NARRATOR: Castro promises free health care, a promise later written into the new constitution. NARRATOR: Watching the news one evening, George learns about new treatments emerging in Cuba. It was really hard for me, very difficult. NARRATOR: Cancer vaccines are already in development around the world, but what surprises Roswell Park researchers is the science that makes this vaccine work. NARRATOR: The popularity of Cuba’s famous cigars and cigarettes, contributes to lung cancer being the deadliest cancer here, as it is in the U.S. NEWS ANCHOR MONTAGE: A substance known as interferon…, …the body produces interferon in minute amounts…. OLIVERA FINN (Cancer Immunologist, University of Pittsburgh): I was a graduate student in the late ’70s, at Stanford. Throughout his regime, Castro continues to emphasize the importance of human capital and science as Cuba’s future. For Cuba, and the rest of the world, it all starts with interferon. So, I had a brain tumor as well. NARRATOR: …even if it’s illegal to get treatment where they’re going: Cuba. Their discoveries led to checkpoint inhibitors, drugs that can turn cancer’s signal off. And when that cell stops listening to those signals, it starts growing out of control, and it turns into cancer. NARRATOR: When they return to Cuba, many of these students and doctors are tasked with building the country’s new public health service, the difficulty heightened by political tensions and economic isolation. For Roswell Park, a partnership with Cuba could allow them to combine C.I.M.’s cancer vaccine with immunotherapy treatments already available, like checkpoint inhibitors. NARRATOR: His research convinces him the Cuban drugs might help him more than what is available in the U.S. George wants in. In general, biotechnology products and the pharmaceutical industry are among Cuba’s main exportable items. AGUSTÍN LAGE: In science, cooperation is everything. LUIS HERRERA: They worked constantly every day until 10 or 11 o’clock at night. But the trade embargo makes all these treatments unavailable in the U.S., like Vaxira®, the cancer vaccine George Keays has been taking for nearly two years. GEORGE KEAYS: My wife was diagnosed years ago. OnCuba and the OnCuba logo are registered® trademarks of Fuego Enterprises, Inc., its subsidiaries or divisions. NARRATOR: But for now, many patients, no matter what therapies they are receiving, will likely reach a point when they run out of treatment options. JOHN KIRK: If you were part of the white, urban, middle class in Havana, you had everything to lose by staying. More than breast, colon and prostate cancers combined. Developed by the Center for Genetic Engineering and Biotechnology (CIGB), a leading entity in this field on the island, the vaccine reduces the formation of blood vessels in the tumor, thereby limiting the supply of nutrients and oxygen and inhibiting its growth and shows “encouraging results” in some patients. NARRATOR: Cuba is a small country with big contradictions. SYLVIA RICE: When I first received the diagnosis of Stage 4 pancreatic cancer, I was like, “Huh? NARRATOR: Some take matters into their own hands…. So, my first question is, “Why are you talking to us?” And she talked about the fact that this is one of the few institutions in the United States where the discoveries in Cuba could be taken to the next level and make sure it benefits a wide range of patients, not only in Cuba, but across the world. NARRATOR: Today, he’s preparing for an unusual trip. How is it possible for a country as poor and isolated as Cuba to come up with cutting-edge medicines like this? NARRATOR: Can scientists whose countries are political adversaries now work together to fight cancer? NARRATOR: At Roswell Park, researchers show how live cancer cells use E.G.F. I thought I was going to die. In the laboratory, scientists remove a section of D.N.A. Can Cuba's innovative lung cancer vaccines give new hope to patients across the world? NARRATOR: One reason lung cancer is so deadly is that often, by the time there are symptoms like coughing, back pain or difficulty breathing, the disease has already spread. It’s one of a new wave of treatments that are transforming some cancers from a death sentence into a chronic condition, like diabetes or high blood pressure. It showed that I had eight metastases in the chest along the lymph nodes, one in the shoulder, and it had spread to my brain. Homeland or death, we shall prevail! JOHN KIRK (Latin American Studies, Dalhousie University): Cuba was forced to think outside the box. Today, the Cuban biotech industry holds around 1200 international patents and markets pharmaceutical products and vaccines in more than 50 countries. One of them is Marta Reymo. To back this up, the Government has made a major investment in biotechnology. NARRATOR: Pérez’s research points out some tumor cells have thousands more E.G.F. So, they tried a test run, with water in a temperature-controlled box. People were suspicious of the ability to actually provoke an immune response against the cancer cells. Oh, no, no, no, no, no. Jeez.”