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What if a drop of blood or menstrual fluid could reveal the hidden biology driving endometriosis? We sit down with Dr. Canio Martinelli, OBGYN and oncology educator, to unpack how liquid biopsy is moving from bold idea to practical tool—and what it will take to make it safe, accurate, and accessible. From circulating “fingerprints” to AI-enhanced signal detection, we chart a path toward earlier detection, better monitoring, and more precise interventions.
We break the science into clear layers: genomics, epigenetics like DNA methylation, RNA transcription, and protein function. That stack of information explains why one-size-fits-all tests fall short and why a multi-omic signature could finally reflect the reality patients live with—wildly variable symptoms, misdiagnosis, and years of unanswered questions. We also tackle the stakes of accuracy. FDA-grade standards for AI diagnostics force meaningful validation so a negative result doesn’t silence someone’s pain or delay necessary care. Noninvasive testing should expand options and trust, not replace clinical judgment or a skilled surgeon when they’re needed.
Beyond diagnosis, we explore how liquid biopsy can accelerate research and drug development, enrich clinical trials with likely responders, and even enable molecular-guided surgery to remove microscopic disease more precisely. We talk equity and access through affordable sensors, transparent reporting, and patient education that demystifies what results mean. The takeaway is both practical and hopeful: rigorous science, ethical design, and patient-centered choices can change outcomes in women’s health. If this conversation gave you new language, new questions, or a new sense of possibility, follow the show, share it with someone who needs validation today, and leave a review to help more listeners find these tools and this community.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker (00:00):
Welcome to Endo Battery Fast Charged, a series
dedicated to keeping youinformed and empowered in the
realm of endometriosis.
Teaming up with board certifiedpatient advocates, we bring you
the latest articles, research,and insights to equip you with
accurate information and adeeper understanding.
Whether you're expanding yourknowledge, staying updated, or
seeking clarity, you're in theright place.
(00:21):
I'm your host, Alanna, and thisis Endo battery Fast Charged,
charging and empowering yourlife with knowledge.
Welcome back to Endo BatteryFast Charge, where we power
through the latest researchshaping endometriosis in women's
health.
I couldn't be more excited tohave our very first guest on
(00:46):
this series, Dr.
Canio Martinelli, an OBGYNspecialist and the head of
clinical program at SavaroHealth Research Organization at
Temple University.
Dr.
Martinelli, recently named FDAAAACR Oncology Educational
Fellow, is at the forefront oftranslating cutting-edge science
into real-world impact.
(01:06):
His work connects emergingresearch, clinical care, and the
future treatment for peoplewith endometriosis, helping us
better understand whereinnovation can truly change
lives.
And just as a friendlyreminder, correlation does not
equal causation.
So let's keep our curiosityfully charged, but stay grounded
as we dig in.
(01:26):
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(02:13):
And let's make this episodeeven better.
Let's get into this.
Thank you so much, Canio, forjoining me and sitting down and
going over this research.
With all the advances comingup, what is one of the things
that you've been researchingthat is exciting for people
across all aspects of women'shealthcare?
Speaker 1 (02:32):
Thank you so much for your incredible question.
Because uh we're always lookingfor something that can be
really game-changing.
And one of the things that hasbeen game-changing is liquid
biopsy.
It's a kind of uh strangeconcept because whenever we
think about biopsy, it'ssomething that you do in
medicine when uh you took asolid part of the body out of
(02:55):
the body of the patient, andthen you examine on a
pathological uh examination andyou get the report.
Here the liquid biopsy is aconceptually a completely
another stuff because uh you canget some sample of any liquid
of the body.
Basically, the the projectstarted with blood, but it can
be saliva, urine, it can betears.
(03:18):
And the idea is uh being ableto find in that sample something
that we can use to betterunderstand the disease, but also
to improve our management in uhin healthcare.
And that's the beauty ofthings, because, for example,
how is it possible that if youhave an ovarian cancer or
endometrial endometriosis, youknow, those are diseases that
(03:40):
start in the ovary, in theperitoneum, or uh like uh all
over the body, even forendometriosis.
But uh how do you get sample ofthat disease in the blood, for
example, on or in themenstruation on in the uterine
bleeding?
Uh well, the beauty of this isthat first of all you need to
(04:02):
understand the biology of thedisease.
Because whenever you develop atool in medicine, uh it's not
just enough developing the tool.
It needs to be then uh you needto show how you want to
implement the management withinwith the new tool.
Because if you introducesomething new, it doesn't mean
that's necessary much betterthan what you're already doing.
(04:24):
And now we are in a point ofhealthcare, especially in
oncology, where the whereinnovation really brought us in
in a fantastic period ofhumanity where we can really,
there are still very, very uhfatal diseases, especially when
you get ovarian cancer latetime.
But uh most of the time, if youcan get them, you can still
give hope to people and givenice uh chances.
(04:46):
So whatever you are doing nowhas to be specific for specific
patients that needs to for suregive much uh more benefit than
before.
So you cannot just try.
Uh in the liquid biopsy, it'sit's extremely innovative stuff
because uh you can be lessinvasive because you can take,
you know, uterine bleeding orblood sample, and you can do
(05:11):
extremely fine diagnosis.
It's like when you have rightnow, if you have a cholesterol,
you just need to take a bloodsample, right?
And cholesterol is somethingthat navigates and swim in the
blood.
Same stuff we need to find forendometriosis of variant cancer,
endometrial cancer, generallywith the cancer works much
better.
Something that circulates inthese uh in these samples and
(05:34):
being able to detect them anduse that kind of detection to
understand the disease and evento develop something new.
So, if I want to have a kind ofmetaphor, I would say that it's
like for the FBI, you know,using fingerprints to find
criminals.
The liquid biopsy is exactlythe same thing.
