Translator: Oliver Sims Reviewer: Mirjana Čutura
Hi there, everyone.
It's a great honor to be here today.
My name is Billy Boyle.
I'm co-founder of Owlstone.
Me and my team have developed a breathalyzer for disease,
and it's our company mission to try and save 100,000 lives
and 1.5 billion dollars in healthcare costs.
So, we see two big problems in healthcare today.
The first is too many people are diagnosed with disease when it's too late to cure,
and too many people are on medications that don't work for them.
So there's no better example than the cancer.
We know if you detect early, survival chances are 10 times better,
and treatment costs are 10 times lower.
So, here's one of the most shocking statistics I think I've ever seen.
One in two of us are going to get cancer:
one in two of us in this room, one in two of everyone you know -
from parents, partners, children, grandchildren,
one in two are going to get cancer.
And in the war on cancer, the battlefield is uneven.
Survival chances are good for some cancers
where screening is effective or treatments are effective.
We have a big problem in cancers like lung and colorectal cancer,
which affect millions of people,
but survival chances are really bad
despite 40 years of trying to develop new drugs.
The crazy thing is we already know what to do:
detect early when treatments that exist today work,
and cure for the long term.
So we know in colorectal cancer, if you pick it up at stage one,
survival chances are about 95 percent.
Stage four - that drops to about five percent,
and you've got to be pretty lucky to be in that five percent.
Early detection is our greatest opportunity.
So, in 2012,
415,000 people were diagnosed with colorectal cancer.
One of them was my wife, Kate.
This is us on our wedding day with my kids.
Kate was rushed in the hospital a couple of months before that
with what turned out to be a stage-four colon cancer,
and she wasn't in the lucky five percent.
She died two years later on Christmas morning 2014.
And every day, I wake up angry:
angry she was diagnosed late - my children don't have a mother -
but most of all, angry that our story's not unique.
There's millions with a story just like this
and lots of people in this room with a story just like this.
We need to do better.
We need to pick up cancers earlier when they're treatable.
And anger's an energy.
It's what drives me and my team
on our mission to try and detect cancer sooner,
so fewer families in future will have the story just like that.
And while the problem and the solution is easy to state -
we save lives by picking up cancer sooner -
making that a reality is incredibly difficult.
So, in colorectal cancer, we have screening programs today,
but too many people go on to late-stage cancer.
So, what's happening? What's the problem?
So, current screening methods in colorectal cancer
are either faecal-based tests or colonoscopy
or some combination of both,
and it varies in the country that you're in.
The reality is patients don't like it.
Compliance rates are low.
They don't show up for the test.
Across Europe, it's about 50 percent compliance rate on average.
So, what this means,
if you take 100 people that have colorectal cancer,
half don’t show up,
and they will go on to develop late-stage disease.
And the second issue is the faecal tests aren’t that good,
so the sensitivity is quite low.
It's not that good at picking up the cancer when it’s present.
So it’s these two factors combined
that lead to too many people being diagnosed late.
And actually, in a lot of cancers, we have no tests whatsoever.
So we need to have next generations of tests
which are acceptable to patients,
which are sensitive to early-stage cancers,
able to pick them up,
that have very low rates of false positives and false alarms
and are cost-effective for healthcare providers.
And that's what we're trying to develop with our breath-biopsy technology.
So, I am sure some of you will have seen the headlines about cancer-sniffing dogs,
and you wonder, you know, What's going on there?
So, every time you breathe out,
there’s thousands of chemicals on your breath
called volatile organic compounds or VOCs.
And some of these VOCs are biomarkers
in everything from cancer to infectious disease
and inflammatory disease.
And the first question you ask is, What are they and where do they come from?
So, some of them are endogenous metabolites.
And why this is important is,
while your genome can tell you about the risk of getting disease,
it’s your downstream metabolism
that gives you the best real-time snapshot of your actual disease state.
And this is especially important in cancer.
We've known for about 75 years that cancer has an altered metabolism
even at early stage,
so that's why things like PET scans work, for instance.
So, the second question is, Where do these compounds come from?
So, some are produced locally in the airways,
but actually quite a lot of them originate from your blood,
which makes sense -
your lungs are very good at exchanging gas from blood to the airways.
And what we can actually do is, every time we breathe out,
we can trap, store, pre-concentrate and enrich these biomarkers.
And here's the cool thing.
Once every minute,
all the blood in your body circulates once and passes through your lungs,
so by sampling over that type of time period,
you have a window into, essentially, your entire blood volume.
And it's for those reasons
that we think this is a really, really interesting technique
when you're trying to pick up disease at an early stage.
So, one of the core technologies that we've developed
is a microchip chemical sensor,
and what makes it special
is you can program what you want to sniff out
just by changing the software.
So it's a bit like an electronic nose.
And me and two friends, researchers at Cambridge University,
we developed this and spun a business out back in 2004,
and the original focus was to build products
in security and industrial applications
and everything from sniffing toxic gases to contamination in crude oil.
But because you have this ability to reprogram what you want to sniff
just by changing the software,
we've always wanted to adapt it for these medical applications.
So, I said earlier patient acceptability is a key factor here,
So, I'll ask you a question:
Would you rather have a colonoscopy or a breath test?
(Laughter)
And, you know, it's a pretty easy answer.
Breath is the ultimate non-invasive test.
It’s the only anytime- , anyplace-sample matrix.
And what this means is that we can take breath biopsy to the patient,
so we can collect samples not just in the hospital setting,
but we can collect samples in the GP setting,
pharmacies, supermarkets, even the home.
And the other things is cancer isn’t just a problem in Europe and the US.
This is a global problem.
Our goal is to make breath biopsy low cost enough
so we can bring it to millions of people around the world
and help pick up cancer sooner.
So, over the years,
we've worked with a lot of academics and clinical researchers
who've been taking the platform and integrating it into clinical studies.
They would collect patient samples,
run those samples and publish those findings.
So we have on our website at the moment about 100 published papers
and scientific posters.
And in one of these studies, a pilot study in colorectal cancer,
they were able to find that they could improve compliance rates,
and they could improve the rates of early detection,
which is tremendously exciting for us.
So, what we're doing now is building on that
and running large-scale clinical trails.
So, with the support of the NHS, Cancer Research UK,
I'm running the studies here in Cambridge.
And this is in lung and colorectal cancer but multiple tumor types as well.
And we aim to recruit about 6,000 patients in total,
which makes it the biggest breath-based trial ever undertaken.
So, how well is it going to work?
That’s what the clinical trial is going to tell us.
But what we know is we have to try.
Someone has to solve the problem.
So, Kate wrote a book called "Late Fragments."
It’s actually a book about life and living.
And in it,
she uses one of my favorite quotes:
"Make use of time while it's present to you."
And I think that applies to all of us.
The work we do, the relationships we have -
we have to make them count.
Thank you.
(Applause)