. NARRATOR: But could Cuban drugs like Vaxira become available in the U.S.? NARRATOR: How did scientists learn to use the immune system as a weapon against cancer? AGUSTÍN LAGE: If you vaccinate a human being with human E.G.F. KUNLE ODUNSI: When you and I get an infection, usually the immune system revs up, but at some point, the immune system has to stop and rest. In addition, the CIMAVAX-EGF vaccine against lung cancer and the Heberferon for the treatment of skin cancer, as well as vaccines against hepatitis B and meningitis and the recombinant Interferon alfa 2B antiviral (IFNrec), which is among the drugs chosen by China to treat COVID-19 coronavirus. ERNESTO CHICO (Chief Executive Officer, Innovative Immunotherapy Alliance): We have limited resources because of we are in a poor country. The doctor said I have one more year to live. Original funding for this program was provided by Draper, the David H. Koch Fund for Science, the NOVA Science Trust and the Corporation for Public Broadcasting. Tens of thousands of cells’ characteristics are rapidly analyzed. for clinical trial in the U.S. At Roswell Park, it’s being combined with a checkpoint inhibitor, nivolumab, that could make CIMAvax even more effective. But why is George risking a trip to Cuba, when some of the most advanced cancer medicine in the world is back in the U.S.? Your email address will not be published. The Centre has also developed the anti-cancer drug nimotuzumab, to treat advanced tumours, for example in the head, neck and brain. By this time, Castro’s ambitions were clear. GEORGE KEAYS: I actually saw it on television, where people from Roswell Cancer Center, in New York, went to Cuba, and they were looking at alternative treatments. I’ll never forget it. GEORGE KEAYS: So, we’re going to turn here. KELVIN LEE: So, it actually got from Havana to Canadian customs; and the F.D.A. So here we all go into Cuba, we’re only there for 36 hours, and Dr. Lee and I decided that this was an opportunity to really do this. When a threat is identified, immune cells, like killer T cells, are signaled to attack and destroy. might play in cancer. Science is going to move relationships forward. But around the same time, a new technology, first developed in California, is gaining ground worldwide: genetic engineering. KELVIN LEE: Cancers are really 99 percent you. Castro sends Luis Herrera to Europe to investigate. I could bring one person, and I took Dr. Lee. National corporate funding for NOVA is provided by Draper. NARRATOR: One in three Americans will be diagnosed with cancer in their lifetime. It’s in your ovary, it’s in your liver, it’s in your pancreas, and you’ve got a couple areas in your lungs. nothing happens, because the immune system interprets that this is self. And so, on the three-year anniversary of being diagnosed with horrible Stage 4 lung cancer, this guy runs a 10K run, and puts an offer down on a house. It was tragic, you know, they were very, very close to their mom. We’re saying we can do something against cancer, and everybody’s sort of laughing, right? SYLVIA RICE: And so then she says, “You have it in multiple areas of your body. to grow, the Cubans came up with a novel idea: starve the tumor by removing E.G.F. To prevent cancer from using E.G.F. NARRATOR: President Obama begins normalizing relations with Cuba, and New York Governor Andrew Cuomo leads a trade delegation to Havana. I don’t have cancer. GEORGE KEAYS: So, this was really kind of a shock. The 1950s, old cars, can’t possibly be any good science going on. It targets a protein that can cause uncontrolled cell division and growth. Castro establishes new universities, clinics and medical schools across the island. In response, Cuba has followed WHO recommendations, putting in place a comprehensive national cancer plan that ensures universal access to all levels of health service - from cancer prevention, through diagnosis and treatment to palliative care. Additional funding is provided by the NOVA Science Trust. NARRATOR: He’s participating in a clinical trial combining checkpoint inhibitors with a cancer vaccine developed by Dr. Elizabeth Jaffee. And it all started with a cold call to Roswell Park Comprehensive Cancer Center in Buffalo, New York. MARTA REYMO (Cancer Patient): (Translated from Spanish) Yes, yes, I smoked. That was four years ago. So, from the very beginning, he saw science as an opportunity to bring Cuba kicking and screaming into the modern era. NARRATOR: But George is not cured. ANABELY GARCIA: We wait for you next May or June. These include a therapeutic vaccine against ovarian tumors and hepatocarcinoma, with “encouraging results” in some patients. FIDEL CASTRO (Film Clip): (Translated from Spanish) The future of this country must necessarily be a future of men of science. NARRATOR: Immunotherapies, including Cuba’s cancer vaccines, are a medical breakthrough. This helps us to achieve our ultimate goal: a longer life and a better quality life for our patients.