We will use fingerprints thatcancer endometriosis live in the
(05:59):
in the in the blood in order todetect them as early as we can,
right in the less invasive waypossible.
But if you think about FBI 200years ago, it it didn't exist,
of course, but let's say that itexists.
If you wanted to catch acriminal by using fingerprints,
it would have been impossiblebecause you didn't even have the
fingerprints.
Now everybody coming to USdidn't need to give, you know,
(06:21):
to record fingerprints, so it'svery easy.
What we are doing right now inscience is that for liquid
biopsy, right now detecting thefingerprints of uh uh
circulating fingerprints ofcancers or very, very high
inflammatory diseases such asendometriosis.
Yeah.
And now we are developing thatyou can look at different
reviews and editorial that we wewrote.
(06:43):
One is exactly liquid biopsy ingynaecological cancer.
The other one is called uhcancer in a drop.
And now we are developingtogether with uh a fantastic
team from Italy new sensors inorder to detect this kind of uh
fingerprints, this is uh fromdifferent uh samples from women
in order even to try to developuh sensors that are cheap so you
(07:07):
can uh let everybody use uh thenew technology.
Speaker (07:11):
What is like the control group for that and like
what's the accuracy of it sofar?
Speaker 1 (07:17):
Exactly.
So whenever you do that, youhave a population.
We are right now in the in thein a phase where we are training
the system.
Speaker (07:26):
Okay.
Speaker 1 (07:27):
There are already some commercial available um
like uh especially forendometriosis, especially in US,
uh tools that you can use todetect endometriosis.
Some of them with even uh AIpowered, they say that they can
have an accuracy of 96%.
The thing is that, and that'sanother actually critical paper
(07:48):
that we are working on.
There are different kinds ofpapers, you know better than me.
Is that FDA, in order toapprove AI liquid biopsy test,
you need to show an accuracythat is higher than 99%.
And I think that FDA wasincredibly smart this time
because they said, okay, youwanna do that, but you need to
(08:09):
show that it's incrediblyaccurate.
Otherwise, I'm not gonna giveyou the FDA approval.
That's why lots of right nowliquid biopsy tools they don't
have they don't have FDAapproval.
I think that's very importantbecause what is I'm gonna ask
you this question actually toyou.
Like let's say that you're ayoung girl and you have pain,
(08:30):
you believe you are ofendometriosis and you live in a
place in the US all over theworld, but you don't have an
easy access to uh like realspecialist, you know, of
endometriosis.
And you feel pain, you feelpain, you go to a doctor and he
says, uh, you don't haveanything, don't worry, you are a
woman.
Uh and then you take the test,and the test is gonna give you
(08:51):
what we call uh false negative.
So the test is gonna, becausethe accuracy is not very, very
high, the test is gonna tell youthere is a risk that tells the
test tells you you you don'thave the disease.
At that point, you're gonna uhbasically say to that woman that
your life, her life is gonna bedestroyed for the rest of the
(09:12):
life because uh she will havethe confirmation that she does
not have any problem and shewill convince herself that she
needs to feel that pain.
So again, whenever there isthis new sexy stuff in science,
validation is first step.
Second step is how can Iintroduce that without uh
(09:32):
creating critical problem forpeople?
Because you know, when you whenyou see the test and the test
test is negative, you don'tthink about okay, what's the
accuracy rate?
That's a question that you uhare uh like right now, you're
making.
But lots of people they don'tthink about that because when
they are in a fight or flightmode, they just are focused on
something, they don't have thecalm to to really be rational
(09:55):
things.
So we need to be very, verycareful, especially when people
want to make money out of this.
So we need to stand up forpeople who says, okay, FDA did
an incredible job here, I haveto say that.
Speaker (10:07):
Right.
So this study is essentially isit going to be an analyzing,
like creating a tool thatanalyzes like the DNA for
inflammatory markers and geneticmutations, or is it is it a
doing it through differentsequencing?
Speaker 1 (10:22):
Well, let's say that we are working on different
kinds of sensor.
One of the most two of the mostpromising one.
One is working on theventilation of the DNA.
We know that there is thegenomics that's actually the
omic related to the sequence ofthe DNA.
But the DNA is not justsomething that stays there, it's
uh it's a living stuff, it'ssomething they change, something
(10:44):
that got modified.
And so we can have the sameDNA, but there could be
different modifications.
So it's called epigenetics.
Right.
So even if you have the samegenomics, it doesn't mean that
you're gonna be the same.
Because the modification of theDNA, in this case, uh
epigenetic modification, canchange the way the gene
(11:04):
expresses themselves intoproteins, and then again there
will be a modification of theproteins, and the way they are
modified will determine thefunction of the proteins.
And if you put all of theselayers together, you're going to
create a unique pattern, notjust as uh like uh
phenotypically human, but evenfrom a functional biological
(11:24):
distinction, and that's thething.
So being able to see themethylation pattern of all the
DNA can give nice information,especially related to
inflammation, like inflammatorydisease such as endometriosis,
because they're gonna leave afit like we said, a fingerprint
somehow.
(11:45):
Like if you don't wanna commitany like a problem, you just
don't create problem.
If you do something, you canhide, but someone is gonna find
you.
That's we are in that phase.
We're gonna find we know thatendometriosis is something
invasive, it's something thatwhenever you know it got
attached to somewhere in thebody, it has to do something.
Maybe the signal is very, verylow, and when the signal is low,
(12:08):
we can use AI stuff to likeenhance the signal, but we're
getting to that.
Speaker (12:13):
Interesting.
I think what's important too,and what you're saying is like
the FDA did a good job in this,is that if they're giving false
negatives, that also plays intothe mental aspect of things,
like how that kind of disruptsour cognitive function in a way,
and and our mental health andeverything else.
