从乐谱到肿瘤学交响曲——First Ascent Biomedical

欢迎回到《医疗创新播客》的又一期节目。

Welcome back to another episode of the Medical Innovation Podcast.

我们今天依然在健康领域继续探讨。

We're still still here at health.

我特别期待和来自First Ascent Biomedical的吉姆·福特聊聊。

I'm really excited to talk to Jim Foote from First Ascent Biomedical.

吉姆，很高兴你能来。

Jim, really great to have you.

是的。

Yeah.

能上你的节目真的很荣幸。

Great to be on your show.

你当初联系我的时候，我特别兴奋，因为我一直对肿瘤学有临床兴趣，再加上最近新任NCI主任安东尼·拉塔伊博士上任的消息，更让我觉得意义重大。

When you first reached out, you know, I was I was really excited because I'd actually, you know, I have clinical interest in oncology, and because recent announcement, we're with the new NCI director, doctor Anthony Latai, who was appointed as as NCI director.

没错。

Right.

他的核心工作和毕生事业都是在功能精准医学领域，尤其是癌症治疗方面。

His foundational work and his life's work is in functional precision medicine, particularly in oncology.

所以他被任命的时候，我就想，得赶紧看看，这到底是什么科学，他在搞什么名堂？

And so when he was appointed, I was like, gotta read it and see, like, what's going on with this what what is this science that he's that he's doing?

我开始去了解，发现真的特别有道理。

And I started reading about it, and it it just made a lot of You know?

我们可以详细聊聊，不过还是让你来介绍吧。

I we we can talk a little bit in detail, and maybe I'll I'll let you do that.

但就在那之后不久，我听说了First Ascent Biomedical这家公司，顿时豁然开朗——原来如此。

But when then I heard about, you know, First Ascent Biomedical shortly after that, it was really enlightening because I I saw, okay.

这就是研究人员已经验证过的、用来提升治疗效果的科学方法。

This is the the science that the researchers are have have established to improve treatment.

对。

Right.

现在终于有公司把这套经过验证的基础研究，真正应用到患者治疗中了。

Now we have a company that's using the foundational research that's been validated to then deliver treatments to patients.

我觉得这真是一个绝佳的例子，展示了基础研究如何真正转化为对患者的临床应用。

So I just I thought that was an incredible example of of of the translation of of really fundamental research to applications in patient care.

没错。

Absolutely.

确实如此。

Yeah.

有趣的是，拉泰博士、黛安娜，还有我们的联合创始人阿扎姆博士，曾经一起在功能精准医学学会共事。

So interestingly enough, so doctor Latai and Diana, doctor Azam, our cofounder, actually served together at the Society for Functional Precision Medicine.

当然，拉泰后来担任了国家癌症研究所的职务，就不得不退出了那个职位，但我认为这恰恰说明了肿瘤学未来该往哪个方向走。

Now, obviously, LaTay had to recuse himself from that position when he took on the NCI, but I see that as a really strong signal specifically around where oncology needs to head.

说到底，过去一百年来，我们一直沿用标准治疗方案。

You know, the reality is we've been treating patients under the standard of care for the last hundred years.

这些方案都是基于长期积累下来的平均数据。

It's based off of averages that are built over time.

可到了2025年，尽管药物和技术这么发达，美国仍有三分之一的癌症患者最终离世。

And in 2025, you know, with all the drugs and all the technology, one in three cancer patients in America still die.

全球有百分之五十的癌症患者会因此去世。

Fifty percent of cancer patients worldwide will die.

癌症将成为儿童因疾病死亡的首要原因。

They'll be the number one killer of children by disease type.

看看我们如今手头拥有的各种工具和技术，这正是功能精准医学真正发挥作用的地方——因为直到最近，我们还无法以可负担的成本大规模开展这项工作。

And you look at all the tools and technology that we have at our fingertips And that's where functional precision medicine I think really comes in because up until recently, we couldn't do it at scale affordably.

现在，随着人工智能、云计算、机器人技术和基因组学的成本大幅下降，我们终于能把这些技术整合起来，以低廉的价格为患者提供精准治疗。

And now with the advances in AI and cloud computing and robotics and genomics getting so inexpensive, we can actually bring all of these solutions together and be able to deliver this to patients' precision at a very, you know, affordable way.

所以，我认为现在是个令人振奋的时刻，而利塔医生的任命，至少在国家癌症研究所层面，明确传递了肿瘤学未来的发展方向。

So, yeah, so I think it's an exciting time, and I think, you know, the appointment of doctor Littay is a very strong signal of at least at a NCI level where they really had intend to head from an oncology perspective.

是的。

Yeah.

