1
00:00:32,209 --> 00:00:35,085
What do these two everyday objects,

2
00:00:35,209 --> 00:00:39,249
a drug and a smartphone,
have in common?

3
00:00:39,250 --> 00:00:43,792
We will try to solve
this little riddle today,

4
00:00:43,800 --> 00:00:46,199
in the next few minutes.

5
00:00:46,209 --> 00:00:50,917
First, the drug: I have always
been fascinated by this object.

6
00:00:50,918 --> 00:00:54,833
The mere fact of swallowing it
is somehow almost magical,

7
00:00:54,834 --> 00:00:59,416
it's enough to cure diseases,
sometimes, to even brave death.

8
00:00:59,417 --> 00:01:01,001
I have always been fascinated

9
00:01:01,125 --> 00:01:05,292
by the fact that this same drug
helps to cure billions of people,

10
00:01:05,459 --> 00:01:08,335
all of them different:
you, your neighbor, me.

11
00:01:08,336 --> 00:01:11,999
It is the challenge
of personalized medicine:

12
00:01:12,000 --> 00:01:15,209
to understand why, when I have a headache,

13
00:01:15,209 --> 00:01:18,501
if I take an aspirin pill,
that is enough to relieve my pain,

14
00:01:18,501 --> 00:01:22,208
while my neighbor needs
two of the same pills

15
00:01:22,209 --> 00:01:24,501
to relieve the same headache pain.

16
00:01:24,501 --> 00:01:28,460
Therefore, these questions are
the challenges of tomorrow

17
00:01:28,501 --> 00:01:31,814
when it comes to understanding
our personal response to treatment,

18
00:01:31,815 --> 00:01:35,376
and above all, finding
the best treatment for everyone.

19
00:01:35,377 --> 00:01:37,959
So I suggest you keep in mind
these questions,

20
00:01:37,959 --> 00:01:41,118
- they are particularly dear to me,
we shall return to them later -

21
00:01:41,238 --> 00:01:45,197
and I first suggest that you look back
in the rearview mirror a little

22
00:01:45,876 --> 00:01:49,710
and notice the extraordinary progress
that has been made in medicine

23
00:01:50,125 --> 00:01:51,541
in the past century:

24
00:01:51,542 --> 00:01:54,751
we've extended life expectancy,
and decoded our genes.

25
00:01:55,292 --> 00:01:58,501
Louis Pasteur would have believed
science was a fiction novel

26
00:01:58,501 --> 00:02:01,543
had he seen the extent
of our modern biology;

27
00:02:02,459 --> 00:02:06,960
there are decades of technological
revolution behind this drug.

28
00:02:07,542 --> 00:02:09,043
On the other hand,

29
00:02:09,167 --> 00:02:14,542
what an extraordinary progress
has been achieved in computer science

30
00:02:14,668 --> 00:02:16,166
in the past 30 years

31
00:02:16,167 --> 00:02:20,501
thinking back at how computers
used to occupy entire rooms.

32
00:02:20,959 --> 00:02:24,084
Today, we concentrate
a phenomenal computing power

33
00:02:24,125 --> 00:02:25,792
in the palm of our hands.

34
00:02:26,626 --> 00:02:28,085
Do you remember Alan Turing?

35
00:02:28,125 --> 00:02:31,188
Alan Turing who was considered
the father of the modern computer

36
00:02:31,308 --> 00:02:33,541
during the World War II;

37
00:02:33,542 --> 00:02:36,501
I think he would have believed
science is a fiction novel too,

38
00:02:36,502 --> 00:02:40,252
had he seen the extent
of our modern computer science.

39
00:02:41,417 --> 00:02:45,043
My vocation is to bring
these two worlds together

40
00:02:45,459 --> 00:02:48,043
and power, inside a computer,

41
00:02:48,751 --> 00:02:55,001
the stimulation of an organism,
of your personal response to treatment.

42
00:02:56,209 --> 00:03:01,334
Of course, behind these
scientific and technological stakes,

43
00:03:01,375 --> 00:03:04,208
there are several social issues hidden.

44
00:03:04,209 --> 00:03:08,791
Do you know that this drug,
apparently so innocent, so familiar,

45
00:03:08,792 --> 00:03:10,792
is very far from being a mere drug?

46
00:03:10,834 --> 00:03:14,958
There are more deaths each year
due to inadequate medication

47
00:03:14,959 --> 00:03:19,668
than people killed in road accidents
and suicides combined.

48
00:03:20,542 --> 00:03:24,791
I think that this small object,
a smartphone or a computer,

49
00:03:24,792 --> 00:03:27,875
can help tackle these issues.

