Original subtitles

One in three Americans will be diagnosed with cancer

in their lifetime.

I... I have cancer?

Like getting hit by a truck.

The PET scan showed that I had

eight metastasizes in the chest.

I become anxious

because their options

become more and more limited.

Some take matters into their own hands.

You know, I'm not trying to break the law.

But I'm also not gonna die.

Even if it's illegal to get treatment

where they're going...

Cuba.

Wow...

In Cuba, jeez.

What could come out of Cuba

that we don't already know?

How did a small nation

cut off from modern medical technology

become a world player in cancer science?

Cuba was forced to think outside the box.

Castro had a vision.

If there's a 2% chance the science is right,

we need to be there.

And there's nothing in the United States.

Can scientists whose countries are political adversaries

now work together to fight cancer?

If you are isolated, you are dead in science.

Cooperation is everything.

Mosquito. Yeah.

We added the Cuban vaccine,

and his cancer gets smaller,

and disappears.

"Cuba's Cancer Hope."

Don't cry.

Right now, on "NOVA."

Life isn't meant to be fair.

It's meant to be lived.

George Keays has always loved the outdoors.

He's 67 years old.

I was very active...

runner, swimmer,

loved mountain sports, skiing, snowboarding,

and that kind of thing.

Today, he's preparing for an unusual trip.

It's a matter of life or death.

George has stage IV lung cancer.

So this was really

kind of a shock.

Something like this put a crimpin your style.

This isn't George's first encounter

with the deadly disease.

My wife was diagnosed years ago

and my daughter was, uh, ten and my other daughter was 20,

and then she passed away when they were 14 and 24.

It was tragic; they were, you know,

very, very close to their mom.

One in three Americans will havecancer in their lifetime.

It's one of the leading causes of death worldwide.

When I first received the diagnosis

of stage IV pancreatic cancer,

I was like, "Huh?

"I... I have cancer?

"Like, other people have cancer,

I don't have cancer... what are you talking about?"

It was, uh, definitely like getting hit by a truck...

unexpected, for sure.

I said, "Did you just drop the bombshell on me

that I think you did?"

And I think that's when it finally clicked.

And he said yes.

I'm about to be 35 in two weeks.

It's been two years that I'm living with

metastatic breast cancer at stage IV.

There are more than 100 different types of cancer.

In the U.S., they kill anestimated 600,000 people a year.

The havoc cancer wreaks on patients and families

is devastating.

My mom passed because of breast cancer,

and my dad passed because of lung cancer.

So for me...

cancer was death.

There's a period between Christmas and New Year's

one time where I didn't get out of bed

for that entire... entire period, you know?

My one daughter came in and said, "Hey, Dad?

You ever...

Are you ever going to come playwith me again?"

You go from being very healthy,

suddenly, "Well, you have six months to live."

It hit my daughters very, very hard.

My oldest daughter said, um...

"I just love you so much."

When George was diagnosed, he discovered patients like him,

where lung cancer metastasizes throughout the body,

often don't live much longer than a year.

That was four years ago.

George is convinced what's helping him stay alive

is a new treatment that goes beyond the radiation

and chemo he's received.

It's actually a lung cancer vaccine.

It's one of a new wave of treatments

that are transforming some cancers from a death sentence

into a chronic condition likediabetes or high blood pressure.

We're really in a scientific revolution,

particularly when it comes to cancer research.

Because there are a number of

patients with deadly cancers,

we can turn them into chronic diseases

where they're living years.

But the cancer vaccine George is receiving

is not available in the U.S.

In fact, it's against the law for him to go

where he's been goingfor this cutting-edge treatment.

You know, I'm not trying to break the law.

I'm not, but I'm also not gonna die.

To fill his prescription, George has to fly 2,000 miles...

to Cuba.

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.?

What could a small communist nation

embargoed by the U.S. for over 50 years

bring to the fight against cancer?

Cuba's advances in cancer treatment are largely unknown

to most Americans.

I think everybody here

thought that Cuba was stuck in "I Love Lucy" days...

you know, the 1950s, old cars,

can't possibly be any good science going on.

