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CarlJune_2018P-_「活体药」开啓肿瘤治疗新方式_
So this is the first time I've told this story in public, the personal aspects of it. 这是我第一次在公衆面前 以个人角度说这件事。
personal:adj.个人的;身体的;亲自的;n.人事消息栏;人称代名词; aspects:n.方面;相位;面貌(aspect的复数);
Yogi Berra was a world-famous baseball player who said, "If you come to a fork in the road, take it." 世界着名的棒球运动员 尤奇贝拉曾说, 「当你遇到人生的岔道,承担起来吧。」
Yogi:n.瑜珈修行者;瑜珈信徒;沉思或神秘的人; world-famous:adj.举世闻名的;
Researchers had been, for more than a century, studying the immune system as a way to fight cancer , and cancer vaccines have, unfortunately , been disappointing . 一个世纪以来, 科学家们都在研究 用免疫系统对抗肿瘤的方法, 但肿瘤疫苗的效果却不如人意,
immune system:n.免疫系统; cancer:n.癌症;恶性肿瘤; vaccines:n.[药][计]疫苗; unfortunately:adv.不幸地; disappointing:adj.令人失望的;v.使失望;使破灭;使落空(disappoint的现在分词)
They've only worked in cancers caused by viruses, like cervical cancer or liver cancer. 它们只对病毒引起的肿瘤起作用, 比如子宫癌和肝癌。
cancers:n.癌; (Cancers是cancer的复数) cervical:adj.颈的;子宫颈的; liver:n.肝;(动物供食用的)肝;
So cancer researchers basically gave up on the idea of using the immune system to fight cancer. 所以肿瘤科学家基本上放弃了 利用免疫系统对抗肿瘤的方法。
basically:adv.主要地,基本上;
And the immune system, in any case , did not evolve to fight cancer; it evolved to fight pathogens invading from the outside. 而且免疫系统的职责 从来不是对付肿瘤, 而是对抗外来的病原体。
in any case:无论如何; evolved:v.(使)逐渐形成;进化;进化形成;(evolve的过去分词和过去式) pathogens:n.[基医]病原体;病原菌;[基医]致病菌; invading:v.武装入侵;侵略;侵犯;涌入;干扰(invade的现在分词)
So its job is to kill bacteria and viruses. 所以它的工作是杀死细菌和病毒。
bacteria:n.[微]细菌;
And the reason the immune system has trouble with most cancers is that it doesn't invade from the outside; it evolves from its own cells. 之所以免疫系统无法对付大多数肿瘤, 是因为肿瘤并不源于外界, 而是从体内细胞产生的。
invade:v.侵犯;侵略;侵袭;干扰; evolves:v.进化,进展(evolve的第三人称单数形式);
And so either the immune system does not recognize the cancer as a problem, or it attacks a cancer and also our normal cells, leading to autoimmune diseases like colitis or multiple sclerosis . 所以免疫系统要不就是 识别不出肿瘤细胞, 要不就是同时攻击其它正常细胞, 引发自体免疫疾病, 例如结肠炎或多发性硬化症。
recognize:v.认识;认出;辨别出;承认;意识到; autoimmune:adj.自身免疫的;自体免疫的; diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类; colitis:n.[内科]结肠炎; multiple sclerosis:n.多发性硬化;
So how do you get around that? 所以有什么解决方法呢？
get around:到处走走;逃避;说服;传开来(等于getround);有办法应付;有办法应付局面;
Our answer turned out to be synthetic immune systems that are designed to recognize and kill cancer cells. 我们的回答是「人造免疫系统」, 设计出识别能力,用来杀死癌细胞。
synthetic:adj.综合的;合成的,人造的;n.合成物;
That's right -- I said a synthetic immune system. 没错——我说人造免疫系统。
You do that with genetic engineering and synthetic biology . 它透过基因工程 与合成生物学来实现。
genetic engineering:n.基因工程;遗传工程(学); biology:n.(一个地区全部的)生物;生物学;
We did it with the naturally occurring parts of the immune system, called B cells and T cells. 我们使用免疫系统的自体成分, 也就是 B 细胞和 T 细胞。
naturally:adv.自然地;自然而然地;轻而易举;天生地;大方地; occurring:n.事件;事故;事变;