50
00:03:27,876 --> 00:03:29,627
And before talking technology,

51
00:03:29,628 --> 00:03:33,001
I would like to start by sharing
a little personal anecdote.

52
00:03:33,417 --> 00:03:36,417
I want to talk to you
about my wife, Caroline.

53
00:03:37,309 --> 00:03:40,708
Caroline is an avid
animal rights activist.

54
00:03:40,709 --> 00:03:43,268
On my part, for several years,

55
00:03:43,269 --> 00:03:46,828
I worked on cancer
in an experimental biology laboratory

56
00:03:46,829 --> 00:03:49,689
and among our activities,
we sometimes worked on animals.

57
00:03:50,209 --> 00:03:53,499
You can imagine the disaster
at home sometimes.

58
00:03:53,501 --> 00:03:54,793
That was something.

59
00:03:55,219 --> 00:03:56,948
Of course, she would question me:

60
00:03:56,949 --> 00:04:00,378
do we have the right 
to sometimes abuse animals

61
00:04:00,379 --> 00:04:03,299
and is it always really that useful?

62
00:04:05,289 --> 00:04:07,849
We have an extremely complex debate

63
00:04:08,730 --> 00:04:11,179
and of course, I will never deny

64
00:04:11,179 --> 00:04:15,498
all the contributions experimental biology
and animal biology to current knowledge.

65
00:04:15,499 --> 00:04:18,137
Nevertheless, this discussion
made me question myself,

66
00:04:18,139 --> 00:04:21,378
and I would like to share with you
some of that reflection today.

67
00:04:21,379 --> 00:04:25,939
That's true, this drug originally
was designed based on animals,

68
00:04:26,249 --> 00:04:29,629
then only afterwards,
it was tested on man.

69
00:04:29,630 --> 00:04:31,349
But not on you in particular!

70
00:04:31,350 --> 00:04:34,958
Remember, we all respond differently,

71
00:04:34,959 --> 00:04:37,409
You, me, my neighbor.

72
00:04:38,189 --> 00:04:43,999
Why? Because you, madam,
are not the replica of you, sir.

73
00:04:44,000 --> 00:04:47,719
That explains why you respond
differently to this treatment.

74
00:04:47,720 --> 00:04:49,188
And if I may,

75
00:04:49,189 --> 00:04:52,769
you, madam, are even less
the replica of a lab mouse.

76
00:04:53,480 --> 00:04:56,505
When, in fact, cancer
is tackled through the animal,

77
00:04:56,506 --> 00:04:58,793
we want to cure Cancer with a big C.

78
00:04:59,581 --> 00:05:01,639
I do not want to cure cancer.

79
00:05:02,599 --> 00:05:05,459
I do not want to cure cancer.

80
00:05:05,460 --> 00:05:08,498
I want to cure your cancer.

81
00:05:08,499 --> 00:05:11,758
If one day it should happen to you,
and I do not wish it,

82
00:05:11,759 --> 00:05:13,488
but if that were the case,

83
00:05:13,489 --> 00:05:16,296
I would love to find
the best treatment for you

84
00:05:16,297 --> 00:05:18,501
which is not the same
as your neighbor’s

85
00:05:18,501 --> 00:05:21,987
because your cancer would not be
the replica of your neighbor’s cancer

86
00:05:21,988 --> 00:05:24,899
and even less, once again,
the replica of a cancer

87
00:05:24,900 --> 00:05:28,880
artificially induced
in a laboratory animal.

88
00:05:29,569 --> 00:05:32,569
Isn't there another way
of conceiving things?

89
00:05:33,329 --> 00:05:37,629
The idea's here to start from the patient,
from you, from your characteristics,

90
00:05:37,630 --> 00:05:40,199
to project them into the machine,

91
00:05:40,719 --> 00:05:43,158
create what is called a digital twin,

92
00:05:43,159 --> 00:05:46,919
and in this digital twin, test
the response to the treatment,

93
00:05:46,920 --> 00:05:49,258
thus decreasing animal testing

94
00:05:49,259 --> 00:05:52,018
which is costly
and ethically questionable,

95
00:05:52,019 --> 00:05:55,760
and in addition, better targeting
the response to treatment.

96
00:05:56,369 --> 00:05:58,520
So how do we get there?

97
00:05:59,430 --> 00:06:03,238
Of course, our organism
is extremely complex:

98
00:06:03,239 --> 00:06:05,480
a man's is diffrent from a woman's

99
00:06:05,480 --> 00:06:09,539
but I believe women's are sometimes 
particularly more complex.