I mean certainly I did not knowabout what was going on.

Kind of, you know, what could come out of Cuba

that we don't already know?

Cuba is a small country with big contradictions.

Even though the island is impoverished,

it continues to provide freehealthcare to all its citizens.

One of them is Marta Reymo.

She shares her small apartment in Havana

with her family, including her grandson.

Yes, yes, I smoked.

But, like a year before I got the disease, I quit smoking.

Why?

Because I had a sister who had the same thing I have today.

And when she had cancer and the doctor talked about

smoking and such,

I quit too, but, well, the damage was already done.

The popularity of Cuba's famouscigars and cigarettes

contributes to lung cancerbeing the deadliest cancer here,

as it is in the U.S.

Some time in 2009, Marta just wasn't feeling like herself.

I went in for my X-ray and an ultrasound

and I had a CT scan.

After all the tests,

they told me that I had a growthin my right lung.

Like George Keays, she was diagnosed with

inoperable stage IV lung cancer.

Saying that disease, I thought the worst.

I thought I was going to die.

Not only did Marta lose her sister to lung cancer,

but Marta's daughter...

who is a nurse... lost her husband as well.

My husband died six months before this,

from the same disease, and now I have to face the situation

again with my mother.

It was really hard for me, very difficult.

Marta's lung cancer began the way all cancers do.

Cancer is

our own body going awry,

starting with a single cellin our body that stops listening

to the signals to stop growing,

or stop behaving in a certain way.

And when that cell stops listening to those signals,

it starts growing out of control,

and it turns into cancer.

The bloodstream becomes cancer'shighway to reach other organs.

And so then she says, um...

"You have it in multiple areas of your body,

"it's already spread.

"It's in your ovary, it's in your liver,

"it's in your pancreas,

and you got a couple areas in your lungs."

One day when I was working,

I heard something, like... breaking,

and they took me to the emergency room,

took the pictures, and it showsa fracture in my spine.

The cancer made that.

Historically in the fight against cancer,

treatment options have been surgery, radiation,

and chemotherapy.

Marta's found another option.

For ten years she's been takinga cancer vaccine

called CIMAvax-EGF.

Cuban clinical trials show that it extends life

by three to five months on average.

And about 15% of patients, including Marta,

have survived five years or more.

CIMAvax is one of a class of new drugs

that activates the immune systemto fight cancer.

They're called immunotherapies.

Immunotherapy broadly is essentially

using the immune system

to fight human disease.

Our immune system protects us from infection and disease

by identifying foreign threats like bacteria or viruses

that are dangerous to the body.

When a threat is identified, immune cells,

like killer T-cells, aresignaled to attack and destroy.

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.

I feel that after all these meds,

I have gotten my life back.

I've been getting treatment for ten years now.

Marta's daughter works the day shift as a nurse.

At night, she helps organize her mother's care.

Most of the medicines distributed to patients

like Marta are manufactured in Cuba.

We have been able to extend her life, and quality of life,

that's the most important thing.

The CIMAvax cancer vaccine Marta's taking

is now used to treat thousands of patients in Cuba

and other countries.

How is it possible for a countryas poor and isolated as Cuba

to come up with cutting-edge medicines like this?

Cuba's unique approach to medical research

stretches back 60 years...

to the time of the Cuban Revolution.

1959.

Fidel Castro, a former lawyer,

leads a revolution thatoverthrows the Cuban government.

The revolution establishes a one-party Communist state

with Castro as its authoritarian leader.

It was not only a change of government.

It was mainly a change of economic, political,

and social structure

of the country.

Medical science is at the heart

of Castro's vision.

He was a person who clearly

was obsessed with public healthand education.

In 1960, year one of the revolution,

he talked about the need for, for science in Cuba.

So from the very beginning, he saw science as an opportunity

to bring Cuba

kicking and screaming into the modern era.

He claimed on several occasions

that access to healthcare wasthe most fundamental human right

that existed in the world.

Castro promises free healthcare...

a promise later written into the new constitution.

But as the new government nationalizes business,

confiscates private wealth, and tears lives apart,

many professionals... including doctors...

flee the country.