These were our building blocks . 这些是基本组件。
building blocks:(儿童玩的)积木;建筑砌块;堆积木;建筑砖块;基石;
T cells have evolved to kill cells infected with viruses, and B cells are the cells that make antibodies that are secreted and then bind to kill bacteria. T 细胞用于杀死 被病毒侵染的细胞, B 细胞用于合成并释放 杀死细菌的抗体。
infected:adj.带菌的; v.传染; (infect的过去分词和过去式) antibodies:n.[免疫]抗体(antibody的复数); secreted:v.分泌;隐藏,藏匿(小物件);(secrete的过去分词和过去式) bind:v.结合;装订;有约束力;过紧;n.捆绑;困境;讨厌的事情;植物的藤蔓;
Well, what if you combined these two functions in a way that was designed to repurpose them to fight cancer? 现在,如果要整合两者的功能 并设计出专门对付 肿瘤的人工细胞,要怎么做呢？
what if:如果…怎么办? repurpose:vt.改换意图;重新目的化;
We realized it would be possible to insert the genes for antibodies from B cells into T cells. 我们意识到,我们有可能 可以把 B 细胞中的抗体基因 插入到 T 细胞中。
genes:n.基因;(gene的复数)
So how do you do that? 但怎么实现呢？
Well, we used an HIV virus as a Trojan horse to get past the T cells' immune system. 我们将 HIV 病毒包装成特洛伊木马, 来骗过 T 细胞的免疫系统。
HIV:n.艾滋病病毒; Trojan horse:n.特洛伊木马;(来自外部的)颠覆分子(或活动);
The result is a chimera , a fantastic fire-breathing creature from Greek mythology , with a lion's head, a goat's body and a serpent's tail. 结果创造出了一个喀迈拉, 这种希腊神话中的噴火兽 融合了狮头、羊身、蛇尾, 由此引申出「嵌合」之义。
chimera:n.[遗]嵌合体;虚构的怪物;妄想; fantastic:奇异的,空想的 creature:n.生物;动物;(具有某种特征的)人; mythology:n.神话;神话学;神话集;
So we decided that the paradoxical thing that we had created with our B-cell antibodies, our T cells carrier and the HIV Trojan horse should be called " Chimeric Antigen Receptor T cells," or CAR T cells. 于是我们决定把创造出的这个 结合了 B 细胞抗体、T 细胞载体 与特定的 HIV 特洛伊木马病毒, 称为「嵌合抗原受体 T 细胞」, 也叫 CAR T细胞。
paradoxical:adj.矛盾的;诡论的;似非而是的; Chimeric:adj.妄想的;荒诞不经的; Antigen:n.[免疫]抗原; Receptor:n.[生化]受体;接受器;感觉器官;
The virus also inserts genetic information to activate the T cells and program them into their killing mode. 这种细胞还插入了 激活 T 细胞消灭功能的基因。
activate:vt.刺激;使活动;使活泼;使产生放射性;vi.激活;有活力;
So when CAR T cells are injected into somebody with cancer, what happens when those CAR T cells see and bind to their tumor target? CAR T细胞进入癌症患者体内后, 它们会如何搜寻和附着肿瘤呢？
injected:v.(给…)注射(药物等); (inject的过去分词和过去式) tumor:n.肿瘤;肿块;赘生物;
They act like supercharged killer T cells on steroids . 它们会像火力全开的杀手
supercharged:adj.超动力的; v.过份给与; steroids:n.甾族化合物;类固醇;(steroid的复数)
They start this crash-defense buildup system in the body and literally divide and multiply by the millions, where they then attack and kill the tumor. 在身体中建起防御系统, 并分裂增殖至上百万, 然后攻击并杀死肿瘤细胞。
buildup:n.增强;发展;形成;组合;树立名誉; literally:adv.按字面:字面上:确实地: multiply:vt.乘; vi.乘; v.多样地; adj.多层的;
All of this means that CAR T cells are the first living drug in medicine. 这些都说明 CAR T细胞 是首种「活体药」。
CAR T cells break the mold . CAR T细胞杀死霉菌。
mold:n.模具;模型;霉菌;类型;v.用可塑材料塑成;浇铸;发霉;
Unlike normal drugs that you take -- they do their job and get metabolized , and then you have to take them again -- 它不像平时服用的普通药, 不会发挥作用后随代谢失效, 然后必须再次摄取。