(12:34):
Like there's there's somethingto be said about making sure
something is very accurate andgiving voice to what we're going
through.
And that's what you're sayingis like you're getting to a
point where this is accuratediagnosis without the invasive
surgery.
Speaker 1 (12:50):
Absolutely.
And uh, it's even about uh, youknow, it's uh it's a way to
explain people how reallyhealthcare is, because uh let's
say that you don't haveabsolutely any access to
healthcare, you are in a ruralplace in the world, and that's
the only chance you have, youknow, maybe you can use it, but
being aware that if it'snegative, it's not necessarily
(13:11):
negative.
Speaker (13:11):
Right.
Speaker 1 (13:12):
But if you have the chance to get access to uh a
very experienced surgeon, then Iwon't spend any money on this
stuff.
I will just get to theexperienced surgeon.
And uh let me share with youwith this.
Uh my mom is uh right now,actually, the issue is gonna
turn 70 years old.
She is a doctor and she's anold school doctor.
(13:33):
She always tells me you have tolisten to patients.
If there is a problem, if theysay that there is a problem, the
problem is there.
Yes, whatever it is, you know,it can be organic, mental,
whatever it is, but there is aproblem.
If you want to convince thepatient that she does not have a
problem, that's because you'renot able to find out what the
problem is.
(13:53):
Yeah, that's okay.
But you need to recognize, toassess the presence of the
problem.
You cannot solve it.
You send to another uhcolleague, you remove something,
you do, you organize something,you go to the you can instantly
say, you know, no, as a doctor,we believe we need to be uh
superhuman.
Absolutely not.
Need to be sincere to people.
(14:14):
So, okay, maybe I don't knowthat.
I'm sorry.
I understand that there is aproblem, I can feel it.
You tell me, actually, so youknow, you're telling me right.
Uh I can I I'm gonna help you,I'm gonna do the best I can in
my knowledge and my connection.
And uh at the end, again,everything cool in tech and in
science needs to be damn fit inthe in the in the right way.
Speaker (14:35):
Yeah.
Well, it's also a tool ofvalidation.
I think that's kind of a bigthing for a lot of people
because I mean this is like it'sa tool that we could utilize
when we are seeing providers whodon't really know a lot about
endometriosis.
I think that's such a coolavenue for us to be able to go
into with the caveat of sayingwe don't always know for certain
(14:57):
100% that it's not there.
Right.
Speaker 1 (15:00):
That means that whenever you want to use a tool,
then uh without the physicianin the loop, people need to be
aware about how it works.
I know that self-education isyou know hard to do.
If we don't talk about medicineor something else like finance,
engineering, you know, I cantry to self-educate me, but then
(15:21):
you need to trust patientadvisor, someone else that that
already went through that andthen uh you know always talk to
people.
Speaker (15:29):
Yeah.
What advances will this bringfor research, though?
I think that's kind of animportant step, is like research
is great, but how will itadvance more research?
What are what do you think thegoal would be for that?
Speaker 1 (15:41):
Regarding liquid biopsy is something that is
already happening in uh in uh inthe oncology field, uh, and
it's something that is alreadyhere.
So it's happening today.
If I'm able to detect cancerearlier, um I'm not just able to
use different treatments orchange the management, but also
(16:02):
able to even give uh the greenlight for some drugs that are
being uh developing right now.
Because uh, whenever youintroduce new drug, you need to
validate those through uh yearsand years of studies, like five,
six years, and they have tofollow up.
And then, you know, during thevalidation of the new drug, only
(16:22):
the people that fit within thetrial can benefit from the new
drug.
There is lots of people thatwon't benefit from that drug
unless, you know, until the thestudy will be over.
In this way, is something thatis working on this.
If we find, and we alreadyfound in some specific case a
target in the liquid biopsy thatare related with clinical
(16:48):
outcomes, so they really have aclinical meaning, it means that
I can accelerate, I can speed upthe process of validation of
drug.
So it's gonna give a greatboost even uh in uh in drug uh
validation and production.
Basically, the goal is even uhif we know the fingerprints,
every cancer can give adifferent fingerprint.
(17:09):
So we can even study thebiology behind that specific
cancer and being able even to dowhat we call molecular guided
surgery.
So whenever you open a patient,you just not remove the organ
or the tissue, you are able tosee the cancer cells, you're
able to visually see the cancercells.
Okay, I'm gonna remove all thetiny little places.
Speaker (17:30):
Interesting.
There's so much hope for somany people.
It's just amazing what you'reable to do with tools that have
been and and creativity, youknow.
Are there studies that you arecurrently working on that are
gonna push the boundaries alittle bit in patient-centered
care or diagnosis?
Speaker 1 (17:51):
And you can talk about because that's always so
there is a molecular medicineproject ongoing in my center,
uh, especially for oncologicalcancers.
I may not say the name of thetarget, but it's something that
has to do with cell cycling anduh translation of the proteins.
The idea here is theexperimental studies right now.
(18:15):
We maybe have found somethinguh that if we target can slow
down uh the oncogenesis processin specific cancers.
So it's just a new, you know, anew target that may be useful
even for synthesizing drugresistance because uh when we
(18:36):
talk about AI, when we talkabout the tools, it's something
that uh we are doing in order toenhance the ability of humans
to cure and treat patterns tosee new data.
But then there is uh the otherpart of the science, so generate
new data, not just being ableto analyze the existing one.
Uh this is still today, thereare something that we are
(18:57):
advancing with the eye, butstill kind of analogical.
So it means that whenever wefound a pattern, then we need to
modify the cells in lab, andthen we need to see what's
happening after we do this kindof genetic editing, and then we
need to skip and next phases,and then we will get to the
patient.