â. Please read the Comment Policy before joining the discussion. NARRATOR: Juan Vela Valdés was minister of higher education. âAmong men, prostate and lung cancers are the most common types of cancer, and among women breast and cervical cancer are at the top of the list.â. NARRATOR: Cuba and Roswell Park come to an agreement to cooperate. NARRATOR: Nearly 200 hours after being packaged in Cuba, the box arrived in Buffalo. The data they could yield for Cuban research would be invaluable. KUNLE ODUNSI (Deputy Director, Roswell Park): What could come out of Cuba that we don’t already know? Jeez. AGUSTÍN LAGE: You can put the bacteria in a fermenter and you have millions of flasks of interferon. MARY REID: It’s a precedent-setting event. ELIZABETH JAFFEE: The first one. In the last 20 years it invested around one billion US dollars in research and development. MARTA REYMO: (Translated from Spanish) Saying that disease, I thought the worst. From ’59 to ’62, in three years, half of the doctors flew away from our country. receptors in about 50 percent of tumors. Centro de Ingenieria Genetica y Biotecnologia, David M. Rubenstein Rare Book & Manuscript Library, Duke University, Instituto Cubano del Arte e Industria Cinematográficos (ICAIC), National Cancer Institute Surveillance, Epidemiology, and End Results Program (NCI SEER), A NOVA Production by BlueSpark Collaborative, LLC for WGBH Boston. It was designed to attract international patients, who pay in hard currency. RYAN SWITZER: It was definitely like getting hit by a truck; unexpected, for sure. of Roswell Park announced the first ever biotech joint venture between the United States and Cuba. MARYAM HATAMI: One day, when I was working, I heard something, like, breaking. In fact, it’s against the law for him to go where he’s been going for this cutting-edge treatment. CANDACE JOHNSON: So, the governor wanted to take a group of leaders from around the state, and he chose me. They’re called “immunotherapies.”. The havoc cancer wreaks on patients and families is devastating. I’ve been getting treatment for 10 years now. Got to U.S. customs, apparently if you’re on the embargo list in the United States, your country is not in the electronic database. Everyone knows George. That’s not the case at La Pradera. Experts featured in this film may have received support from funders of this program. New cases of coronavirus rise to 37 in Cuba, 18 are imported, Cuba reports 28 new coronavirus infections, 35 patients are discharged, PCR test for Cubans leaving the country remains free of cost, Western Union suspends sending of remittances to Cuba from all over the world except the United States, Cuban press denies rumors about cases of coronavirus on island, Cuba: birth, marriage and death certificates will not have an expiry date, Havana airport restarts regular flights, while Cuba leaves baggage limitation without effect, Femicide in Santiago de Cuba: a young woman manages to escape alive, Online business forum to replace Havana International Trade Fair this year, 46th President-elect of the United States, Padura: “I don’t like radical postures at all”. GEORGE KEAYS: You know, I’m not trying to break the law. Okay? That’s the most important thing. As the bacteria replicates, it carries the code for the human protein in its own D.N.A. It’s one of the leading causes of death, worldwide. NARRATOR: Honjo and Allison figured out how to turn the immune system back on. KELVIN LEE: Immunotherapy, broadly, is essentially using the immune system to fight human disease. So, the box went back to Canada, sat there for, I think, two days. My oldest daughter said, “I just love you so much.”. He claimed, on several occasions, that access to healthcare was the most fundamental human right that existed in the world. According to Pérez, it is a product of the field of cancer immunotherapy, in which intensive research is being carried out. One is broken. MARTA FERRAN (Daughter of Marta Reymo): (Translated from Spanish) My husband died six months before this, from the same disease, and now I have to face the situation again with my mother. And it was tough on her when they, when they said, “That’s it, there is no more,” and, “Treatment would only make you worse.” But Kathy held the doctor’s hand and said, “I understand.”