metabolized:vt.使新陈代谢;使变形;vi.新陈代谢;
CAR T cells stay alive and on the job for years. CAR T细胞会在人体中 保持活性的时间长达数年,
We have had CAR T cells stay in the bodies of our cancer patients now for more than eight years. 我们有参与实验的癌症患者 体内的 CAR T 细胞 至今已存活超过八年。
patients:n.接受治疗者,病人;(patient的复数)
And these designer cancer T cells, CAR T cells, have a calculated half-life of more than 17 years. 针对癌症而设计的 CAR T细胞 生物半衰期预计超过 17 年。
half-life:n.[核]半衰期;
So one infusion can do the job; they stay on patrol for the rest of your life. 只需要一次输注, 它们就能守护你的余生。
infusion:n.灌输;浸泡;注入物;激励; patrol:n.巡逻;巡逻队;侦察队;vt.巡逻;巡查;vi.巡逻;巡查;
This is the beginning of a new paradigm in medicine. 这是医药新典范的开端。
paradigm:n.范例;词形变化表;
Now, there was one major challenge to these T-cell infusions . 但是,这些 T 细胞的 其中一个重大挑战是:
infusions:n.[临床]输液;灌输;[化学]浸剂(infusion的复数);
The only source of T cells that will work in a patient are your own T cells, unless you happen to have an identical twin . 能在体内发挥作用的 T 细胞 只能是自体的 T 细胞, 除非你刚好是同卵双胞胎。
source:n.来源;水源;原始资料; identical twin:n.单卵性双胞胎之一(性别相同,外貌相似);
So for most of us, we're out of luck . 因此,我们大多数人的运气背极了。
out of luck:运气不好;
So what we did was to make CAR T cells. 我们改造了 CAR T 细胞。
We had to learn to grow the patient's own T cells. 我们必须学会如何培养 患者的自体 T 细胞。
And we developed a robust platform for this in the 1990s. 我们在 90 年代 搭建了一个很厉害的平台。
robust:adj.强健的;健康的;粗野的;粗鲁的; platform:n.平台; v.把…放在台上[放在高处;
Then in 1997, we first tested CAR T cells in patients with advanced HIV-AIDS. 1997 年,我们首次 对晚期爱滋病患者 测试 CAR T 细胞。
advanced:adj.先进的; v.前进; (advance的过去式和过去分词形式)
And we found that those CAR T cells survived in the patients for more than a decade. 我们发现这些 CAR T 细胞 在患者体内存活超过十年。
And it improved their immune system and decreased their viruses, but it didn't cure them. 它们增强了免疫系统, 减少了体内病毒, 但并没有治愈爱滋病。
improved:adj.改良的:v.改进:改善(improve的过去分词和过去式) decreased:v.减少,减小,降低;(decrease的过去分词和过去式)
So we went back to the laboratory , and over the next decade made improvements to the CAR T cell design. 于是我们重新进行实验室实验, 用十年的时间改进了 CAR T 细胞的设计。
laboratory:n.实验室,研究室; improvements:n.改善;改进;改善的事物;(improvement的复数)
And by 2010, we began treating leukemia patients. 2012 年,我们开始治疗白血病患者。
treating:v.以…态度对待;把…看作;处理;讨论;(treat的现在分词) leukemia:n.[内科][肿瘤]白血病;
And our team treated three patients with advanced chronic lymphocytic leukemia in 2012. 我们团队负责治疗三位 晚期 B 细胞慢性淋巴性白血病患者。
treated:v.以…态度对待;把…看作;(treat的过去分词和过去式) chronic:adj.慢性的;长期的;习惯性的; lymphocytic:adj.淋巴细胞的;淋巴球的;
It's a form of incurable leukemia that afflicts approximately 20,000 adults every year in the United States. 这是一种无法治愈的白血病, 每年折磨着大约两万名美国成人。
incurable:adj.不能治愈的;无可救药的;n.患不治之症者,不能治愈的人; afflicts:vt.折磨;使痛苦;使苦恼; approximately:adv.大约,近似地;近于; United:adj.联合的; v.联合,团结; (unite的过去分词和过去式)
The first patient that we treated was a retired Marine sergeant and a prison corrections officer. 我们治疗的第一位患者 是一位退休的海军陆战队中士狱警,
