How Personalized Will Medicine Get?

Sep 13, 2013
Originally published on May 6, 2015 1:40 pm

Part 2 of the TED Radio Hour episode Predicting The Future.

About Nina Tandon's TED Talk

Call it extremely personalized medicine. Tissue engineer Nina Tandon explains how in the future, we'll be able to grow replacement organs from our very own cells. In the future, that same technology will help develop custom designed drugs.

About Nina Tandon

Nina Tandon studies ways to use electrical signals to grow artificial tissues for transplants and other therapies, with the goal of creating "spare parts" for human implantation and disease models. After receiving a bachelor's degree in electrical engineering from Cooper Union, Tandon worked on an electronic nose used to "smell" lung cancer as a Fulbright scholar in Rome. She studied electrical stimulation for cardiac tissue engineering at MIT and Columbia, and now continues her research on electrical stimulation for broader tissue-engineering applications. Tandon was a 2011 TED Fellow and a 2012 Senior Fellow.

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So right now, in a lab in New York City, a tissue engineer named Nina Tandon is experimenting with human cells. Now imagine taking those cells from your heart or your liver and then growing a new heart and a new liver identical to the ones you have. That's where Nina's research is headed, which she described in her TED Talk.


NINA TANDON: I work in a lab where we take cells out of their native environment and we feed them, sterilely of course, with what we call cell culture media, which is like their food. And we grow them in incubators, but what we're really trying to do in my lab is to engineer tissues out of them. What does that even mean? Well, it means growing an actual heart, let's say, or grow a piece of bone that can be put into the body. Let's take the example of the heart - the topic of a lot of my research. What makes the heart unique? Well, the heart beats - rhythmically, tirelessly, faithfully. We copy this in the lab by outfitting cell culture systems with electrodes. These electrodes act like mini pacemakers to get the cells to contract in the lab.


TANDON: And so if you can copy those two things in the technology that you use to grow the cells in the lab, you can get pretty far with tricking them into believing they're inside the body and therefore behaving much closer to the way they would behave in a petri dish than they would otherwise.

RAZ: How far are we from growing spare parts for our bodies?

TANDON: Well, the heart is pretty tough. But actually, we're just in the beginning stages of a startup right now where we're growing bones for skeletal reconstruction. So living, personalized, human bones in the right shape and with the right cells. And the idea of growing organs and growing spare parts for the human body - I like to call this the idea of body 3.0, is spare living parts for the human body because, actually, they're not just parts anymore. They fully integrate back into the body.

RAZ: I mean, this could end that whole system of organ donations.

TANDON: Yeah. And if you think about organs where the lines for transplants are so long that people die waiting, this is huge.

RAZ: OK, so if that idea doesn't blow your mind, just wait for this one. Tissue engineering that may lead to personalized medicine - made-to-order drugs for each and every person. Here's more from Nina Tandon's TED Talk.


TANDON: Well, let's think about the drug screening process for a moment. You go from drug formulation, lab testing, animal testing and then clinical trials, which you might call human testing, before the drugs get to market. Costs a lot of money, a lot of time. And sometimes, even when a drug hits the market, it acts in an unpredictable way and actually hurts people. And the later it fails, the worse the consequences. It all boils down to two issues. One, humans are not rats. And two, despite our incredible similarities to one another, actually, those tiny differences between you and I have huge impacts with how we metabolize drugs and how those drugs affect us. So what if we had better models in the lab that could not only mimic us better than rats, but also reflect our diversity?

Let's see how we can do it with tissue engineering. One of the key technologies that's really important is what's called induced pluripotent stem cells. They were developed in Japan pretty recently. They're a lot like embryonic stem cells except without the controversy. We induce cells, OK, say skin cells, by adding a few genes to them, culturing them and then harvesting them. So they're skin cells that can be tricked, kind of like cellular amnesia, into an embryonic state. So without the controversy, that's cool thing number one. Cool thing number two, you can grow any type of tissue out of them - brain, heart, liver. You get the picture, but out of your cells. So we can make a model of your heart, your brain, on a chip.

RAZ: That idea is so incredible, I mean, you can imagine how that will revolutionize the history of the world. And, you know, 10, 20, 30, 40 years from now you're diagnosed with, let's say, an aggressive form of bone cancer. If this technology heads in the direction where you think it might be headed, like, how do you imagine that person might be treated?

TANDON: I can imagine taking stem cells from that patient, in addition to cancer cells from that patient, growing a piece of bone, probably growing, maybe, lymph tissue, breast tissue, and exposing those cells to certain type of drugs and seeing which ones would work best. I can also imagine developing cancer treatments that are specific to that cancer by using molecular biology techniques to actually make a targeted therapeutic for that patient. So it's kind of two things, you know, screening known drugs against those cancers, but then also, possibly, even in the future, developing a new drug specifically for that cancer.

RAZ: Essentially, you could clone a part of a person with cancer and just experiment on that person's clone, just throw everything you have at it to see how it responds.

TANDON: Yeah, and a person with cancer doesn't have a whole lot of time to waste and a whole lot of freedom to experiment on themselves. They really only have kind of one shot to try each and every thing. And so time is of the essence.

RAZ: It's interesting 'cause right now, I mean, the way medicine works, it seems normal to us, like, there's a disease and a medication is developed for that disease. And then everyone who has that disease takes that medication, but I guess that probably won't be the way we do things in the future.

TANDON: In the past, we've just sort of taken a statistical approach. We say, OK, 50 percent of people with depression respond to this drug so let's prescribe it to a hundred percent of the people and if it doesn't work, well, we'll try something else. That, in a way, is like - is low-hanging fruit. As we think about more and more complicated diseases with complicated mechanisms and if you consider that everybody's cancer is different, those kind of statistical methods don't work as well. They just don't.

RAZ: So you could imagine actually creating like, an individual medicine for one person that might not ever be used on anybody else.

TANDON: You can definitely see that, for sure.


TANDON: Going forward, tissue engineering is actually poised to help revolutionize drug screening at every single step of the path - disease models making for better drug formulations, massively parallel human tissue models helping to revolutionize lab testing, reduce animal testing and human testing in clinical trials. And individualized therapies that disrupt what we even consider to be a market at all. Essentially, we're dramatically speeding up that feedback between developing a molecule and learning about how it acts in the human body. Our process for doing this is essentially transforming biotechnology and pharmacology into an information technology, helping us discover and evaluate drugs faster, more cheaply and more effectively. Thank you.


RAZ: Nina Tandon. She's a TED fellow and an electrical and biomedical engineer at Columbia University's Laboratory for Stem Cells and Tissue Engineering. Check out her full talk at I'm Guy Raz. You're listening to the TED Radio Hour from NPR. Back in a moment with more mind-blowing predictions. Transcript provided by NPR, Copyright NPR.