我们就不深入技术细节了，但或许可以简单介绍一下功能精准医学的背景。

And not getting too into the weeds, but maybe a little bit of background on functional precision medicine.

如果你觉得我说得不对，尽管纠正我，我的理解是，它指的是你有一个肿瘤。

And and if you like, correct me when I'm wrong, but my understanding is it's this concept of you have a tumor.

对吧？

Right?

你得了癌症，不管是什么类型的癌。

You have this cancer, whatever cancer it may be.

针对这种癌症，通常有好几种治疗方法。

There are multiple therapies that are used for that particular cancer.

没错。

Yep.

好几种标准治疗方案。

Multiple standards of care.

就拿胰腺癌来说吧。

Like, think about pancreatic cancer.

比如，你可以用FOLFOX方案。

You know, you can do, like, FOLFOX.

也可以用奥沙利铂方案。

You can do, you know, oxalapod.

你可以用多种不同的细胞毒性药物方案。

You can do multiple different regimens of cytobine.

通常来说，医生更倾向于用哪一种？你一般会选哪个？

And oftentimes, it's just like, one are they more apt to, or, like, which one does the physician you typically reach for?

其实并没有固定的做法。

It's not really a particular approach.

但这时候，你会取这个肿瘤样本，然后去测试，看看。

But this is where you take that tumor, and then you target, okay.

这个肿瘤对不同化疗药物的反应怎么样。

Let's see, like, how this tumor reacts to different chemo.

没错。

Right.

哪种化疗效果更好，就让患者用那种治疗方案。

And whichever chemo has a better response, well, let that let's put that the patient on that therapy.

就是这样。

That's exactly it.

这挺有意思的，因为它又回到了我们医疗工作中一个非常基础且常用的环节，也就是微生物学方面。

It it's interesting because this this ties back to a very fundamental thing we do all the time in medicine, which is in microbiology.

对吧？

Right?

当我们考虑到这一点时，好的。

When we think about, okay.

我们面临这种感染。

We have this infection.

我们来做个样本。

Let's do a sample of it.

所以我们会培养那些正在生长的微生物，然后做药敏试验。

So we grow the culture of whatever micro bi microorganisms that are growing, and we'll do susceptibility testing.

比如，这些细菌对哪些抗生素敏感？

Like, what antibiotics are the bugs susceptible?

这种情况很少见。

It's rare.

然后根据结果给病人用药。

And then you treat the patient with those.

这其实是一个非常基础的科学原理，我觉得它已经融入了多种医疗实践。

And so it's like a very fundamental scientific principle that I think has been tied into multiple actions.

确实如此。

It is.

而且你知道，全球有八十亿人，这是事实。

And it's you know, it's based on fundamentally, there are 8,000,000,000 people on this planet.

通过基因组测序，我们知道每个人在生物学上都是独一无二的。

We know by mapping the genome that every one of us biologically are different.

没错。

Right.

既然我们每个人在生理和基因上都不同，那为什么还要用平均值来治疗病人呢？

So if we're biologically different and genetically we're different, then why would we use the laws of averages to treat patients?

如果你、我、他，虽然得了同样的癌症，但标准疗法却给所有人开一样的药，这合理吗？

If you're different and you're different and I'm different and we all got the same cancer, the standard of care would give us the same treatment.

但你看看我们自己。

But look at us.

现在，治疗会根据我们的年龄和体重有所不同。

Now, the treatment would vary based on our age and our weight.

但如果我们都是前列腺癌，还是会用同样的药方。

But if we all got prostate cancer, cancer, we would all get the same cocktail.

从根本上说，我们在种族和基因上都是不一样的。

And, you know, fundamentally, racially, genetically, we're different.

是的。

Yeah.

所以，这就是功能性精准医学的真正意义所在。

And so that's really where functional precision medicine comes in.

举个例子吧，因为这事确实容易让人混淆，连很多医生都会说：你知道吗？

You know, the one of the illustrations because it does get confusing, lot of even physicians will say, well, you know what?

我们已经在做功能性精准医学了。

We're doing functional precision medicine.

我们会做DNA和RNA测序。

You know, we do DNA and RNA sequencing.

弄清楚哪些基因存在，哪些是活跃的。

We find out what's, you know, what's present, what's active.

我们还会开发生物标志物。

We do biomarker development.

然后把药物和这些标志物匹配，再用药物精准靶向。

We map a drug to that and then we use that drug to target.

这还是在尝试和等待效果。

That's still trying and hoping.

而功能精准医疗真正带给你的，是先测试、再治疗。

And what functional precision medicine actually gives you is testing and treating.

对。

Yeah.

提前就知道哪种方法有效，然后根据已知有效的方案来治疗。

You know what works in advance and you treat based on what you know works.

我常举的例子是，我们都去过交响乐演奏会。

The the illustration I always give is, we've all been to an orchestra.