Marine:adj.海的;海产的;海生的;海船的;n.(尤指美国或英国皇家)海军陆战队士兵; sergeant:n.军士;警察小队长;海军陆战队中士;高等律师;
He had only weeks to live and had, in fact, already paid for his funeral . 他的生命只剩下几周, 事实上,他已经准备好了葬礼。
funeral:n.葬礼;麻烦事;adj.丧葬的,出殡的;
The cells were infused , and within days, he had high fevers. CAR T 细胞输注后的几天内, 他出现了高烧,
infused:灌输;
He developed multiple organ failures, was transferred to the ICU and was comatose . 并发展出多个器官衰竭, 他被转移到加护病房,重度昏迷。
organ:n.[生物]器官;机构;风琴;管风琴;嗓音; transferred:v.(使)转移,搬迁;(使)调动;(transfer的过去分词和过去式) comatose:adj.昏迷的;昏睡状态的;麻木的;怠惰的;
We thought he would die, and, in fact, he was given last rights. 我们以为他会死, 甚至给他做了临终圣事。
But then, another fork in the road happened. 就在此时,岔道出现,要他做决定了。
So, around 28 days after the CAR T cell infusion, he woke up, and the physicians finally examined him, and the cancer was gone. 在输注 CAR T 细胞的 28 天后, 他苏醒过来。 医生对他做了檢查, 他的肿瘤消失了。
physicians:n.[内科]内科医生(physician的复数); finally:adv.终于;最终;(用于列举)最后;彻底地;
The big masses that had been there had melted . 原来的肿瘤块溶解了。
masses:n.民众;大量(mass的复数);包块;v.集中;聚集(mass的三单形式); melted:v.(使)熔化,融化;(使)软化,变得温柔;(melt的过去分词和过去式)
Bone marrow biopsies found no evidence of leukemia, and that year, in our first three patients we treated, two of three have had durable remissions now for eight years, and one had a partial remission. 骨髓檢查没有白血病的迹象, 那一年,在首批治疗的三位患者中, 其中两位癌症完全缓解, 至今已达八年, 一位癌症部分缓解。
Bone marrow:n.骨髓; biopsies:活组织检查; evidence:n.证据,证明;迹象;明显;v.证明; durable:adj.耐用的;耐久的;长期的;长久的;n.耐久品; remissions:n.缓解;宽恕;豁免; partial:adj.部分的;不完整的;片面的;有偏见的;
The CAR T cells had attacked the leukemia in these patients and had dissolved between 2.9 and 7.7 pounds of tumor in each patient. CAR T 细胞攻击白血病细胞, 消灭了每位患者 2.9 到 7.7 磅的肿瘤。
dissolved:v.溶;使(固体)溶解;解除;终止;(dissolve的过去式和过去分词)
Their bodies had become veritable bioreactors for these CAR T cells, producing millions and millions of CAR T cells in the bone marrow, blood and tumor masses. 身体为这些 CAR T 细胞 提供了绝佳的环境, CAR T 细胞得以繁殖至百万, 遍布骨髓、血液和肿瘤块。
veritable:adj.真正的,名副其实的; bioreactors:n.生物反应器;生物发电站;(bioreactor的复数)
And we discovered that these CAR T cells can punch far above their weight class, to use a boxing analogy . 我们发现 CAR T 细胞 会使用「拳击技巧」 来击倒重量级的对手。
punch:n.冲床; v.拳打; (用打孔器等)打孔; analogy:n.类比;类推;类似;
Just one CAR T cell can kill 1,000 tumor cells. 一个 CAR T 细胞 能杀死一千个肿瘤细胞,
That's right -- it's a ratio of one to a thousand. 没错,这是一比一千的比率。
ratio:n.比率;比例;v.用比例方式表达;求出…的比值;使…成比例;
The CAR T cell and its daughter progeny cells can divide and divide and divide in the body until the last tumor cell is gone. CAR T 细胞和子代细胞 在体内会不断分裂分化, 直到最后一个肿瘤细胞被消灭。
progeny:n.子孙;后裔;成果;
There's no precedent for this in cancer medicine. 这在癌症治疗上是史无前例的。
precedent:n.先例;前例;adj.在前的;在先的;
The first two patients who had full remission remain today leukemia-free, and we think they are cured. 首批中两位癌症完全缓解的患者 到今天仍然没有白血病复发的迹象, 我们判断他们已然痊愈。