If you were part of the white urban middle class in Havana,

you had everything to lose by staying.

Most of the doctors decided that it was in

their best interest to, to leave.

Juan Vela Valdés was minister of higher education.

In 1958, we had 6,500 physiciansin our country.

From '59 to '62, in three years,

half of the doctors flew away from our country.

Cuba has to rebuild the healthcare system

from the ground up.

Castro establishes new universities,

clinics, and medical schools

across the island.

And he sends thousands

of medical students and doctors abroad

to study at some of the top medical universities

in the developed world.

During the '60s and the '70s,

many people were sent abroad to study science.

I spent two and a half years in Paris.

Agustín Lage was later chosen to be the first director

for the Center of Molecular Immunology,

one of Cuba's leading biopharma research centers.

Getting training

in biochemistry and cancer biology,

my... my supervisor

is Luc Montagnier, discoverer of the AIDS virus.

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.

The forces of Communism

are not to be underestimated

in Cuba or anywhere else in the world.

In 1962,

at the height of the Cold War,

President Kennedy announces an expanded trade embargo

against Cuba.

Today, Cubans call it "el bloqueo"... "the blockade."

The American embargo would include hospital equipment,

medical supplies, and even ordinary antibiotics.

As a result,

Cuba was forced to think outside the box,

particularly in terms of medical research.

One of the things that-that allowed it to do

was to start producing its own medicines.

Castro developsa self-sustaining medical sector

to manufacture medicines

for Cuba's public health service.

Throughout his regime, Castro continues to emphasize

the importance of human capitaland science as Cuba's future.

Today, Cuba reports health statistics

that rival the U.S.

But some researchers caution these may be unreliable

due to manipulated data.

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.

That's not the case at La Pradera.

It was designed to attract

international patients who pay in hard currency.

So we're going to turn... here.

For nearly two years,

George Keays has been coming here for treatment and rest.

Everyone knows George.

My mother in Cuba.

I think it was March of 2015, and I went for

an annual physical with my primary care doctor.

He said at that time, "You know, your cough looks kinda like

maybe an allergic cough."

But the cough was getting worse

and so ordered a CAT scan.

And I remember I left the officeand the doctor called me.

"Get back in here.

You have a growth in your lung."

So, then I went for a full-body PET scan

to determine how far this had spread.

It showed that I hadeight metastasizes in the chest

along the lymph nodes,

one in the shoulder and it had spread to my brain,

so I had a brain tumor as well.

Lung cancer is the leading causeof cancer deaths worldwide...

more than 1.6 million each year.

More than breast, colon, and prostate cancers combined.

Here is a reconstructedCAT scan.

This is the metastasis.

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.

The large tumor here...

This was distressing news

for George, a non-smoker.

His lung cancer cells had been growing undetected for years.

At that point, you know, the prognosis was pretty grim...

less than two years, probably less than a year.

Late-stage lung cancer progresses very quickly.

Historically there hasn't reallybeen much to do other than

try chemotherapy, try radiation,

try some maybe targeted therapy,

and then keep people comfortable...

until they die.

I had had 15 radiation treatments

in the clinical trial program.

And one radiation treatment to the brain.

I was taking gene therapy.

And then cancer mutates, it basically

starts to get smart about what you're...

what you're treating it with.

Watching the news one evening, George learns about

new treatments emerging in Cuba.

A lung cancer vaccine, developed in Cuba...

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.

His research convinces him the Cuban drugs

might help him more than what is available in the U.S.

George wants in.

His doctor urges him to call Havana.

And they said,"Yeah, we think that, you know,

"you, you could... you could come down here,

and see if a vaccine might work."

Immunotherapies,

including Cuba's cancer vaccines,

are a medical breakthrough.

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.

Cancers are really 99% you.

They're 99% normal.

So the immune system largely sees them as normal.

Even into the 1980s, researcherswho believe they can harness

the immune system against cancerare considered renegades.

I was a graduate student in the late '70s at Stanford.

People were suspicious of the ability to actually

provoke an immune response against the cancer cells.

We're saying we can do somethingagainst cancer,

and everybody's sort of laughing, right.