. NARRATOR: One department at Roswell Park has over 20 of these expensive machines. AGUSTÍN LAGE DÁVILA (Former Director, Center of Molecular Immunology): If you are isolated, you are dead, in science. I’m exactly at third year. LUIS HERRERA: I remained in Europe some time getting that information. Nobody can believe…. KELVIN LEE: Long before anybody knows that they have cancer, there’s this ongoing war of the immune system trying to control the cancer and the cancer trying to escape. NARRATOR: Two years later, Cuba’s Center of Molecular Immunology and Roswell Park double down on their partnership and make history again. When an E.G.F. SYLVIA RICE: I’m handling it, and I want to keep going, because I have things that I want to do, I have things I want to see. NARRATOR: This isn’t George’s first encounter with the deadly disease. ANA MARIA SALAZAR (Cancer Patient): My mom passed from breast cancer, and my dad had passed because of lung cancer. The Secret Life of Scientists and Engineers. MARTA REYMO: (Translated from Spanish) I went in for my X-ray and an ultrasound, and I had a C.T. NARRATOR: Interferon can prevent viral infection from spreading and signals immune cells to attack the virus. In Cuba. His oncologist increased the dosage; the cancer continued to get bigger. ELIZABETH JAFFEE: So, I don’t know how much of your scans you’ve seen. NARRATOR: Today, Cuba reports health statistics that rival the U.S., but some researchers caution these may be unreliable due to manipulated data. This vaccine targets EGFR’s ligand, epidermal growth factor (EGF). In 1960, the year one of the revolution, he talked about the need for, for science in Cuba. I have to tell you, my initial response was skeptical. In Cuba. MARYAM HATAMI: They say usually it’s three years, the time. NARRATOR: The embargo will continue to be one of the biggest challenges for the Roswell Park-C.I.M. NARRATOR: Like George Keays, she was diagnosed with inoperable Stage 4 lung cancer. George is convinced what’s helping him stay alive is a new treatment that goes beyond the radiation and chemo he’s received. Genetic engineering started a new approach to fighting cancer around the world and in Cuba. This is partly because people live longer but also because many have adopted unhealthy lifestyles. Anti-cancer drugs and vaccines in development at the Centre of Molecular Immunology (CIM), Havana, Cuba. My sister and I just stood there just awestruck. Major funding for NOVA is provided by the David H. Koch Fund for Science, the Corporation for Public Broadcasting, and PBS viewers. ANABELY GARCIA: And, here, we put in the date that you receive. BRUCE TOMA: …that I’m Stage 4 metastasized pancreatic cancer. BRUCE TOMA: Oh, wow, yes. protein connects with an E.G.F. AGUSTÍN LAGE: You are making a trick to the immune system, no? NARRATOR: Lung cancer is the leading cause of cancer deaths worldwide, more than 1.6 million each year. GEORGE KEAYS: One of the things you learn is to live in the moment. AGUSTÍN LAGE: I hope, I really hope that this won’t be stopped, because this is cancer treatment and these are American citizens being treated by cancer vaccines manufactured here in this small country. We can’t detect it. NARRATOR: The CIMAvax cancer vaccine Marta’s taking is now used to treat thousands of patients in Cuba and other countries. Candace Johnson, to consider the possibility of a partnership. No pain. NARRATOR: Cuba would go on to build a world class biotech industry. NARRATOR: Our immune system protects us from infection and disease by identifying foreign threats like bacteria or viruses that are dangerous to the body. JUAN VELA VALDÉS: In 1958, we had 6,500 physicians in our country. It’s totally gone. After all the tests, they told me that I had a growth in my right lung. At night, she helps organize her mother’s care. So, then I went for a full body PET scan to determine how far this had spread. OnCuba © by Fuego Enterprises, Inc. All Rights Reserved. NARRATOR: If the cancer learns how to mask itself from the immune system, it can gain the upper hand and grow. But I’ll continually try to get back up. Memory cells remember it, in case it comes back again. But it was only in the last few decades that scientists realized they could use the immune system to not only attack foreign invaders, but also attack cancer. JOHN F. KENNEDY (President of the United States, 1960-963/Address to the Media April 20, 1961/Film Clip): The forces of communism are not to be underestimated in Cuba or anywhere else in the world. AGUSTÍN LAGE: Getting training in biochemistry and cancer biology, my supervisor is Luc Montagnier, discoverer