These are people who had run out of options , and by all traditional methods they had, they were like modern-day Lazarus cases. 这是一些走投无路的人, 在所有传统疗法以失败告终后, 他们沦落为现代的拉撒路案例。 （一部反应医疗困境的文学作品）
run out of:用完; options:n.选择; v.得到或获准进行选择; (option的三单形式) traditional:传统的,惯例的, modern-day:adj.当代的;今日的;
All I can say is: thank goodness for those forks in the road. 我只能说:感谢那些岔道。
Our next step was to get permission to treat children with acute leukemia, the most common form of cancer in kids. 我们的第二步是治疗晚期白血病患儿, 这是幼儿中最常见的癌症。
acute:adj.严重的,[医]急性的;敏锐的;激烈的;尖声的;
The first patient we enrolled on the trial was Emily Whitehead, and at that time, she was six years old. 首位试验患者是艾美莉·怀特海, 当时她六岁。
enrolled:v.(使)加入;注册;登记;(enroll的过去分词和过去式)
She had gone through a series of chemotherapy and radiation treatments over several years, and her leukemia had always come back. 她在过去几年里 接受了一系列化疗和辐射治疗, 但白血病每次都会复发,
series:n.系列,连续;[电]串联;级数;丛书; chemotherapy:n.[临床]化学疗法; radiation:n.辐射;放射线;放射疗法; treatments:n.治疗;疗法;对待;处理;讨论;(treatment的复数)
In fact, it had come back three times. 事实上,她已复发了三次。
When we first saw her, Emily was very ill. 第一次看到她时,她病得很重。
Her official diagnosis was advanced, incurable leukemia. 她的诊疗结果是晚期、 不可治愈的白血病。
official:adj.官方的;正式的;公务的;n.官员;公务员;高级职员; diagnosis:n.诊断;
Cancer had invaded her bone marrow, her liver, her spleen . 肿瘤扩散到她的骨髓、肝和脾脏。
invaded:v.入侵;拥入;遍布(invade的过去分词);adj.被侵入的; spleen:n.脾脏;坏脾气;怒气;
And when we infused her with the CAR T cells in the spring of April 2012, over the next few days, she did not get better. 我们在 2012 年 4 月 给她输注了 CAR T 细胞, 接下来的几天,她的病情没有好转,
She got worse, and in fact, much worse. 反而恶化,变得更严重。
As our prison corrections officer had in 2010, she, in 2012, was admitted to the ICU, and this was the scariest fork in the whole road of this story. 像 2010 年那位狱警一样, 她被转移到加护病房。 这是整个故事最惊险的岔道。
By day three, she was comatose and on life support for kidney failure, lung failure and coma. 第三天时,她陷入昏迷, 依靠呼吸机维持生命, 出现肾衰竭、肺衰竭并陷入昏迷,
life support:adj.保障生命的,维持生命的; kidney:n.[解剖]肾脏;腰子;个性;
Her fever was as high as 106 degrees Fahrenheit for three days. 连续三天高烧至 41 摄氏度。
Fahrenheit:adj.华氏的;华氏温度计的;n.华氏温度计;华氏温标;
And we didn't know what was causing those fevers. 但我们不知道发热原因。
We did all the standard blood tests for infections , and we could not find an infectious cause for her fever. 我们做了所有标准的 血液感染物檢查, 但找不到高烧感染的原因。
standard:n.标准;水准;旗;度量衡标准;adj.标准的;合规格的;公认为优秀的; infections:n.传染病;口腔病害(infection复数形式); infectious:adj.传染的;传染性的;易传染的;
But we did find something very unusual in her blood that had never been seen before in medicine. 不过我们发现她血液中的不寻常之处, 这种症状在医学上从未见过。
She had elevated levels of a protein called interleukin-6, or IL-6, in her blood. 她血液中的间白素-6（IL-6）含量过高,
elevated:adj.提高的;高尚的;欢欣的;v.提高;振奋;提拔;(elevate的过去分词和过去式) protein:n.蛋白质;
It was, in fact, more than a thousandfold above the normal levels. 事实上已超过正常含量的一千倍。
thousandfold:adv.千倍地;adj.千倍的;
And here's where yet another fork in the road came in. 这时,另一个岔道出现了。