That's the part of the researchthat's very, very exhausting
(19:18):
because uh whenever you modify acell, you never know what's
happening.
Speaker (19:21):
Right.
Speaker 1 (19:22):
One gene can have uh a role in one cancer, and
there's a complete another rolein another cancer, and then
there is another one gene, as wesaid, is it's not just one, but
then you have to look at theepigenetics and the way you get
transcripted in RNA and thegatting gets translated in
proteins, and how the proteinsget modified.
So the goal here is uh tryingto put all as again all the
(19:46):
layers together, otherwise wewon't understand very precisely
what's going on.
Speaker (19:50):
Right.
Yeah.
There's so many layers to allof this research.
They're insane.
And I'm excited to see likewhere that goes because you
know, we I feel like a lot oftimes we talk about needing more
research, but we there'sresearch happening, we just
don't know it.
We don't know what's beingdone.
And yet there's people that arestarting to pay more and more
(20:12):
attention to things likeendometriosis and cancers and
like specifically women'shealth-related research.
And I there's people that arepassionate, like you, who are
putting things together.
We just aren't always aware ofit.
And it's going to change thetrajectory of those living with
this disease because earlierdiagnosis, better care, better
(20:33):
treatment, better precision insurgery, what uh maybe even
future is reversing some of thatinflammatory markers.
Speaker 1 (20:43):
Exactly.
Yes, you're getting there.
See, I mean, uh that that's thereal goal.
Like we publish this these umthese studies called
endometriosis cancer mimicking,is on it's in uh the annals of
oncology journal.
And uh the cool thing aboutthat is uh endometriosis.
I'm sorry if I say cool, butit's uh scientifically cool.
(21:06):
Let's say that it's not a isthat endometriosis looks like it
behaves like a cancer, but it'snot a cancer, but has some
traits of a cancer.
And as you said, when it comesto cancer, it's a very
paradoxical stuff because uhcancer cells discovered how to
become immortal because uh theyare able to proliferate, to
(21:27):
invade, to move, to metastasize,so they are super, you know,
supercells.
And they can live forever,actually, but there is one
problem they will die once theywill kill the organism they are
into.
So it's kind of the price todiscover immortality is actually
death.
And it's something that makesme reflect a lot because maybe
(21:49):
humans not made for immortalitybecause the price to pay is is
uh is death.
There have been lots of uhresearch right now in longevity,
aging, trying to be immortaland blah blah blah.
But whenever you act and youtry to modify some natural
processing, such as aging, youdon't know what's happening
there.
That's why most of theanti-aging stuff in the long
(22:12):
term or hormone treatment longterm have been associated with
cancer issues and cancer riskbecause nature is a very
specific way to work and tofunction.
And whenever you want to changeit, something may happen.
Speaker (22:27):
Right, right.
And it I feel likeendometriosis is definitely
always leaving us on this pathof like which way is it gonna
go?
Like it's not something that islinear, it plays by its own
rules.
Exactly.
Speaker 1 (22:42):
That's something that science learned from patient
because uh patient understoodthat much earlier than uh
physician and scientists.
Whenever you talk with thepatient with endometriosis, you
know that her story iscompletely different than
someone else.
Someone has a very small lesionand huge pain, someone has a
very large lesion and like very,very soft pain.
(23:04):
Someone has fertility problems,other ones has intestinal bowel
problems.
And then there was a case thatwas a case in Italy actually.
This girl has endometriosis inthe brain.
And so it happened, you know,that during the period uh uh
this this brain lesion startedto bleed, and she started to
have uh epilepsy uh seizure, andthen after the period
(23:26):
everything was okay, everybodywas uh ready to start uh for you
know they thought it could becancer.
They started to do the theywanted to do the excision
surgery in the brain, that'svery, very hard and
debilitating.
But somehow there was adiscussion where, you know, it
was uh several years ago.
So what happened is uh someonenoticed the correlation with the
(23:49):
periods that it may beendometriosis.
And so they put uh the patientunder hormonal treatment to stop
the let's say the the period,the cycle, and she was
completely fine.
So it was endometriosis, brainendometriosis.
So you see that we are talkingabout endometriosis as a single
disease, but already has beenyears that patient already
(24:11):
telling us that endometriosis isnot a single disease, so it's
not something that we discoverlike, oh, we're genius.
No, we're just opening theeyes.
We just right now, what we needto do is finding the resources,
the team, the collaboration tokeep working on that.
And that's the paper we'retalking about.
We did a research and we sawthat endometriosis is like
(24:32):
having a car for each patient.
You know, the way the car goesand depends, the way you use uh
the pedals, the way you drive,uh the gears, and uh so you can
shift whatever she wants.
And uh the question is there isthe way to detect and predict
the behavior?
There may be, because in thestudy what we propose is that we
(24:54):
studied all the possiblepathways that the pneumatic
cells are can be possiblyactivated, doesn't mean that the
pathways are active at the sametime altogether, right?
So now the goal is trying to,and we are starting a
collaboration with the biotech,I cannot say the name, but uh,
we're starting a collaborationto see through specific analysis
(25:15):
whether these uh functionalityare like uh specifically related
to specific clinical symptoms.
Interesting.
So we can go on the way back,so from the clinical symptoms,
we can then uh relate with thebiology of the single cells.
Speaker (25:31):
Fascinating.
We're changing so much overhere in that world.
Thank you, Kanye, for justsitting down and going over this
research.
I hope, I hope that talking toyou and people being in this
conversation and hearing thisgives them hope that there's
more to look forward to inendometriosis research and care
(25:55):
and in women's health andpatient outcomes, not just
looking at surgery, but lookingat the whole picture.
You are doing a phen phenomenaljob of thinking outside of the
box and what really matters notonly to the patient but to the
provider and looking at it as acollective effort to create
better health care for everyone.