But it turns out theimmune system does fight cancer.

The battle begins as soon as normal cells

mutate into cancer cells.

Long before anybody knows that they have cancer,

there's this ongoing war of the immune system

trying to control the cancerand the cancer trying to escape.

If the cancer learns how to maskitself from the immune system,

it can gain the upper hand and grow.

So by the time the cancer actually grows large enough

to be detected by our normal tests,

it's already figured out how toget away from the immune system.

But finally, researchers learnedhow cancer masks itself.

And in 2018, Tasuku Honjo and James Allison

won the Nobel Prize

for discovering how to unmask cancer

and let the immune system do its job.

This is how it works.

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.

The body has natural mechanismsthat stop the immune system

so it won't damage ordinary cells.

These are called checkpoints.

But, it turns out

that these same mechanisms

that tells the immune system to stop

have been hijacked in cancer.

The cancer is sending a signal to the immune system to stop.

Honjo and Allison figured out how to turn the immune system

back on.

Their discoveries led to checkpoint inhibitors...

drugs that can turn cancer's signal off.

Now, the immune system canrecognize the cancer and attack.

It took 30 years ofunderstanding the immune system

before we could understand how to make the immune system

recognize cancer.

How did scientists learn to use the immune system

as a weapon against cancer?

For Cuba, and the rest of the world,

it all starts with interferon.

A substance known as interferon...

The body produces interferonin minute amounts.

the body's natural first line of defense

against viral infection.

In the 1980s, interferon was a science sensation...

the first breakthrough drug madefrom the body's own immune cells

with the potential to fight cancer.

Interferon is a major defense mechanism the body uses

when it is infected with a virusor has a cancer growing in it.

Interferon can prevent viral infection from spreading

and signals immune cells to attack the virus.

Interferon was our very first immunotherapeutic drug

that could be made in large quantities.

In 1980,

renowned American oncologist Randolph Lee Clark visits Cuba

and tells Castro about interferon.

Dr. Clark explained to Fidel

that interferon was one of the promising drugs

for cancer treatment.

That's what drove him to want to make interferon.

Castro sends doctors first to study with Clark in Texas

and then to Helsinki, Finland,

where they learn how to purify interferon

from white blood cells.

When they return to Havana,

the doctors are taken straight to a house

refitted with a new laboratory...

House 149.

Castro gives them a simple instruction:

make interferon for Cuba.

They worked constantly every day

until 10:00 or 11:00 at night.

Fidel came here almost every day,

just making questions.

It was very, very, very intensive.

It takes scientists in other countries

as long as a year to replicate the purification process.

The Cuban doctors master it in 42 days.

But around the same time, a new technology,

first developed in California,

is gaining ground worldwide: genetic engineering.

Castro sends Luis Herrera to Europe to investigate.

I remained in Europe some time getting that information.

I came back, and I met Fidel.

And then he started to make questions

concerning genetic engineering.

The genetic engineering processHerrera brings back to Cuba

is transforming science across the globe.

In the laboratory, scientists remove a section of DNA

from a human cell

that codes for a specific protein.

They then insert that DNA into the DNA of a bacterial cell.

As the bacteria replicates,

it carries the code for the human protein in its own DNA.

And you can put the bacteria in a fermenter,

and you have millions of flasks of interferon.

It turned out interferon only works against a few cancers.

But the process of making interferon

took immunotherapy science to a new level.

Genetic engineering started a new approach

to fighting cancer around the world and in Cuba.

By this time, Castro's ambitions were clear.

That's the first time I heard him to say

that we can become a medical power.

That was the beginning of the whole biotechnology

development in Cuba.

Cuba would go on to build a world-class biotech industry.

Research, development,

quality control, and distribution

are all the responsibility of one government agency:

BioCubaFarma.

They're a small country,

the communication is much quicker and faster.

They can, um, immediately

make a drug available to all the patients

who qualify for that drug

and immediately collect the dataon a large number of patients.

Cuba's 30-plus bio-pharma facilities

hold over 2,000 international patents

for drugs and processes in use around the world.

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.