100
00:06:10,210 --> 00:06:13,278
The complete opposite 
is also true, I assure you.

101
00:06:13,279 --> 00:06:17,509
On a more serius note, I like
the analogy with electronics

102
00:06:17,510 --> 00:06:20,279
to grasp this magnificent complexity.

103
00:06:20,280 --> 00:06:24,909
I am always amazed when I see
the circuit in a simple radio,

104
00:06:24,910 --> 00:06:29,398
the complexity of its connections,
sub-circuits, and components.

105
00:06:29,399 --> 00:06:32,488
There is very similar
to our complex organism.

106
00:06:32,489 --> 00:06:35,508
Of course in biology, in our organism,

107
00:06:35,509 --> 00:06:37,508
the interactions are not electronic,

108
00:06:37,509 --> 00:06:40,719
they are chemical, physical, biological

109
00:06:40,720 --> 00:06:44,498
and this is precisely
the mission of biology:

110
00:06:44,499 --> 00:06:47,258
to decipher this complexity.

111
00:06:47,259 --> 00:06:50,198
But there is a fundamental
difference with electronics:

112
00:06:50,199 --> 00:06:54,069
no human has conceived
the blueprint of our organism.

113
00:06:54,879 --> 00:06:57,749
When a radio breaks down,

114
00:06:57,750 --> 00:07:00,318
since we know the blueprint,
we know how to repair it.

115
00:07:00,319 --> 00:07:04,698
It's a whole different story
when our organism breaks down,

116
00:07:04,699 --> 00:07:06,279
gets sick.

117
00:07:07,439 --> 00:07:11,291
we do not know the blueprint,
so it's a little bit as if

118
00:07:11,292 --> 00:07:14,084
some natives of Amazon,
however intelligent they may be,

119
00:07:14,090 --> 00:07:18,528
had to understand and repair
a radio overnight.

120
00:07:18,529 --> 00:07:21,168
That, again, is the challenge of biology.

121
00:07:21,169 --> 00:07:24,489
In recent years, we have come
to understand better

122
00:07:24,490 --> 00:07:26,638
and more and more pathologies.

123
00:07:26,639 --> 00:07:29,189
Thousands of research teams
around the world,

124
00:07:29,190 --> 00:07:31,129
are decrypting this complexity,

125
00:07:31,130 --> 00:07:37,959
understanding small pieces of circuitry,
independent pieces of the puzzle.

126
00:07:37,960 --> 00:07:42,139
This is where computer science
and mathematics come into play.

127
00:07:42,749 --> 00:07:44,388
With these tools,

128
00:07:44,389 --> 00:07:48,750
we will be able to reattach
these little bits

129
00:07:49,470 --> 00:07:53,768
and to make live in a virtual world,
in the machine,

130
00:07:53,769 --> 00:07:58,028
these bits, assembled circuits,
puzzle pieces that we simulate,

131
00:07:58,029 --> 00:08:00,418
that we make come alive
inside the computer.

132
00:08:00,419 --> 00:08:04,378
What you see here is a virtual cell,

133
00:08:04,379 --> 00:08:05,639
a cancer cell,

134
00:08:05,640 --> 00:08:10,349
It is in fact the projection
of a cancer cell in a software,

135
00:08:10,350 --> 00:08:12,749
what is commonly called an application.

136
00:08:12,750 --> 00:08:15,499
Again we see the analogy
with electronics,

137
00:08:15,500 --> 00:08:17,749
there are all these circuits,
these connections.

138
00:08:17,869 --> 00:08:19,778
Again, it's biology.

139
00:08:19,779 --> 00:08:23,198
And we see all this complexity
of the cancer cell

140
00:08:23,199 --> 00:08:24,949
which makes it formidably effective.

141
00:08:24,950 --> 00:08:29,859
Each dot, of course these are not
dots of electronic components,

142
00:08:29,860 --> 00:08:33,020
is a biological interaction,
a protein for example.

143
00:08:33,020 --> 00:08:36,249
We saw there Akt, Ras,

144
00:08:36,250 --> 00:08:39,938
which is a protein that is involved
in the virulence of many cancers:

145
00:08:39,940 --> 00:08:42,770
pancreatic cancer, skin cancer...

146
00:08:44,039 --> 00:08:48,730
What is particularly interesting
in this virtual cancer cell

147
00:08:48,740 --> 00:08:52,540
is that it is not simply
a collection of information.

148
00:08:52,820 --> 00:08:55,819
In fact, behind each dot,
each entity in this network,

149
00:08:55,820 --> 00:08:58,369
hides an equation.