By sheer coincidence , one of my daughters has a form of pediatric arthritis . 机缘巧合, 我的一个女儿患上了 儿童特发性关节炎。
sheer:adj.纯; v.十足地; n.透明薄纱; v.[航海](使)偏航; (使)转向; coincidence:n.巧合,巧事;同时存在;并存;相同; pediatric:adj.小儿科的; arthritis:n.[外科]关节炎;
And as a result , I had been following as a cancer doc, experimental therapies for arthritis for my daughter, in case she would need them. 于是作为肿瘤医生, 我跟进关节炎实现性疗法的研究发展, 以便她要用到。
as a result:结果; experimental:adj.实验的;根据实验的;试验性的; therapies:n.治疗方法(therapy复数形式);
And it so happened that just months before Emily was admitted to the hospital, a new therapy had been approved by the FDA to treat elevated levels of interleukin-6. 正巧艾美莉接受治疗的几个月前, 一种新的疗法获美国药物管理局通过, 它有治疗间白素-6 含量升高的功效,
approved:adj.被正式接受的,被正式认可的; v.赞成; (approve的过去分词和过去式)
And it was approved for the arthritis that my daughter had. 可以用来治疗我女儿的关节炎。
It's called tocilizumab. 一种叫托珠单抗（Tocilizumab）的药。
And, in fact, it had just been added to the pharmacy at Emily's hospital, for arthritis. 它刚被纳入艾美莉所在医院的药房, 以治疗关节炎。
pharmacy:n.药房;配药学,药剂学;制药业;一批备用药品;
So when we found Emily had these very high levels of IL-6, 当我们发现艾美莉的 高间白素 -6 含量时,
I called her doctors in the ICU and said, "Why don't you treat her with this arthritis drug?" 我联系她的加护病房医生,说, 为什么不用这种关节炎药来治疗呢？
They said I was a cowboy for suggesting that. 他们说我太大胆了。
And since her fever and low blood pressure had not responded to any other therapy, her doctor quickly asked permission to the institutional review board, her parents, and everybody, of course, said yes. 由于她的高烧和低血压 对其它任何疗法都没有反应, 她的医生迅速申请研究伦理审查会 和她的父母的批准, 当然,每个人都同意了。
blood pressure:n.[医]血压; responded:v.回答,回应;作出反应;响应;反应灵敏;(respond的过去式和过去分词) institutional:adj.制度的;
And they tried it, and the results were nothing short of striking. 于是他们着手尝试, 结果令人惊讶。
Within hours after treatment with tocilizumab, 使用托珠单抗药物后的几小时内,
Emily began to improve very rapidly. 艾美莉开始迅速好转。
Twenty-three days after her treatment, she was declared cancer-free. 治疗后的第 23 天, 她的癌症完全缓解。
And today, she's 12 years old and still in remission. 今天,她已 12 岁,病情仍未复发。
(Applause) （掌声）
So we now call this violent reaction of the high fevers and coma, following CAR T cells, cytokine release syndrome , or CRS. 我们现在把 CAR-T 细胞输注后 出现的发热和昏迷反应 称为 CRS 。 称为 CRS 。
violent:adj.暴力的;猛烈的; reaction:n.反应,感应;反动,复古;反作用; cytokine:n.[细胞]细胞因子;细胞激素; release:v.释放;发射;让与;允许发表;n.释放;发布;让与; syndrome:n.[临床]综合征;综合症状;并发症状;校验子;并发位;
We've found that it occurs in nearly all patients who respond to the therapy. 我们发现对疗法有反应的患者 大多出现了这些症状,
occurs:v.重现(occur的第三人称单数);
But it does not happen in those patients who fail to respond. 反之,对疗法无反应的患者都没出现。
So paradoxically , our patients now hope for these high fevers after therapy, which feels like "the worst flu in their life," 所以矛盾的现象就是, 我们的患者盼望在输注后 出现这些症状, 像是「这辈子最痛苦流感」的高烧。
paradoxically:adv.自相矛盾地;似非而是地;反常地;
when they get CAR T-cell therapies. 接受 CAR T 细胞治疗后,