I get one to two calls a week

from people who have heard about me,

have heard that I'm coming here,

and ask questions, like, "Where do you get the vaccine?

How did it work for you?" You know?

I think there are some people for whom this might not work,

but I think there are a lot of people

for whom this can be beneficial.

But now American patients could be on their way

to having access toCuban cancer treatments legally.

And it all started with a cold call

to Roswell Park Comprehensive Cancer Center

in Buffalo, New York.

I was sitting in my office,

and my secretary came to me and said,

"There's a telephone call for you

from someone who is from Cuba."

When I picked up the phone,

what she talked about was the fact that

they have some innovative approaches in Cuba

that she would like to discuss with Roswell Park.

I have to tell you, myinitial response was skeptical.

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.

Eventually, the researcher

from Cuba's Center of Molecular Immunology,

or C.I.M.,

is invited to make a presentation

on the lung cancer vaccine CIMAvax-EGF,

the same vaccine that Marta Reymo has been taking.

It is a standing room only event.

Well, I think, scientists, we're all a little crazy.

And so we all... we all want to, uh,

hear something really interesting.

It sparked curiosity of how it came to be.

And so, that was what I recall from it, is, "Wow.

In Cuba, jeez."

Cancer vaccines are already in development around the world,

but what surprises Roswell Park researchers is

the science that makes this vaccine work.

They had thrown out the first chapter

of any basic immunology textbook

to actually accomplish the science.

Cuban scientists claim to havefound a new way to fight cancer

by first getting the immune system

to do something it's never supposed to do:

attack a healthy human protein.

The research Cuba presents atRoswell Park goes back to 1981.

A young scientist named Rolando Pérez

is investigatingepidermal growth factor, or EGF.

It's a natural protein in the body

that tells cells to multiply.

Pérez is one of many scientists around the world

trying to understand the role EGF might play in cancer.

We wanted to know whether human breast tumors

were dependent on EGF for their growth.

What we found was ahigh expression of EGF receptors

in about 50% of tumors.

A receptor is a protein molecule

on the cell's outer surface.

When an EGF protein connects

with an EGF receptor on the cell's surface,

the protein sends a signal to grow and multiply.

It was really a surprise to find that there were tumors

which had a high dependence on EGF.

At Roswell Park,

researchers show how live cancer cells

use EGF to grow into the beginnings of a tumor mass.

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.

In the culture that has the lung cancer cells

but has been depleted of EGF,

you can see that the lung cancer cells

have in fact stopped growing.

Pérez's research points out

some tumor cells have thousands more EGF receptors

than healthy cells.

To prevent cancer from using EGF to grow,

the Cubans came up with a novel idea:

starve the tumor by removing EGFfrom the equation.

To do this, they would have to vaccinate the body against EGF

and convince the immune system

this normal human protein is a threat.

But it wouldn't be easy.

If you vaccinate a human being with human EGF,

nothing happens,

because the immune system interprets that this is self.

A typical vaccine includes a weakened dose

of the virus or bacteria being targeted.

Once it's injected into the body,

the immune system produces antibodies

that attach to the invader

and attract other immune cells to destroy it.

Memory cells remember it in case it comes back again.

To get the body to recognize EGFas a threat,

Cuban scientists attached a protein

from the meningitis bacteria to the EGF protein.

So, then the invention was to link human EGF

with a protein that is coming from a bacteria,

from the meningitis bacteria, by the way.

And as the bacteria protein is there,

then the immune system interpret,

"This is non-self and dangerous."

The attached bacterial molecule

causes the immune system to see all EGF as a threat.

Antibodies signal immune cells to eliminate the EGF.

The idea is to starve lung cancer cells

of something they depend on to multiply

but leave enough EGF in the bodyfor ordinary cells to function.

As it turns out, CIMAvax is most effective

for lung cancer patients like Marta,

who already have high levels of EGF in their blood.

You are making a trick to the immune system, no?

You trick the immune system,

because you present something self as if it were non-self.

When Roswell Park researchers

learn the science behind CIMAvax,

many are convinced it could be a game-changer.

They urge president and C.E.O. Candace Johnson

to consider the possibility of a partnership.