150
00:08:58,370 --> 00:09:02,059
And behind a whole network
is a system of equations

151
00:09:02,060 --> 00:09:05,005
at the confluence between
mathematics and biology.

152
00:09:05,006 --> 00:09:06,834
It is called bio-mathematics,

153
00:09:06,850 --> 00:09:09,529
also called the biology of systems

154
00:09:09,530 --> 00:09:14,059
and it allows us
to set this network to music,

155
00:09:14,060 --> 00:09:17,269
to play, to simulate parts
of this virtual cell,

156
00:09:17,270 --> 00:09:21,360
parts, pieces of this puzzle
in the machine.

157
00:09:22,080 --> 00:09:24,499
So this is an incredible playground,

158
00:09:24,500 --> 00:09:28,499
because this complexity is very difficult
for the human brain to apprehend.

159
00:09:28,500 --> 00:09:31,579
And thanks to the computer tool
and the mathematical tool,

160
00:09:31,580 --> 00:09:35,749
we are able to master, control
and visualize this complexity.

161
00:09:35,750 --> 00:09:37,659
And when we visualize things,

162
00:09:37,660 --> 00:09:41,800
we are making a big step
towards solving problems.

163
00:09:43,010 --> 00:09:46,999
Now, let's put us in the shoes
of a drug designer.

164
00:09:47,000 --> 00:09:49,980
Let us play the role
of the pharmaceutical laboratory.

165
00:09:50,760 --> 00:09:52,709
In this digital twin,

166
00:09:52,710 --> 00:09:55,149
we will be able to test the new drugs

167
00:09:55,150 --> 00:09:57,709
to reduce animal testing

168
00:09:57,710 --> 00:10:01,389
and to promote experimentation
on virtual patients

169
00:10:01,390 --> 00:10:04,439
who will reflect your own diversity.

170
00:10:04,440 --> 00:10:09,329
Tomorrow, why not test your own response
to your medications

171
00:10:09,330 --> 00:10:12,759
on your own avatar,
your own digital twin?

172
00:10:15,090 --> 00:10:19,490
Not to cure cancer, to cure your cancer.

173
00:10:21,160 --> 00:10:24,169
Personally, I am convinced
that this innovation, tomorrow,

174
00:10:24,170 --> 00:10:25,659
will knock on our door,

175
00:10:25,660 --> 00:10:28,980
for medicines of everyday life.

176
00:10:30,680 --> 00:10:34,489
I say that because we talk a lot about
big data, right now in biology.

177
00:10:34,490 --> 00:10:37,739
It is in direct connection
with our subject, these massive data,

178
00:10:37,740 --> 00:10:40,069
are the data that make us all different,

179
00:10:40,070 --> 00:10:43,619
explain our differences,
my weight, my age, my height,

180
00:10:43,620 --> 00:10:45,239
but also my genetic data,

181
00:10:45,250 --> 00:10:48,250
my bio-markers...

182
00:10:48,770 --> 00:10:52,609
therefore explain our difference
in response to treatment

183
00:10:52,610 --> 00:10:55,849
and why I need less aspirin
than my next door neighbour.

184
00:10:55,850 --> 00:10:58,721
These numerical and mathematical
models that I have shown you

185
00:10:58,841 --> 00:11:02,129
feed on these massive data
and biological data.

186
00:11:02,130 --> 00:11:05,609
Thanks to them, we will be able
to build and specify your avatar,

187
00:11:05,610 --> 00:11:09,060
set up your digital twin.

188
00:11:09,660 --> 00:11:11,229
So you understood it,

189
00:11:11,230 --> 00:11:13,999
presently, we talk a lot
about personalized medicine.

190
00:11:14,000 --> 00:11:19,409
Today, I told you about
customized modeling

191
00:11:19,410 --> 00:11:22,079
in a calculation concentrate,
like this one,

192
00:11:22,080 --> 00:11:26,430
to be able tomorrow to simulate
your personal response to the treatment.

193
00:11:29,310 --> 00:11:32,249
This is really the challenge
of personalized medicine,

194
00:11:32,250 --> 00:11:35,270
digital medicine,
the medicine of the future.

195
00:11:35,710 --> 00:11:39,729
You may think I'm exaggerating a little.

196
00:11:39,730 --> 00:11:43,699
In fact, that is my belief,
even if perhaps today, for some,

197
00:11:43,700 --> 00:11:47,059
my words resonate
like a science fiction novel.

198
00:11:47,060 --> 00:11:48,079
Thank you.

199
00:11:48,080 --> 00:11:50,770
(Applause)