对吧？

Right?

DNA和RNA就像乐谱上的音符。

DNA and RNA is like the music letters on a sheet of paper.

这就是DNA和RNA。

That's DNA and RNA.

而功能性精准医疗，就像是整个乐团协同演奏，创造出美妙的音乐和谐。

The orchestra is functional precision medicine coming together and creating an amazing harmony of music.

而指挥家就是人工智能，它会实时调整，根据房间的声学特性、空气密度、湿度等各种因素做出反应。

And the conductor is AI, changing in real time, you know, based on the harmonics of the room and based on the density of the air and humidity and all of those types of things.

当你能把这一切整合起来，才能真正对人们的生活产生巨大的改变。

And when you can bring that all together, that's when you can make really dramatic differences in people's lives.

这说得通。

That makes sense.

我觉得，对于癌症患者来说，每一天都至关重要。

I think, in oncology patients specifically, every single day matters.

越早开始有效的治疗，患者存活并战胜癌症的机会就越大。

The earlier you start treatment, effective treatment, the more likely that patient has a chance to survive and beat that cancer.

没错。

Exactly.

如果你一开始就像你说的，用那种通用的前列腺癌治疗方案，或者其他什么常规组合，那可就浪费了好几个月，甚至好几年的时间。

If you start off with, like you said, a common cocktail for prostate cancer, or whatever it is, you're wasting those several months, sometimes even years Right.

只是在给无效的治疗，等着根本不会出现的结果。

Just giving ineffective treatments, waiting to see a result when it's not gonna happen.

对。

Yep.

如果能尽早做检测，弄清楚哪种治疗组合真正适合这位患者和他的肿瘤，就能

Being able to test early on and figure out what cocktail would actually work for that patient and their tumor allows you

尽早开始有效的治疗， hopefully 帮助他们摆脱病痛。

to start effective treatment and hopefully help them get it.

这正是核心所在。

And that's really the idea.

我的意思是，如果真有魔法棒，我觉得——当然不是我来决定——但功能性精准医疗应该在初次确诊时就立即应用。

I mean, you know, if I had a magic wand, I believe and and again, not my but I believe, you know, functional precision medicine approach should be applied upon primary diagnosis.

当然，标准疗法确实存在，它做得很好，为社会带来了巨大帮助，挽救了无数生命。

You know, understanding that again, the standard of care exists and it's been great and it served society amazing and it saved you know.

我们也不能让美国两万名医生都变成疯狂的科学家，各自捣鼓出不同的治疗方案。

And we can't have, you know, 20,000 doctors in America all being mad scientists and trying to cook up their own cocktail.

这绝对不行。

We we can't have that.

对吧？

Right?

那样太危险了。

That would be unsafe.

但与此同时，如果我们真想显著提升疗效，就得停止那种基于癌症在体内位置来选药的百年老办法。

But at the same time, if we want to dramatically improve results, we've got to stop giving drugs based on where they find the cancer in your body, a 100 year old practice.

我给你举个完美的例子。

I'll give you a perfect example.

在乳腺癌中，有一个叫HER2阳性的标志物。

In breast cancer, there's a marker called HER2 plus.

你们都应该听说过这个。

You guys are all familiar with it.

有一家药企开发了一种叫曲妥珠单抗的药。

There is a drug company that has created a drug called trastuzumab.

曲妥珠单抗对HER2阳性的乳腺癌患者效果非常好。

Trastuzumab is very effective at treating breast cancer patients that are HER two positive.

每年有八万两千次使用，效果非常显著。

They dispense that drug 82,000 times a year, very, very effective.

但如果你是那500个HER2阳性膀胱癌患者呢？

But what if you're the 500 bladder cancer patients that are also h r two positive?

他们没法用这种药治疗HER2阳性的膀胱癌，因为这药从来没获批用于这个适应症。

They can't get that drug to treat for that h e r two positive bladder cancer because it's never been approved for that indicator.

我觉得，这里其实有个机会，可以重新思考我们目前的做法——如果你有一种药，而且有公开发表的科学证据证明它有效，不只是我一个人的研究，还有很多公司都发表了经过验证的可靠数据。

And that's where I think, you know again, there's an opportunity to you know, kind of reimagine the way that we're doing it and saying, if you have a drug and you have evidence that that drug is effective based on a published technology, again not just mine but there's lots of companies out there that have published, validated, verified scientific evidence.

只要你满足这两个条件，再加上有认证的肿瘤科医生愿意开这个药，那这个药就应该能给患者使用，依据的就是这些数据。

If you meet those two criteria then giving that drug should, you know, if you have a board certified medical oncologist willing to give that drug, then that drug should be able to be given to that patient based on that, you know, that data.