(26:16):
And so thanks for breaking thisresearch down.
Thank you for doing it.
Thanks for you know beingpassionate about this because
this is what's gonna change thefuture.
Thank you.
Speaker 1 (26:28):
I wanna let me let me thank you because here you're
doing an incredible job too.
If we will be successful, it'sbecause everybody will work
together and uh we will committo the same challenge.
And uh, the history of theworld is showing us that when
people work together, we can dothat.
Alone, of course, you won't gofarther.
Speaker (26:48):
Right?
Speaker 1 (26:48):
No, just thank you so much.
Speaker (26:50):
Yes, thank you.
And I always love talking toyou and I love spending time
with you, so it's just apleasure all around to be able
to do this.
But remember everyone,knowledge is power, and what you
do with that power is createchange.
So until next time, continueadvocating for you and for
others.
Welcome to Endo Battery Fast Charged, a series
dedicated to keeping youinformed and empowered in the
realm of endometriosis.
Teaming up with board certifiedpatient advocates, we bring you
the latest articles, research,and insights to equip you with
accurate information and adeeper understanding.
Whether you're expanding yourknowledge, staying updated, or
seeking clarity, you're in theright place.
(00:21):
I'm your host, Alanna, and thisis Endo battery Fast Charged,
charging and empowering yourlife with knowledge.
Welcome back to Endo BatteryFast Charge, where we power
through the latest researchshaping endometriosis in women's
health.
I couldn't be more excited tohave our very first guest on
(00:46):
this series, Dr.
Canio Martinelli, an OBGYNspecialist and the head of
clinical program at SavaroHealth Research Organization at
Temple University.
Dr.
Martinelli, recently named FDAAAACR Oncology Educational
Fellow, is at the forefront oftranslating cutting-edge science
into real-world impact.
(01:06):
His work connects emergingresearch, clinical care, and the
future treatment for peoplewith endometriosis, helping us
better understand whereinnovation can truly change
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(02:13):
And let's make this episodeeven better.
Let's get into this.
Thank you so much, Canio, forjoining me and sitting down and
going over this research.
With all the advances comingup, what is one of the things
that you've been researchingthat is exciting for people
across all aspects of women'shealthcare?
Speaker 1 (02:32):
Thank you so much for your incredible question.
Because uh we're always lookingfor something that can be
really game-changing.
And one of the things that hasbeen game-changing is liquid
biopsy.
It's a kind of uh strangeconcept because whenever we
think about biopsy, it'ssomething that you do in
medicine when uh you took asolid part of the body out of
(02:55):
the body of the patient, andthen you examine on a
pathological uh examination andyou get the report.
Here the liquid biopsy is aconceptually a completely
another stuff because uh you canget some sample of any liquid
of the body.
Basically, the the projectstarted with blood, but it can
be saliva, urine, it can betears.
(03:18):
And the idea is uh being ableto find in that sample something
that we can use to betterunderstand the disease, but also
to improve our management in uhin healthcare.
And that's the beauty ofthings, because, for example,
how is it possible that if youhave an ovarian cancer or
endometrial endometriosis, youknow, those are diseases that
(03:40):
start in the ovary, in theperitoneum, or uh like uh all
over the body, even forendometriosis.
But uh how do you get sample ofthat disease in the blood, for
example, on or in themenstruation on in the uterine
bleeding?
Uh well, the beauty of this isthat first of all you need to
(04:02):
understand the biology of thedisease.
Because whenever you develop atool in medicine, uh it's not
just enough developing the tool.
It needs to be then uh you needto show how you want to
implement the management withinwith the new tool.
Because if you introducesomething new, it doesn't mean
that's necessary much betterthan what you're already doing.
(04:24):
And now we are in a point ofhealthcare, especially in
oncology, where the whereinnovation really brought us in
in a fantastic period ofhumanity where we can really,
there are still very, very uhfatal diseases, especially when
you get ovarian cancer latetime.
But uh most of the time, if youcan get them, you can still
give hope to people and givenice uh chances.
(04:46):
So whatever you are doing nowhas to be specific for specific
patients that needs to for suregive much uh more benefit than
before.
So you cannot just try.
Uh in the liquid biopsy, it'sit's extremely innovative stuff
because uh you can be lessinvasive because you can take,
you know, uterine bleeding orblood sample, and you can do
(05:11):
extremely fine diagnosis.
It's like when you have rightnow, if you have a cholesterol,
you just need to take a bloodsample, right?
And cholesterol is somethingthat navigates and swim in the
blood.
Same stuff we need to find forendometriosis of variant cancer,
endometrial cancer, generallywith the cancer works much
better.
Something that circulates inthese uh in these samples and
(05:34):
being able to detect them anduse that kind of detection to
understand the disease and evento develop something new.
So, if I want to have a kind ofmetaphor, I would say that it's
like for the FBI, you know,using fingerprints to find
criminals.
The liquid biopsy is exactlythe same thing.
We will use fingerprints thatcancer endometriosis live in the
(05:59):
in the in the blood in order todetect them as early as we can,
right in the less invasive waypossible.
But if you think about FBI 200years ago, it it didn't exist,
of course, but let's say that itexists.
If you wanted to catch acriminal by using fingerprints,
it would have been impossiblebecause you didn't even have the
fingerprints.
Now everybody coming to USdidn't need to give, you know,
(06:21):
to record fingerprints, so it'svery easy.
What we are doing right now inscience is that for liquid
biopsy, right now detecting thefingerprints of uh uh
circulating fingerprints ofcancers or very, very high
inflammatory diseases such asendometriosis.
Yeah.
And now we are developing thatyou can look at different
reviews and editorial that we wewrote.
(06:43):
One is exactly liquid biopsy ingynaecological cancer.