of the AIDS virus. For its part, a biopharmaceutical created at the Molecular Immunology Center is about to begin a phase I clinical trial in patients with solid tumors. Let’s reach out to these folks in Havana and see if we can establish some sort of relationship with them. GEORGE KEAYS: And they said, “Yeah, we think that, you know, you, you could, you could come down here, and see if a vaccine might work. RYAN SWITZER (Cancer Patient): Like getting hit by a truck. KELVIN LEE (Cancer Immunologist, Roswell Park): If there’s a two percent chance that the science is right, we need to be there. The real vaccine would have been destroyed. NARRATOR: Historically in the fight against cancer, treatment options have been surgery, radiation and chemotherapy. YOUSUF ZAFAR: If we can understand why certain patients do benefit from immunotherapy while others don’t benefit from treatment, we can make great leaps forward in our cancer treatment. Cuban clinical trials show that it extends life by three to five months, on average. Free medical care for ordinary Cubans is provided, often at clinics with scarce equipment or serviced by physicians who drive cabs to make ends meet. NARRATOR: It turned out interferon only works against a few cancers, but the process of making interferon took immunotherapy science to a new level. JOHN KIRK: He was a person who clearly was obsessed with public health and education. Despite this, his doctors recently discovered a new metastasis in his liver. Pérez is one of many scientists around the world trying to understand the role E.G.F. scan. For years, scientists believed the immune system could not attack cancer cells, because, unlike an invading virus or bacteria, they are considered to be part of us. NARRATOR: Cuba has to rebuild the healthcare system from the ground up. NARRATOR: Roswell Park scientists believe Cuba’s CIMAvax could add to the arsenal of weapons available for cancer patients. NARRATOR: The two agree to build a new biotech facility in Cuba, dedicated to cancer drugs, jointly owned by Roswell Park and C.I.M. You trick the immune system, because you present something “self” as if it were “non-self.”. receptor on the cell’s surface, the protein sends a signal to grow and multiply. BILL BLANCHET: The cancer was growing, the cancer markers were getting bigger on this agent. NARRATOR: George Keays has always loved the outdoors. CANDACE JOHNSON (President and Chief Executive Officer, Roswell Park): Wow. What are you talking about?”. NARRATOR: Even into the 1980s, researchers who believe they can harness the immune system against cancer are considered renegades. NARRATOR: Marta’s lung cancer began the way all cancers do. And let’s, let’s see what we can do. A shortage of Vaxira in Cuba has prevented him from filling his prescription. âCancer is one of the major killers in Cuba. They then insert that D.N.A. In addition to Vaxira, he’s undergoing a number of treatments in the U.S. But it wouldn’t be easy. GEORGE KEAYS: I was very active: runner, swimmer, loved mountain sports, skiing, snowboarding and that kind of thing. George’s doctor and close friend Dr. William Blanchet is in Havana to lend support. George has Stage 4 lung cancer. Cooperation is everything. I came back and I met Fidel, and then he started to make questions concerning genetic engineering. GEORGE KEAYS: I had had 15 radiation treatments in the clinical trial program and one radiation treatment to the brain; I was taking gene therapy. Sometime in 2009, Marta just wasn’t feeling like herself. KELVIN LEE: And there is nothing in the United States. BILL BLANCHET: Here is a reconstructed CAT scan. NARRATOR: The revolution establishes a one-party communist state with Castro as its authoritarian leader. KELVIN LEE: In the culture that has epidermal growth factor, you can see a layer of lung cancer cells that, over time, are dividing and growing and getting bigger and bigger. LUIS HERRERA: That was the beginning of the whole biotechnology development in Cuba. Those are things that people three years into Stage 4 lung cancer tend not to do. And so, we all, we all want to hear something really interesting. It was very, very, very intensive. A phase II clinical trial is currently underway in patients with acute myocardial infarction, whose results should be ready in the second half of the year,” said Pérez. It suspends samples in a fluid and whisks them through multiple lasers, one cell at a time. NARRATOR: For nearly two years George Keays has been coming here for treatment and rest. Any headaches or…. ELIZABETH JAFFEE: Your most recent scan, there’s nothing there. Even after the F.D.A. And then she passed away when they were 14 and 24.
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