明白吧。

Make sense.

这是我的看法。

That's my opinion.

对。

Yeah.

不，我说真的，这确实很有道理。

No, I mean, that that definitely makes sense.

我觉得可以再深入聊聊你们公司，比如你们说的‘功能精准医学’具体是怎么回事。

And I think it would be helpful to, like, talking a little bit more about, like, your your company, and, you know, we talk about the basis of, like, functional precision medicine, what it entails.

你们是怎么把基础科学研究转化成一家公司的？

How did you then take that those fundamental science, the fundamental research, and then turn that into a company?

你们在这些基础上具体做了些什么呢？

What are you building on top of those Yeah.

公司其实主要由三部分组成。

So the company was act or the so there's really three parts.

我们目前的工作主要有两个方面。

There are two parts of what we do.

一个是功能精准医学，另一个是人工智能。

We have the functional precision medicine side, and then we have the AI side.

好的。

K.

这套生物学方法其实是我们的联合创始人阿扎姆医生开发的。

The the biology was actually developed by our cofounder, doctor Azam.

她目前还在佛罗里达国际大学做癌症研究。

She's a cancer researcher out at Florida International University, still is.

正是她研发出了这套技术，让我们能够快速富集化疗耐药细胞和肿瘤组织，现在可以同时对数百种已获FDA批准的药物在这两类细胞上进行测试。

And she's the one that developed the biology that allowed us to rapidly enrich both chemo resistant cells and tumor bulk to the point now that we can test hundreds of FDA approved drugs against both cell populations.

我们根据药物的最大血药浓度和半数抑制浓度来生成药物敏感性评分。

And what we do is we generate a drug sensitivity score based on c max and I c 50.

我们会测试数百种药物，每种都用六种不同浓度，还有各种组合。

So we see what you know, we test, you know, hundreds of drugs at six different concentrations and in combinations.

由于我们的方法特殊，细胞培养速度非常快。

And because of the way that we do it, we rapidly culture.

你刚才提到过时间的问题。

You you talked a little bit about time.

我们培养细胞的速度非常快。

We rapidly culture.

整个流程大约需要十天，我们能在十天内给出结果。

It takes about ten days to do everything we can return results in ten days.

真惊人。

Oh wow.

我们实际做的不只是培养癌细胞，还构建了一个更复杂的微环境。

But what we're actually doing is it's not just the microenvironment we create is not just cancer cells.

里面还有基质细胞。

It's got stroma cells.

还有免疫细胞。

It's got immuno cells.

所以我们实际上在培养皿里复刻了人体内的微环境。

So it actually, we've emulated, you know, the microenvironment of the human body in a petri dish.

我们发表在《自然医学》上的研究显示，我们在培养皿中观察到的细胞反应，与医生给患者用药后的真实反应，吻合度高达85%。

And what we were able to show and publish in Nature Medicine is that there's about an 85% correlation between what we observe and how the cells respond in the petri dish and how the patient responds when the drugs are administered based on physician.

所以，就像阿尔文之前说的，你其实是在给癌症做药敏试验。

So, in a way, to Arvind's point earlier, you're sort of giving an antibiogram of cancer.

这是癌症细胞。

This is a cancer.

这些药物的效果最好。

These are the drugs that will work best.

没错。

Yep.

这会给整个事情带来另一个层面。

Well, it'll add another kind of dimension to this.

很多人根本想不到这一点。

A lot of people don't even think about this.

这位是我们的一位患者，EB13，来自我们的一项临床研究。

And this was one of our patients, EB thirteen, that was one of our clinical studies.

我们不仅能找出有效的药物，更重要的是，还能明确哪些药物完全无效。

And not only can we find the drugs that are effective, but almost as important, we show the drugs that are a 100% ineffective.

其中一些药物，实际上还是针对这种癌症的标准治疗方案。

And some of these drugs are actually part of the standard of care for that particular cancer type.

所以，Logan就是EV13。

So Logan was EV thirteen.

他患有白血病，做过骨髓移植，很快复发，之后就加入了我们的研究。

He had a leukemia, went through a bone marrow transplant, quickly relapsed, and he enrolled in our study.

我们很快找到了能让他的癌症再次缓解的药物。

We quickly found the drugs to put his cancer into remission again.

我们发现，他们原本打算给他用的那种药，完全没效果，还会毁掉他一辈子的心脏。

Well, we actually found that one of the drugs they were gonna give him was a 100% ineffective but it would have destroyed his heart for the rest of his life.

哦。

Oh.

他们停用了那种药，癌症很快就缓解了。

And they eliminated the drug, got the cancer into remission.

五年后的今天，他活得好好的，什么都能做。

He's here today five years later doing everything.