The other one is called uhcancer in a drop.
And now we are developingtogether with uh a fantastic
team from Italy new sensors inorder to detect this kind of uh
fingerprints, this is uh fromdifferent uh samples from women
in order even to try to developuh sensors that are cheap so you
(07:07):
can uh let everybody use uh thenew technology.
Speaker (07:11):
What is like the control group for that and like
what's the accuracy of it sofar?
Speaker 1 (07:17):
Exactly.
So whenever you do that, youhave a population.
We are right now in the in thein a phase where we are training
the system.
Speaker (07:26):
Okay.
Speaker 1 (07:27):
There are already some commercial available um
like uh especially forendometriosis, especially in US,
uh tools that you can use todetect endometriosis.
Some of them with even uh AIpowered, they say that they can
have an accuracy of 96%.
The thing is that, and that'sanother actually critical paper
(07:48):
that we are working on.
There are different kinds ofpapers, you know better than me.
Is that FDA, in order toapprove AI liquid biopsy test,
you need to show an accuracythat is higher than 99%.
And I think that FDA wasincredibly smart this time
because they said, okay, youwanna do that, but you need to
(08:09):
show that it's incrediblyaccurate.
Otherwise, I'm not gonna giveyou the FDA approval.
That's why lots of right nowliquid biopsy tools they don't
have they don't have FDAapproval.
I think that's very importantbecause what is I'm gonna ask
you this question actually toyou.
Like let's say that you're ayoung girl and you have pain,
(08:30):
you believe you are ofendometriosis and you live in a
place in the US all over theworld, but you don't have an
easy access to uh like realspecialist, you know, of
endometriosis.
And you feel pain, you feelpain, you go to a doctor and he
says, uh, you don't haveanything, don't worry, you are a
woman.
Uh and then you take the test,and the test is gonna give you
(08:51):
what we call uh false negative.
So the test is gonna, becausethe accuracy is not very, very
high, the test is gonna tell youthere is a risk that tells the
test tells you you you don'thave the disease.
At that point, you're gonna uhbasically say to that woman that
your life, her life is gonna bedestroyed for the rest of the
(09:12):
life because uh she will havethe confirmation that she does
not have any problem and shewill convince herself that she
needs to feel that pain.
So again, whenever there isthis new sexy stuff in science,
validation is first step.
Second step is how can Iintroduce that without uh
(09:32):
creating critical problem forpeople?
Because you know, when you whenyou see the test and the test
test is negative, you don'tthink about okay, what's the
accuracy rate?
That's a question that you uhare uh like right now, you're
making.
But lots of people they don'tthink about that because when
they are in a fight or flightmode, they just are focused on
something, they don't have thecalm to to really be rational
(09:55):
things.
So we need to be very, verycareful, especially when people
want to make money out of this.
So we need to stand up forpeople who says, okay, FDA did
an incredible job here, I haveto say that.
Speaker (10:07):
Right.
So this study is essentially isit going to be an analyzing,
like creating a tool thatanalyzes like the DNA for
inflammatory markers and geneticmutations, or is it is it a
doing it through differentsequencing?
Speaker 1 (10:22):
Well, let's say that we are working on different
kinds of sensor.
One of the most two of the mostpromising one.
One is working on theventilation of the DNA.
We know that there is thegenomics that's actually the
omic related to the sequence ofthe DNA.
But the DNA is not justsomething that stays there, it's
uh it's a living stuff, it'ssomething they change, something
(10:44):
that got modified.
And so we can have the sameDNA, but there could be
different modifications.
So it's called epigenetics.
Right.
So even if you have the samegenomics, it doesn't mean that
you're gonna be the same.
Because the modification of theDNA, in this case, uh
epigenetic modification, canchange the way the gene
(11:04):
expresses themselves intoproteins, and then again there
will be a modification of theproteins, and the way they are
modified will determine thefunction of the proteins.
And if you put all of theselayers together, you're going to
create a unique pattern, notjust as uh like uh
phenotypically human, but evenfrom a functional biological
(11:24):
distinction, and that's thething.
So being able to see themethylation pattern of all the
DNA can give nice information,especially related to
inflammation, like inflammatorydisease such as endometriosis,
because they're gonna leave afit like we said, a fingerprint
somehow.
(11:45):
Like if you don't wanna commitany like a problem, you just
don't create problem.
If you do something, you canhide, but someone is gonna find
you.
That's we are in that phase.
We're gonna find we know thatendometriosis is something
invasive, it's something thatwhenever you know it got
attached to somewhere in thebody, it has to do something.
Maybe the signal is very, verylow, and when the signal is low,
(12:08):
we can use AI stuff to likeenhance the signal, but we're
getting to that.
Speaker (12:13):
Interesting.
I think what's important too,and what you're saying is like
the FDA did a good job in this,is that if they're giving false
negatives, that also plays intothe mental aspect of things,
like how that kind of disruptsour cognitive function in a way,
and and our mental health andeverything else.
(12:34):
Like there's there's somethingto be said about making sure
something is very accurate andgiving voice to what we're going
through.
And that's what you're sayingis like you're getting to a
point where this is accuratediagnosis without the invasive
surgery.
Speaker 1 (12:50):
Absolutely.
And uh, it's even about uh, youknow, it's uh it's a way to
explain people how reallyhealthcare is, because uh let's
say that you don't haveabsolutely any access to
healthcare, you are in a ruralplace in the world, and that's
the only chance you have, youknow, maybe you can use it, but
being aware that if it'snegative, it's not necessarily
(13:11):
negative.
Speaker (13:11):
Right.
Speaker 1 (13:12):
But if you have the chance to get access to uh a
very experienced surgeon, then Iwon't spend any money on this
stuff.
I will just get to theexperienced surgeon.