It was really a couple of individuals

that decided to really press this.

"And let's, let's see what we can do.

"Let's reach out to these folksin Havana

and see if we can establish somesort of relationship with them."

Then, in 2014...

Good afternoon.

History opens a door.

Today, the United States of America

is changing its relationship with the people of Cuba.

President Obama beginsnormalizing relations with Cuba.

And New York Governor Andrew Cuomo

leads a trade delegation to Havana.

So, the governor wanted to take a group of leaders

from around the state, and he chose me.

I could bring one person, and I took Dr. Lee.

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.

Roswell Park scientists believeCuba's CIMAvax could add

to the arsenal of weapons available for cancer patients.

The Cubans hope for access toresearch data from Roswell Park

and even technologies that couldimprove their immunology drugs.

We have limited resources,

because of... we are in a poor country.

We have also limited resources,

because the best and the most efficient technology

are usually coming from the U.S.,

and we don't have access to that.

One example is this American-made flow cytometer.

It suspends samples in a fluid

and whisks them through multiple lasers,

one cell at a time.

Tens of thousands of cells' characteristics

are rapidly analyzed.

In the U.S., the device is standard

for advanced research and clinical trials.

So, in this case,

we're measuring the T-cells in the patient's blood

in order to determine what type of T-cells are present.

One department at Roswell Park has over 20

of these expensive machines.

The data they could yield for Cuban research

would be invaluable.

There are only two such devices at C.I.M.

One is broken.

So, we had this equipment broke for one year,

because we had to send the equipment to Germany.

If this equipment has more than ten percent

of the American component, we can't buy.

Despite these limitations,

Cuban science makes important strides,

even as American discoveries in immunology treatment

continue to lead the world.

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.

What we're realizing now is that

you have to combine immunotherapy agents.

So, we're seeing studies that are testing vaccine

with immune checkpoint agents.

At Johns Hopkins Kimmel Cancer Center in Baltimore,

Bruce Toma is being treated

for stage IV pancreatic cancer.

One more.

He's participating in a clinical trial

combining checkpoint inhibitors

with a cancer vaccine developed

by Dr. Elizabeth Jaffee.

This is how goodyour work has done.

Nobody can believe... It's, it's so exciting.

that I'm stage IVmetastasized pancreatic cancer.

I don't know how much of your scans you've seen.

First one. The first one.

So what we're reallyexcited about

is that you had all of this tumor here

at the peritoneum. Mm-hmm.

Your most recent scan, there's nothing there.

We can't detect it.

It's totally gone.

Oh wow, yes, I can see the difference.

Immunotherapies are incredibly expensive.

And not everyone has the same success as Bruce.

And we don't know why.

If we can understand

why certain patients do benefitfrom immunotherapy

while others don't benefit from treatment,

we can make great leaps forwardin our cancer treatment.

Anything else going on? Any headaches...

But for now, many patients...

no matter what therapies they are receiving...

will likely reach a point

when they run out of treatment options.

As their cancer grows,

and the treatment that I'm giving them fails,

I become anxious, because with every step,

their options become more and more limited.

Mum, she took the scissors,

and she started just chopping off her own hair.

I'll never forget it.

My sister and I just stood there just awestruck.

It was a very emotional experience.

And Kathy was willing to try anything.

And it was tough on her when they, when they said,

"That's it, there-there is no more,

and treatment would only make you worse."

But Kathy held the doctor's handand said, "I understand."

They say usually it's three years, the time.

I'm exactly at third year.

The doctor said I have one more year to live.

It's no pain, because the needle is so thin.

No, I see, mm-hmm. Mosquito.

Yeah.

At La Pradera,

oncologists administer George's Vaxira prescription.

Okay.

George's doctor and close friend

Dr. William Blanchet is in Havana to lend support.

The cancer was growing,

the cancer markers were getting bigger on this agent.

His oncologist increased the dosage;

the cancer continued to get bigger.

We added the Vaxira, and his cancer gets smaller.

And so, on the three-year anniversary

of being diagnosed with horrible

stage IV lung cancer,

this guy runs a ten-K run and puts an offer down on a house.