They hope for this reaction because they know it's part of the twisting and turning path back to health. 他们希望出现这些症状, 因为他们知道这是条看似曲折 却通往健康的路。
twisting:v.使弯曲;转动(身体部位);(twist的现在分词)
Unfortunately, not every patient recovers. 不幸的是,不是每位患者都能被治愈,
Patients who do not get CRS are often those who are not cured. 没有出现 CRS 的患者, 病情通常不会好转。
So there's a strong link now between CRS and the ability of the immune system to eradicate leukemia. 所以 CRS 和 CAR T 细胞 清除白血病肿瘤之间 有着强烈的关联。
eradicate:vt.根除,根绝;消灭;
That's why last summer, when the FDA approved CAR T cells for leukemia, they also co-approved the use of tocilizumab to block the IL-6 effects and the accompanying CRS in these patients. 因此去年夏季, 美国药物管理局在通过 CAR T 细胞疗法的同时, 也通过了托珠单抗药物, 以治疗间白素含量过高 以及 CRS 症状。
accompanying:v.陪同;陪伴;与…同时发生;为…伴奏;(accompany的现在分词)
That was a very unusual event in medical history. 这在药物史上很少见。
Emily's doctors have now completed further trials and reported that 27 out of 30 patients, the first 30 we treated, or 90 percent, had a complete remission after CAR T cells, within a month. 艾美莉的医生完成了进一步实验, 并报告第一批治疗的 30 位患者中,有 27 位,或者说 90% 癌症完全缓解。 在 CAR T 细胞治疗后的一个月内,
A 90 percent complete remission rate in patients with advanced cancer is unheard of in more than 50 years of cancer research. 晚期癌症的痊愈率达 90%, 这在超过 50 年的 癌症研究中闻所未闻。
unheard:adj.听不到的;未被倾听的;不予理睬的;
In fact, companies often declare success in a cancer trial if 15 percent of the patients had a complete response rate. 事实上若疗法对 15% 的 患者完全起作用, 药物公司通常宣布疗法有效。
response:n.响应;反应;回答;
A remarkable study appeared in the "New England Journal of Medicine" in 2013. 2013 年,《新英格兰医学杂志》 发表了一篇出色的相关研究,
remarkable:adj.卓越的;非凡的;值得注意的; Journal:n.杂志;日记;日志;(用于报纸名)…报;
An international study has since confirmed those results. 此后国际研究证实了研究结果。
And that led to the approval by the FDA for pediatric and young adult leukemia in August of 2017. 这使得美国药物管理局 在 2017 年 8 月准许了 用该疗法治疗小儿和青少年白血病。
approval:n.批准;认可;赞成;
So as a first-ever approval of a cell and gene therapy , 作为首个获准的细胞基因疗法,
first-ever:adj.第一例;前所未有; gene therapy:n.基因疗法;基因治疗;
CAR T-cell therapy has also been tested now in adults with refractory lymphoma . CAR T 细胞疗法目前也在试验 对成人难治性淋巴瘤的治疗。
refractory:adj.难治的;难熔的;不听话的;n.倔强的人;耐火物质; lymphoma:n.[肿瘤]淋巴瘤;
This disease afflicts about 20,000 a year in the United States. 这种病每年折磨着两万位美国公民。
The results were equally impressive and have been durable to date. 治疗结果同样显着,且效果持久。
impressive:adj.感人的;令人钦佩的;给人以深刻印象的;
And six months ago, the FDA approved the therapy of this advanced lymphoma with CAR T cells. 6 个月前,美国药物管理局通过了 针对这种晚期淋巴瘤的 CAR T 细胞疗法。
So now there are many labs and physicians and scientists around the world who have tested CAR T cells across many different diseases, and understandably , we're all thrilled with the rapid pace of advancement . 现在,全世界衆多实验室和医师 在多种疾病上测试 CAR T 细胞疗法。 当然,飞速的进展令人激动。