And uh let me share with youwith this.
Uh my mom is uh right now,actually, the issue is gonna
turn 70 years old.
She is a doctor and she's anold school doctor.
(13:33):
She always tells me you have tolisten to patients.
If there is a problem, if theysay that there is a problem, the
problem is there.
Yes, whatever it is, you know,it can be organic, mental,
whatever it is, but there is aproblem.
If you want to convince thepatient that she does not have a
problem, that's because you'renot able to find out what the
problem is.
(13:53):
Yeah, that's okay.
But you need to recognize, toassess the presence of the
problem.
You cannot solve it.
You send to another uhcolleague, you remove something,
you do, you organize something,you go to the you can instantly
say, you know, no, as a doctor,we believe we need to be uh
superhuman.
Absolutely not.
Need to be sincere to people.
(14:14):
So, okay, maybe I don't knowthat.
I'm sorry.
I understand that there is aproblem, I can feel it.
You tell me, actually, so youknow, you're telling me right.
Uh I can I I'm gonna help you,I'm gonna do the best I can in
my knowledge and my connection.
And uh at the end, again,everything cool in tech and in
science needs to be damn fit inthe in the in the right way.
Speaker (14:35):
Yeah.
Well, it's also a tool ofvalidation.
I think that's kind of a bigthing for a lot of people
because I mean this is like it'sa tool that we could utilize
when we are seeing providers whodon't really know a lot about
endometriosis.
I think that's such a coolavenue for us to be able to go
into with the caveat of sayingwe don't always know for certain
(14:57):
100% that it's not there.
Right.
Speaker 1 (15:00):
That means that whenever you want to use a tool,
then uh without the physicianin the loop, people need to be
aware about how it works.
I know that self-education isyou know hard to do.
If we don't talk about medicineor something else like finance,
engineering, you know, I cantry to self-educate me, but then
(15:21):
you need to trust patientadvisor, someone else that that
already went through that andthen uh you know always talk to
people.
Speaker (15:29):
Yeah.
What advances will this bringfor research, though?
I think that's kind of animportant step, is like research
is great, but how will itadvance more research?
What are what do you think thegoal would be for that?
Speaker 1 (15:41):
Regarding liquid biopsy is something that is
already happening in uh in uh inthe oncology field, uh, and
it's something that is alreadyhere.
So it's happening today.
If I'm able to detect cancerearlier, um I'm not just able to
use different treatments orchange the management, but also
(16:02):
able to even give uh the greenlight for some drugs that are
being uh developing right now.
Because uh, whenever youintroduce new drug, you need to
validate those through uh yearsand years of studies, like five,
six years, and they have tofollow up.
And then, you know, during thevalidation of the new drug, only
(16:22):
the people that fit within thetrial can benefit from the new
drug.
There is lots of people thatwon't benefit from that drug
unless, you know, until the thestudy will be over.
In this way, is something thatis working on this.
If we find, and we alreadyfound in some specific case a
target in the liquid biopsy thatare related with clinical
(16:48):
outcomes, so they really have aclinical meaning, it means that
I can accelerate, I can speed upthe process of validation of
drug.
So it's gonna give a greatboost even uh in uh in drug uh
validation and production.
Basically, the goal is even uhif we know the fingerprints,
every cancer can give adifferent fingerprint.
(17:09):
So we can even study thebiology behind that specific
cancer and being able even to dowhat we call molecular guided
surgery.
So whenever you open a patient,you just not remove the organ
or the tissue, you are able tosee the cancer cells, you're
able to visually see the cancercells.
Okay, I'm gonna remove all thetiny little places.
Speaker (17:30):
Interesting.
There's so much hope for somany people.
It's just amazing what you'reable to do with tools that have
been and and creativity, youknow.
Are there studies that you arecurrently working on that are
gonna push the boundaries alittle bit in patient-centered
care or diagnosis?
Speaker 1 (17:51):
And you can talk about because that's always so
there is a molecular medicineproject ongoing in my center,
uh, especially for oncologicalcancers.
I may not say the name of thetarget, but it's something that
has to do with cell cycling anduh translation of the proteins.
The idea here is theexperimental studies right now.
(18:15):
We maybe have found somethinguh that if we target can slow
down uh the oncogenesis processin specific cancers.
So it's just a new, you know, anew target that may be useful
even for synthesizing drugresistance because uh when we
(18:36):
talk about AI, when we talkabout the tools, it's something
that uh we are doing in order toenhance the ability of humans
to cure and treat patterns tosee new data.
But then there is uh the otherpart of the science, so generate
new data, not just being ableto analyze the existing one.
Uh this is still today, thereare something that we are
(18:57):
advancing with the eye, butstill kind of analogical.
So it means that whenever wefound a pattern, then we need to
modify the cells in lab, andthen we need to see what's
happening after we do this kindof genetic editing, and then we
need to skip and next phases,and then we will get to the
patient.
That's the part of the researchthat's very, very exhausting
(19:18):
because uh whenever you modify acell, you never know what's
happening.
Speaker (19:21):
Right.
Speaker 1 (19:22):
One gene can have uh a role in one cancer, and
there's a complete another rolein another cancer, and then
there is another one gene, as wesaid, is it's not just one, but
then you have to look at theepigenetics and the way you get
transcripted in RNA and thegatting gets translated in
proteins, and how the proteinsget modified.
So the goal here is uh tryingto put all as again all the
(19:46):
layers together, otherwise wewon't understand very precisely
what's going on.
Speaker (19:50):
Right.
Yeah.
There's so many layers to allof this research.
They're insane.
And I'm excited to see likewhere that goes because you
know, we I feel like a lot oftimes we talk about needing more
research, but we there'sresearch happening, we just
don't know it.
We don't know what's beingdone.