现在他应该十岁了。

Now he's, I think, 10 years old.

心脏一点问题都没有。

No heart disease.

也没有任何毒性反应。

No toxicity.

这恰恰是另一面。

Again, that's the other side of the coin.

我开始这段旅程的原因，是我有个儿子。

How I got started on this journey is I had a son.

他就是那些统计数据中的一个。

He was one of those statistics.

他得了骨癌。

He had bone cancer.

治疗骨肉瘤的方案，五十年来都没变过。

Osteosarcoma, the protocol for osteo hasn't changed in fifty years.

他接受了八个月的化疗，他们切掉了一段股骨，后来回来告诉我说，肿瘤全死了。

And he went through eight months of chemotherapy, know, they took a portion of his femur out and they came back and they said, it's all dead.

百分之百的坏死。

A hundred percent necrosis.

那是在化疗八个月之后的结果。

That was after eight months of chemotherapy.

可短短三个月后，他膝盖后面就长出了一个五英寸的肿块。

Within three months, he had a five inch lesion behind his knee.

你知道，这就是关键所在。

And you know, and that was the piece of the puzzle.

我实在想不通，怎么从百分之百的坏死变成膝盖后面长了个五英寸的病灶？

I couldn't How do you go from a 100 to a five inch lesion behind your knee?

正是这一点，让我开始了这段探索之旅。

And and that was the piece of the puzzle that's kinda started me on this journey.

当然，我看到的医疗体系是真心实意想救我儿子的命。

Obviously, you know, I saw a health care system that, you know, that were deeply committed to saving my son's life.

当时涉及的有医生、护士、医院网络、保险公司还有制药公司。

And this was doctors and nurses and the hospital network and insurance companies and pharmaceutical companies.

大家都在齐心协力推进这件事。

They were all working together to make it happen.

但他们手里没有我作为高科技行业高管那样随时可用的工具和技术来做决策。

But they didn't have access to tools and technologies that I had at my fingertips to make decisions as an executive in a high-tech industry.

所以，这就是我怎么走到今天这一步的。

So that's really kinda how I got, you know, to where I am.

但我认为，真正的机会在于利用这些信息生成数据，帮助医生更快地做出更准确的决策。

But I think that's really the opportunity is to use this information to generate the data to allow physicians to make better decisions faster.

没错。

Right.

这真的太惊人了。

It's incredible.

首先，听到你儿子的事，我很难过。

Sorry to hear about your son, first of all.

哦，谢谢你。

Oh, Well, thank you.

是啊。

Yeah.

我们每个人身边都有癌症的故事。

We've all got cancer stories.

说到底，这就是现实。

I mean, that's the reality of it.

但你其实是有选择的，对吧？

But, you you have a choice, right?

你打算怎么做？

What are you gonna do?

没错。

Right.

一旦你看到了那些东西，就再也无法装作没看见了。

Once you see what you've seen, you can't unsee it.

我的意思是，你们大概也都有类似的经历吧。

I mean, you know, you guys all probably have stories as well.

你做了一个播客。

You started a podcast.

你选择了另一条路，就是想说：算了，

You've taken a different path in your life to to say, you know what?

我想做出一些改变。

I wanna make a difference.

所以。

So.

对。

Right.

而且你们所做的工作

And the work that

让这一切成为可能，确实如此。

you do makes it all Exactly, really

我很好奇，你能跟我们多说说你们公司目前的情况吗？

I'm curious, can you tell us a little more about where your company is at right now?

你提到已经完成了五项试验，还有三项正在进行中。

You've mentioned you've done, I think, five trials, you have three more ongoing trials.

是的。

Yes.

你说‘试验’这个词不太准确，但这是目前对临床试验的通用叫法。

You said trial is not the best word, but it's what you have to call clinical trials.

是的。

Yes.

我们已经完成了三项试验，并发表了相关证据。

So we've completed three trials, published the evidence.

目前还有两项试验正在进行中。

We have two trials underway.

在我们发表于《自然医学》的证据中，我们发现，当我们的平台协助指导治疗时，患者受益的比例达到了百分之八十三。

In the evidence that we published in Nature Medicine, what we showed was when our platform helped guide treatment, patients benefited eighty three percent of the time better.

这些患者都是对标准治疗无效的晚期癌症患者，他们是在常规治疗失败后才加入我们的研究的。

Now these are all refractory cancer patients, so patients who failed the standard of care and then they enrolled in our study.

现在我们有两项临床研究同时进行，涵盖成人和儿童，涉及多种癌症类型，我们正在开始分析数据——当初我们公布的是百分之八十三，但实际情况会更好。

And so, we have two clinical studies going now, both adult and children, all cancer types and we're starting to look at the data and and you know, we published originally eighty three percent.