labs:n.实验室;实验大楼;(lab的复数) understandably:adv.可理解地; thrilled:adj.非常兴奋; v.使非常兴奋; (thrill的过去分词和过去式) advancement:n.前进,进步;提升;
We're so grateful to see patients who were formerly terminal return to healthy lives, as Emily has. 我们高兴的看到, 那些原本已至绝路的患者 回归到了健康的生活, 就像艾美莉那样。
formerly:adv.以前;原来; terminal:n.终端;航站楼;终端机;航空终点站;adj.晚期的;不治的;致命的;患绝症的;
We're thrilled to see long remissions that may, in fact, be a cure. 我们看到了长期的完全缓解, 而这有可能意味着彻底治愈。
At the same time , we're also concerned about the financial cost. 但同时,我们也关注着治疗费用,
At the same time:同时;另一方面;与此同时; concerned:adj.有关的;关心的;v.关心;与…有关;(concern的过去时和过去分词) financial:adj.金融的;财政的,财务的;
It can cost up to 150,000 dollars to make the CAR T cells for each patient. 接受 CAR T 细胞治疗, 病人要花上十五万美元。
And when you add in the cost of treating CRS and other complications, the cost can reach one million dollars per patient. 若加上治疗 CRS 和其它併发症的费用, 每位患者的支出可达一百万美元。
We must remember that the cost of failure, though, is even worse. 我们还要知道, 若疗法失败,费用更高。
The current noncurative therapies for cancer are also expensive and, in addition , the patient dies. 其它疗效甚微的癌症疗法 同样费用高昂, 并且患者还会死亡。
addition:n.添加;[数]加法;增加物;
So, of course, we'd like to see research done now to make this more efficient and increase affordability to all patients. 所以,我们当然希望研究马上完成, 让疗法更高效、 让更多患者负担得起治疗费用。
efficient:adj.有效率的;有能力的;生效的; affordability:n.支付能力;负担能力;可购性;
Fortunately, this is a new and evolving field, and as with many other new therapies and services, prices will come down as industry learns to do things more efficiently . 很幸运地,这是个新的进化性领域, 随着其它新疗法和服务的出现, 产業的高效化将降低治疗费用。
evolving:v.(使)逐渐形成,逐渐演变;进化形成;(evolve的现在分词) efficiently:adv.有效地;效率高地(efficient的副词形式);
When I think about all the forks in the road that have led to CAR T-cell therapy, there is one thing that strikes me as very important. 当我想到这些岔道, 通往 CAR T 细胞疗法的岔道, 有一件事情对我意义非凡:
We're reminded that discoveries of this magnitude don't happen overnight . 我们领悟到,重大发现 不是一蹴而就的,
reminded:v.提醒;使想起;(remind的过去分词和过去式) magnitude:n.大小;量级;[地震]震级;重要;光度; overnight:adj.夜间的; v.在夜间; n.(美)前一天的晚上;
CAR T-cell therapies came to us after a 30-year journey , along a road full of setbacks and surprises. CAR T 细胞疗法 走过 30 年才得以问世, 这条路上有挫折也有惊喜。
journey:n.旅行;行程;vi.旅行; setbacks:n.挫折;周折(setback复数);
In all this world of instant gratification and 24/7, on-demand results, scientists require persistence , vision and patience to rise above all that. 这个世界热爱即时满足, 崇拜急功近利, 但科学家需要毅力、视野和耐心, 来让这些成为现实。
instant:n.瞬间; adj.立即的; conj.同"assoonas"; gratification:n.满意;喜悦;使人满意之事; persistence:n.持续;固执;存留;坚持不懈;毅力; vision:n.视力;美景;幻象;想象力;v.想象;显现;梦见; patience:n.耐性,耐心;忍耐,容忍;
They can see that the fork in the road is not always a dilemma or a detour; sometimes, even though we may not know it at the time, the fork is the way home. 这些岔道不总是艰难抉择或者险径, 有时候,或许当时未曾得知, 但那是条通向终点的路。
dilemma:n.困境;进退两难;两刀论法;
Thank you very much. 谢谢大家。
(Applause) （掌声）