And yet there's people that arestarting to pay more and more
(20:12):
attention to things likeendometriosis and cancers and
like specifically women'shealth-related research.
And I there's people that arepassionate, like you, who are
putting things together.
We just aren't always aware ofit.
And it's going to change thetrajectory of those living with
this disease because earlierdiagnosis, better care, better
(20:33):
treatment, better precision insurgery, what uh maybe even
future is reversing some of thatinflammatory markers.
Speaker 1 (20:43):
Exactly.
Yes, you're getting there.
See, I mean, uh that that's thereal goal.
Like we publish this these umthese studies called
endometriosis cancer mimicking,is on it's in uh the annals of
oncology journal.
And uh the cool thing aboutthat is uh endometriosis.
I'm sorry if I say cool, butit's uh scientifically cool.
(21:06):
Let's say that it's not a isthat endometriosis looks like it
behaves like a cancer, but it'snot a cancer, but has some
traits of a cancer.
And as you said, when it comesto cancer, it's a very
paradoxical stuff because uhcancer cells discovered how to
become immortal because uh theyare able to proliferate, to
(21:27):
invade, to move, to metastasize,so they are super, you know,
supercells.
And they can live forever,actually, but there is one
problem they will die once theywill kill the organism they are
into.
So it's kind of the price todiscover immortality is actually
death.
And it's something that makesme reflect a lot because maybe
(21:49):
humans not made for immortalitybecause the price to pay is is
uh is death.
There have been lots of uhresearch right now in longevity,
aging, trying to be immortaland blah blah blah.
But whenever you act and youtry to modify some natural
processing, such as aging, youdon't know what's happening
there.
That's why most of theanti-aging stuff in the long
(22:12):
term or hormone treatment longterm have been associated with
cancer issues and cancer riskbecause nature is a very
specific way to work and tofunction.
And whenever you want to changeit, something may happen.
Speaker (22:27):
Right, right.
And it I feel likeendometriosis is definitely
always leaving us on this pathof like which way is it gonna
go?
Like it's not something that islinear, it plays by its own
rules.
Exactly.
Speaker 1 (22:42):
That's something that science learned from patient
because uh patient understoodthat much earlier than uh
physician and scientists.
Whenever you talk with thepatient with endometriosis, you
know that her story iscompletely different than
someone else.
Someone has a very small lesionand huge pain, someone has a
very large lesion and like very,very soft pain.
(23:04):
Someone has fertility problems,other ones has intestinal bowel
problems.
And then there was a case thatwas a case in Italy actually.
This girl has endometriosis inthe brain.
And so it happened, you know,that during the period uh uh
this this brain lesion startedto bleed, and she started to
have uh epilepsy uh seizure, andthen after the period
(23:26):
everything was okay, everybodywas uh ready to start uh for you
know they thought it could becancer.
They started to do the theywanted to do the excision
surgery in the brain, that'svery, very hard and
debilitating.
But somehow there was adiscussion where, you know, it
was uh several years ago.
So what happened is uh someonenoticed the correlation with the
(23:49):
periods that it may beendometriosis.
And so they put uh the patientunder hormonal treatment to stop
the let's say the the period,the cycle, and she was
completely fine.
So it was endometriosis, brainendometriosis.
So you see that we are talkingabout endometriosis as a single
disease, but already has beenyears that patient already
(24:11):
telling us that endometriosis isnot a single disease, so it's
not something that we discoverlike, oh, we're genius.
No, we're just opening theeyes.
We just right now, what we needto do is finding the resources,
the team, the collaboration tokeep working on that.
And that's the paper we'retalking about.
We did a research and we sawthat endometriosis is like
(24:32):
having a car for each patient.
You know, the way the car goesand depends, the way you use uh
the pedals, the way you drive,uh the gears, and uh so you can
shift whatever she wants.
And uh the question is there isthe way to detect and predict
the behavior?
There may be, because in thestudy what we propose is that we
(24:54):
studied all the possiblepathways that the pneumatic
cells are can be possiblyactivated, doesn't mean that the
pathways are active at the sametime altogether, right?
So now the goal is trying to,and we are starting a
collaboration with the biotech,I cannot say the name, but uh,
we're starting a collaborationto see through specific analysis
(25:15):
whether these uh functionalityare like uh specifically related
to specific clinical symptoms.
Interesting.
So we can go on the way back,so from the clinical symptoms,
we can then uh relate with thebiology of the single cells.
Speaker (25:31):
Fascinating.
We're changing so much overhere in that world.
Thank you, Kanye, for justsitting down and going over this
research.
I hope, I hope that talking toyou and people being in this
conversation and hearing thisgives them hope that there's
more to look forward to inendometriosis research and care
(25:55):
and in women's health andpatient outcomes, not just
looking at surgery, but lookingat the whole picture.
You are doing a phen phenomenaljob of thinking outside of the
box and what really matters notonly to the patient but to the
provider and looking at it as acollective effort to create
better health care for everyone.
(26:16):
And so thanks for breaking thisresearch down.
Thank you for doing it.
Thanks for you know beingpassionate about this because
this is what's gonna change thefuture.
Thank you.
Speaker 1 (26:28):
I wanna let me let me thank you because here you're
doing an incredible job too.
If we will be successful, it'sbecause everybody will work
together and uh we will committo the same challenge.
And uh, the history of theworld is showing us that when
people work together, we can dothat.
Alone, of course, you won't gofarther.
Speaker (26:48):
Right?
Speaker 1 (26:48):
No, just thank you so much.
Speaker (26:50):
Yes, thank you.
And I always love talking toyou and I love spending time
with you, so it's just apleasure all around to be able
to do this.
But remember everyone,knowledge is power, and what you
do with that power is createchange.
So until next time, continueadvocating for you and for
others.
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