我可以告诉你，最新数据会比那个数字更好。

I can tell you the data is gonna be better than that.

听到这个真让人欣慰。

It's great to hear.

正在上升。

It's going up.

当时我们遇到的质疑之一就是，你们的患者数量相对少，这个比例却这么高。

And that was part of the skepticism that we got was, well, your patient count's relatively low so that number's pretty high.

等看到更多数据的时候，我们才会真正认真对待。

You know, we'll really get serious about it when you see more data.

我们还有三项研究在筹备中。

We have three more studies in the pipeline.

我们正在和一家保险公司洽谈，想为胰腺癌研究争取资金支持。

We have a pancreatic cancer study being, you know, that we're, you know, in discussions with an insurance company to fund that study.

哦。

Oh.

对，就是这样。

Yeah, exactly.

结直肠癌的研究由抗击结直肠癌基金会资助，因为他们真正想做的，就是帮助正在与癌症抗争的患者。

We have a colorectal cancer study funded by the Fight Colorectal Cancer Foundation because what they really wanted to do was help patients fighting cancer.

我们还拿到了佛罗里达创新基金，州政府给了我们两百万美元，用于让佛罗里达州内200名患者免费使用我们的平台。

And then we have a Florida Innovation Fund where the state of Florida gave our company $2,000,000 to help provide access to our platform for free for 200 patients in the state of Florida across the state.

你想想，说到死亡率，很多情况都是因为家庭负担不起去癌症中心的路费。

Because you think about, you know, when you start looking at mortalities, a lot of these mortalities exist because families don't have the money to travel to a cancer hub.

他们去不了纽约，去不了MD安德森，也去不了其他地方，只能在当地由医生尽力治疗。

They can't go to New York, they can't go to MD Anderson, they can't go to and so they get treated locally by the doctors who did the best they can.

我们做法的巧妙之处在于，活检样本在当地取完，直接寄到我们在迈阿密的实验室。

The beauty about what we do is we take a biopsy, it's taken locally, shipped to our lab in Miami.

样本必须在48小时内送达。

We have to get it within forty eight hours.

我们会测试上百种药物。

We test the hundreds of drugs.

找出哪些真正有效。

We figure out which ones work.

然后在临床可行的时间内反馈结果，这样患者就不用背负高昂的路费，也能在当地得到精准治疗。

We return results in a clinically actionable time frame and they can get treated locally without the financial toxicity of traveling to a cancer hub.

所以塞萨尼斯州长看到了佛罗里达创新基金的价值，给了我们两百万美元，帮助全州的患者。

And so that's what Governor Sesantis saw in the Florida Innovation Fund and awarded us $2,000,000 to help the patients across the state of Florida.

这太了不起了。

That's incredible.

对啊。

Yeah.

你又提到了这种复杂性，就是十天内测试几百种药物这件事。

You you mentioned this complexity again, this idea of testing hundreds of drugs in a matter of ten days.

我有时候想到，去医院做化验，哪怕只是查一个简单的抗体，都要等十天。

And I think about sometimes when you get lab tests in the hospital, you can get, like, a simple antibody, and it takes ten days to get it.

所以这自然就让人想问了。

So I'm like so is it that just begs the question then.

面对这么复杂的流程，你们是怎么做到这么快出结果的？

When you're dealing with that level of complexity, how how you how are you able to do it in such a timely manner?

而且我们现在老在谈人工智能，这在你们的工作流程里是不是起了关键作用？还是说你们是怎么做到的？

And is is you know, we we were talking a lot about AI these days too, and is that a big part of the workflow that's in in enabling you to do those things, or or how how are you

是的。

Yeah.

你知道，其实并不是。

You know, it's no.

好问题。

Great question.

我想说的是，现在科技和生物学正真正地交汇在一起。

You know, what I would say is it this is where technology and biology are really kinda, you know, converging at this moment.

我们已经持续测试、验证和发表研究成果将近十年了。

And that's a really exciting thing is, you know, we've been testing, we've been validating, we've been publishing for almost a decade.

而现在，我们终于能以低成本大规模地实现了。

And and and now, we can do it affordably at scale.

让我举个例子。

So let me give you an example.

以前要把一百种药物放到成千上万个培养板上，得花五个小时。

You know, laying a 100 drugs on you know, thousands of well plates used to take five hours.

现在有了机器人，只需要五分钟。

Now with robotics, it takes five minutes.

天哪，真厉害。

Oh wow.

是的。

Yeah.

我们用声波来分配药物。

And we use sound to dispense, you know, the the drugs.

以前人工智能处理数据的成本非常高，但现在有了云计算，像AWS这样的平台，费用才几美分。

You know, the cost of AI used to be, you know, processing data used to be hugely Now, with cloud computing and any one of the cloud computing environments like AWS, costs a few cents.