Those are things that people

three years into stage IV lung cancer tend not to do.

But George is not cured.

Cancer continues to be a daily struggle.

In addition to Vaxira,

he's undergoing a number of treatments in the U.S.

Despite this, his doctors recently discovered

a new metastasis in his liver.

It's a hell of a thing

to have to take a risk

with, you know, your-your wellbeing

that you... that somebody could say,

"Well, you're breaking the law."

But could Cuban drugs like Vaxira

become available in the U.S.?

In science, cooperation is everything.

So if you are isolated, you are dead in science.

Our legal department saying, "How are we going to do this?

Is this going to be worth it?"

And I said, "If there's a two-percent chance

that the science is right, we need to be there."

Cuba and Roswell Park come to an agreement to cooperate.

In 2016, CIMAvax becomes the first Cuban drug ever

approved by the FDA for clinical trial in the U.S.

At Roswell Park,

it's being combined with acheckpoint inhibitor, nivolumab,

that could make CIMAvax even more effective.

And the flip side is the way CIMAvax works,

it may make nivolumab work better as well.

Think of it like, can one plus one equal to five?

So that's the ultimate goal of testing.

Two years later, Cuba's Center of Molecular Immunology

and Roswell Park double down on their partnership

and make history again.

The president and C.E.O. of Roswell Park

announced the first-ever biotech joint venture

between the United States and Cuba.

We did it!

The two agree to build a new biotech facility in Cuba

dedicated to cancer drugs,

jointly owned by Roswell Park and C.I.M.

Eventually, we will build factories.

And at some point of time

we will reachthe medical community

in Cuba and the U.S.

with new medicinesfor the people.

The embargo will continue to beone of the biggest challenges

for the Roswell Park-C.I.M. research partnership.

Even after the FDA approved clinical trials in 2016,

Roswell Park worried the embargowould make it almost impossible

to ship CIMAvax safely from Havana to Buffalo.

So they tried a test run with water

in a temperature-controlled box.

It actually got from Havana to Canadian customs;

and the FDA was expecting it,

because we told them there it would come.

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.

So, the box went back to Canada

and sat there for, I think, two days.

So the box is good for holding temperature for 72 hours.

Nearly 200 hours after being packaged in Cuba,

the box arrived in Buffalo.

The real vaccine would have been destroyed.

These kinds of challenges are critical to overcome

for the research partnership to succeed.

Both sides are convinced it's worth it.

let's come tobrain tumors,

where the data thatwe have is pretty good.

Then there is nothing in the United States...

It's a precedent-setting event.

You know, these are American scientists

working so closely with Cuban scientists.

They are presenting us with very novel drugs.

CIMAvax has the potential to work as a vaccine

to prevent lung-cancer formation,

and that has a substantial public-health implication.

I hope, I really hope,

that this won't be stopped

because this is cancer treatment,

and these are American citizensbeing treated

by cancer vaccines manufacturedhere in this small country.

Even as political tensions risebetween their two countries,

Cuban and American scientists continue on

in the hopes of improving cancer treatment

and one day finding a cure.

If we work together

to raise the quality of the lifeof our peoples,

that will bring us together.

Science is going to move relationships forward.

The promise of lifting theburden of cancer in all peoples

is going to move the relationship forward.

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.

I have things I want to... complete with my children.

I'm so lucky that I see things,

that I feel things on my skin,

and I don't want to lose it.

I want to live my life the fullest.

If I can't walk,

I'll be on my knees.

If I can't be on my knees, I'll crawl.

But I'll continually try to get back up.

And that will be my life.

How do you feel today?

Very good, very good. Very good?

No pain. Okay.

No pain.

Before going home,

George meets once more

with Dr. Anabely Garcia,

chief of his Havana medical team.

And, here, we put in the date that you receive.

You have vaccines until August, okay?

Yes, that's right. We wait for you next May or June.

Oh, no, no, no, no, no.

Don't cry.

Thank you.

I'll see you again in May.

Yes, of course.

Hasta luego.

One of the things you learn is to live in the moment.

I may not be here in six months, I-I don't know.