. We're not using something artificial. This is a natural pathway.
But what you're doing, instead of saying we're just going to suppress the excess messenger in a you can say I'm going to suppress all of the messenger RNA that leads to the production of something that is vital to a fungi or a weed or an insect. Now, the best part about this is it won't work on vertebrates.
It won't work on fish, birds, humans, cats, dogs. So because we have this built in protection, it is quite literally impossible for our products to have any impact on human health or the health of a whole bunch of organisms.
The best part, however.
Is that you can finally tune the sequence of that RNA to only affect the pest that you're interested in affecting and nothing else, and you can be extraordinarily specific in that sense.
Let me give you an example.
Our very first product is an insecticide against something called the Colorado potato beetle.
It's just a beetle.
It's about yay, big, has big stripes on its back. Another beetle that you should be very familiar with is the lady bog. The ladybug is in fact a beetle, and it is very closely related to the Colorado potato beetle.
They are like first cousins.
If you apply any chemical synthetic pesticide that will kill the Colorado potato beetle, you will likely destroy the ladybug.
Colonies that are in your field or in your.
Surrounding areas and so on. Okay, because they're so closely related that anything chemical that will impact the potato beetle will impact the lady Our product is designed to affect the Colorado potato beetle without having any impact whatsoever on the ladybog, even though they share like ninety five percent of their genes. We can tailor we can fine tune our RNA to kill one and not have any impact whatsoever.
On the other one. And not only the ladybug is faired.
Honey Bees, butterflies, earthworms, et cetera, et cetera are not affected by this RNA because this RNA specific to the gene that exists in the potato.
Beet And where's it being used today?
This product right now, it's the number one selling product in potatoes in the US, and so it's approved in the US. It's now its sales have now surpassed the sales of all of the leaning chemical pesticides in potato fields treating the Colorado potato beet So in two years we became the market lead and we're incredibly happy with its performance.
Now, you said a moment ago that is not GMO, But there have been some criticisms that in a sense, my releasing this biological agent and effecting the internal mechanism of these insects that you're in essense to playing god or intervening in nature in a way that's kind of could have unpredictable consequences. How do you respond to some of those criticisms.
I love that question because like, oh, you're playing God. No, no, no, We've been playing god for one hundred years. Agriculture is not the natural state of planet Earth.
It's a human invention.
Look, we scientific community have the responsibility to be extraordinarily transparent about the mechanism of action, about the testing that's been done, about how we've done it, about why we feel so strongly that our products are safe and effective and better for society and for nature than the products that we're replacing. So, if we're going to sustain ten billion people on this planet, we need industrial agriculture. It's
no way around it. And if we're going to do that, it's much better to spray something that is highly targeted, that is safe, that is a natural pathway, that is bithgradable, that does not accumulate raise some chemical that is derived from oil that is going to drill a hole or destroy the brain of every insect that it comes in contact with. If I had my choice, I would move to a different planet, and I would keep the population low and we would all leave off the land.
Okay, that's not a choice we have.
And we have a responsibility to another nine billion humans to provide them with clean, inexpensive, sustainably grown food. That's the state of reality. I love people who argue that society's gone wrong. Okay, great, we know all right. It's not our responsibility to bitch and wine about it. It's our responsibility to fix it.
We like bold predictions on this show. You have one very bold prediction earlier about effectively curing cancer within our lifetimes. What's your bold prediction for where this RNA technology might lead us within our lifetimes?
Well, I think green Light is going to have dozens of products in the market.
I think that we will provide tools to farmers in every continent, will allow them to add more tools to their toolkit to deal with destructive bests.
What I can't tell you is if other companies will follow.
Suit and come up with other biological solutions that are as good as effective.
As ours are.
My hope is they will, because farmers need them. Chemicals are on their way out, whether we like it or not. They are just not working anymore.
You opened this conversation talking about growing up in a middle class house in Mexico and with Monica got very sick. She said to you know, we didn't send you to Boston for no reason. What do you think that your global perspective? I mean, the fact that you grew up in Mexico brings you as a technologist.
Yeah, it's really interesting and it's hard not to get political about this.
But disease knows no boundaries.
Disease in any form, whether it's human disease, plant disease, crop disease, animal disease doesn't care about the lines that we humans have artificially painted on maps.
They don't care about what rays you are. Cancer affects every race more or less equally. They don't care whether you were born in the US or not. It's global.
We are fighting global battles, and we are increasingly using local armies. Can't find a global battle using local armies.
You need to be global.
You need to make the tools that you have affordable and accessible in the US to everybody. It is the right thing to do. It is the only way in which you can achieve global equilibrium. We have people from one hundred countries working at Greenland, and we're only three hundred people.
Science is not Science is global.
No matter what religion you are or what political system you subscribe to, it is our responsibility to think globally because these global problems affect us all. And so my mission has always been from day one to make all these solutions, whether it's in cancer, whether it's in our ability to grow food global.
Andrew, thank you, thanks my pleasure, Thank you so much.
For tech Stuff. I'm as Valoshian and I'm Kara Price.
This episode was produced by Eliza Dennis and Adriana Tapia. It was executive produced by me Ozwaaloshan and Kate Osborne for Kaleidoscope and Katrina Norvell for iHeart Podcasts. Jack Insley mixed this episode and Kyle Murdoch wrote our theme song.
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