基因组测序以前要一万美金左右。

Genomics used to cost about $10,000.

现在不到一千美金。

Now, it's less than $1,000.

把这些技术结合起来，就能真正实现低成本了。

And you bring all of this together and that's where, you know, it really we can make it affordable.

而我们正是在这上面测试和验证了整整十年。

And that's where we've been testing and validating for, you know, a decade.

这回答了你的问题吗？

That answer your question?

是的。

Yeah.

不，这听起来太棒了。

No, that sounds great.

就像你所说的，是一连串的创新才让你能实现这些——机器人、人工智能、基因组学等等。

Think, as you say, sort of a series of innovations that led to your ability to do this, robotics, artificial intelligence, genomics, etcetera.

十年前根本不可能做到。

So it would have been possible, you know, ten years ago even.

十年前根本不可能。

It wouldn't have been possible ten years ago.

对。

Yeah.

或者以可负担的成本大规模实现。

Or or to do it affordably at scale.

对吧？

Right?

说到底就是这么回事。

And that's really it.

其实就是，你知道的，如果我们稍微想想的话。

It's it's you know, if we kinda yeah.

我的意思是，这事儿吧，我刚才开始讲了个故事。

It's I mean, this was, you know, I've started to tell a story.

你可能想不到，这家公司当初是我研究生的论文课题。

This was my grad school thesis, believe it or not, this company.

我又回学校读研了。

I went back to grads.

是的。

Yeah.

我们在测试和验证的过程中，结果越来越好。

As we were testing, as we were validating, our results kept getting better and better.

当时我们是在一个非营利的框架下做的。

And we were doing it under a non profit set.

我意识到，在非营利的模式里，我们的能力是有限的。

And I realized that there was only so much we could do in a non profit setting.

你可能不信，我50岁的时候又回了学校，拿了MBA，这个项目就是我的毕业论文，我想弄清楚两件事：第一，我们能不能以低成本做到？

Believe it or not, I went back to grad school at 50 years old, got my MBA, this was my grad school thesis and I wanted to see number one, could we do it affordably?

第二，我能不能打造一个真正有价值的公司？

And number two, could I grow a company of value?

我后来发现，这两件事其实完全可以同时做到。

And what I realized is we could actually do both.

于是我们就把原本的非营利项目，真正转型成了一个企业，

And that's when we you know, really transformed it from a nonprofit into a you know,

一家公司。

a company.

你提到已经看到了积极的结果，84%只是最低估计值。

You mentioned you've been seeing positive results and 84 is sort of the lower estimate.

你预期疗效还能再往上提升。

You expected to go even higher in terms of efficacy level.

没错。

Right.

很好奇你和你的公司未来一年、五年会往哪个方向发展？

Curious where you see yourself and your company going in the next year, next five years.

你希望产生什么样的影响？又打算怎么扩大规模？

What impact do you hope to have and how do you plan to scale?

是的。

Yeah.

不是。

No.

这是个很好的问题。

It's a great question.

说到底，我们越早接触到患者，效果就越好。

So, you know, ultimately, the sooner that we can get to a patient, the better the results that we can generate.

对吧？

Right?

功能精准医疗不应该是所有治疗都失败后的最后希望。

You know, functional precision medicine shouldn't be the last chance when everything fails.

它应该是首选方案。

It should be the first chance.

没错。

Right.

或者一复发，就该立刻用上它。

Or or the moment you relapse, this is exactly where you go.

我们其实是站在基因组学的肩膀上前进的。

I mean, we're standing on the shoulders of genomics.

你知道，基因组测序早在二十年前就完成了。

You know, the genome was mapped twenty years ago.

这就是下一代重大突破，把基因组学和功能精准医学结合起来。

This is that next quantum leap forward combining genomics with functional precision medicine.

所以，这也就是我看待这个问题的一部分。

So that's part, you know, part of where I see it.

但在我看来，另一个关键机会在于：用对的药，给对的病人，在对的时间。

But I think the other opportunity, at least from my perspective, is it's all about right drug, right patient, right time.

想想那些药企，花六到十五年、投入超过五十亿美元研发一种药，结果有97%的概率拿不到FDA批准。

Think about a drug company who spends, you know, six to fifteen years developing a drug and upwards of $5,000,000,000 and it fails to get FDA approval 97% of the time.

想想我能实时提供给他们的数据——关于这种药在不同生物学背景的患者群体中的实际效果。

Think about the data that I could give them in real time about the efficacy of that drug against the biologically diverse patient population.

所以说，这其实就是一个敏捷开发的过程，对吧？

So, again, it's that whole agile development process, right?

快速试错，低成本失败，或者直接加速推进。

Fail fast and fail cheaply or accelerate.

如果我能用患者活检样本测试所有这些药物，就能提前把还在临床前阶段的新分子和新药加入测试，帮药企积累数据，这些数据要么能用于提交更高级的IND申请，要么能加速药物进入研发流程，最终实现‘对的药、对的病人、对的时间’，让我们整体做得更好。

So, if I have the ability to test all of these drugs on a patient's derived biopsy, I can actually add new molecules and new drugs that are preclinical and help that pharma company generate a dataset that can either be used as an advanced IND or to accelerate a drug into the pipeline, ultimately feeding back to the right drug to the right patient at the right time, which helps us get better.

这些临床前的药物，我当然不能直接给患者用。

Now, you know, those preclinical drugs, I obviously couldn't offer to a patient.

但能把这些数据提供给制药公司，这才是真正让人兴奋的地方。

But to be able to give that dataset to the pharma companies and that's what's really exciting.

我刚和一家制药公司同台发言，挺有意思的，他们有个药，适应症我一时想不起来了。

Mean, we you know, I just shared the the stage with a pharma company and it was interesting because they have a drug for a I forget what drug indicator it is.

我们发现他们的药对尤文肉瘤、骨肉瘤、横纹肌肉瘤这些很难治的癌症效果特别好。

We're seeing their drug be very effective against Ewing sarcoma, osteosarcoma, rhabdomyosarcoma, some very difficult cancers to treat.

我们曾有一位患者，得了眼眶部位的小细胞去分化肿瘤，当时已经在家接受临终关怀，情况很不乐观。

We actually had one patient that had an orbital small cell demoplastic tumor and he was on hospice at home expecting the worst.

医生让他参与了这项研究，我们取了活检样本。

Doctor enrolled him into the study, we got a biopsy.

他开始接受治疗后，居然从临终关怀直接回到了学校，重新踢起了足球。

He went, they started treatment, went from hospice back to school to playing football with their draw.

所以我觉得，我们真正能帮到患者的途径，就是帮药企更快地把新药推入研发流程。

So that's where I see, you know, us really trying to, you know, to help patients faster by helping drug companies get drugs in pipeline.

我本来还想说，我们现在也有临床研究了。

And I was gonna say, and so we have the clinical studies.

我知道我跑题了。

I know I went off on a tangent.

不好意思。

I'm sorry.

另外，我们的实验室刚刚通过了CLIA认证。

But and so we also just had our lab CLIA cat validated.

这意味着我们可以开始接收那些不在临床研究中的患者了。

And what that means is it means that we can start accepting patients outside of a clinical study.

比如说，如果我们自己或者家人得了癌症，标准治疗无效了，接下来该怎么办？

So, you know, if any one of us or our family members got cancer or they failed the standard of care and they needed, you know, what do I do next?

这时候我们就能提供专业的指导，帮助医生做决策。

This is where we could come in and provide that guidance physician.

我觉得你刚刚提到的，正是你这项工作的可扩展性。

I think that the you just alluded to the scalability of what you're doing here.

我一向喜欢回到基础科学层面，你知道的。

You know, we were getting I always like going to the basic science, right?

你确实是把一个很基础的科学原理，

Like, you're you're taking this very basic Yep.

转化成一家公司，不仅主动为患者提供治疗，优化现有疗法，还能加速开发新疗法，尤其是那些现有治疗无效的患者。

Scientific principle, turning into a company not only providing care actively for patients and improving the treatments thereon, but then accelerating the development of new treatments that maybe the existing treatments aren't working for.

我觉得这真的非常了不起。

And I think that's that's truly incredible.

这就说到你之前提过的一点了——比如乳腺癌中的HER2阳性病例，你说得对，我们知道用赫赛汀治疗，研究显示生存率会提升，因为我们精准靶向了这个目标，但这毕竟只是理论，对吧？

And it gets to that point where you you mentioned this earlier, you know, we think about HER two positive cancers in breast in breast cancer, and it's like you said, it's we know that if we treat it with Herceptin, then in these studies that it's it's most likely to have an improved survival outcome because we're targeting this thing, but it's theory, right?

理论上是这样，但肿瘤的复杂性很难用单一标志物完全捕捉，确实如此。

It's like in theory, this is, but it's hard to capture the complexity of any tumor with one marker That's right.

而真正能做到这一点的，只有直接检测肿瘤本身，没错。

Versus the only way you can do that is, like, actually test that tumor That's right.

而你们能做到这一点，而且方式能兼顾这种复杂的生物学特性，根本不需要你从最基础的层面完全理解它。

And and you're able to do that in a in a way that accommodates for all that complex biology that you don't necessarily need to understand at the very basic level.