WEBVTT 00:00:02.887 --> 00:00:08.357 ¶ ¶ 00:00:08.693 --> 00:00:10.359 NARRATOR: HOW MANY PEOPLE ARE ALIVE ON 00:00:10.478 --> 00:00:13.779 PLANET EARTH RIGHT NOW? 00:00:14.565 --> 00:00:18.784 7,400,000,000 GIVE OR TAKE. 00:00:21.155 --> 00:00:24.073 WHATEVER YOU DO OR DON'T BELIEVE ABOUT HOW WE GOT HERE, 00:00:24.875 --> 00:00:28.744 THE FACT IS, WE ARE ALIVE, HERE AND NOW. 00:00:33.751 --> 00:00:36.668 THERE ARE THREATS TO OUR VERY EXISTENCE ON A DAILY BASIS; 00:00:38.139 --> 00:00:41.340 INTERNAL AND EXTERNAL CHAOS, 00:00:41.425 --> 00:00:44.777 NATURAL DISASTERS, WAR, DISEASES. 00:00:46.814 --> 00:00:50.516 AND RIGHT NOW, THERE IS A MONSTER ON THE LOOSE. 00:00:59.627 --> 00:01:01.560 DR. ANDRE CHOULIKA: THE BEST IMAGE THAT YOU CAN TAKE IS 00:01:01.662 --> 00:01:03.996 LIKE THESE ZOMBIES MOVIES. 00:01:06.867 --> 00:01:12.404 SOME PEOPLE TURN TOTALLY WILD, AND GO AND START BITING EACH 00:01:12.506 --> 00:01:14.373 OTHER AND CONVERT THE OTHERS. 00:01:18.796 --> 00:01:21.880 DR. DAVID PORTER: DARK, SCARY MONSTER. 00:01:23.217 --> 00:01:26.301 DR. PAUL VEYS: CAN'T SEE IT TILL IT'S SORT OF RIGHT UPON YOU. 00:01:28.773 --> 00:01:30.722 DR. BRUCE LEVINE: IT COMES IN AND POSSESSES YOU. 00:01:32.693 --> 00:01:34.693 DR. CARL JUNE: YOU DON'T KNOW WHERE THE ENEMY REALLY IS. 00:01:34.779 --> 00:01:36.478 IT'S AMONG US. 00:01:38.065 --> 00:01:43.986 ¶ [THEME MUSIC PLAYS] ¶ 00:02:01.422 --> 00:02:03.589 DR. DAVID PORTER: CANCER IS WHEN CELLS GO BAD. 00:02:03.674 --> 00:02:05.474 THEY GROW INAPPROPRIATELY. 00:02:05.593 --> 00:02:08.960 THEY GROW FASTER THAN THEY SHOULD OR THEY GROW IN PLACES 00:02:09.063 --> 00:02:11.897 THAT THEY SHOULDN'T GROW. 00:02:11.982 --> 00:02:14.983 I DON'T THINK THE IDEA OF CURING CANCER IS NAIVE. 00:02:15.102 --> 00:02:17.019 I THINK IT'S MANDATORY. 00:02:17.104 --> 00:02:19.905 I MIGHT, I MIGHT JUST CHANGE IT A LITTLE BIT AND I WOULD 00:02:19.990 --> 00:02:22.024 SAY CURING CANCERS. 00:02:27.364 --> 00:02:29.331 NARRATOR: AT THIS VERY MOMENT, 00:02:29.450 --> 00:02:32.817 POTENTIAL CANCER CELLS EXIST INSIDE OUR BODIES. 00:02:33.587 --> 00:02:36.255 CELLS THAT NEED JUST A FEW GENETIC MUTATIONS 00:02:36.340 --> 00:02:38.624 TO BECOME CANCER. 00:02:39.960 --> 00:02:43.545 OF THE TENS OF TRILLIONS OF CELLS IN YOUR BODY, 00:02:43.631 --> 00:02:46.515 IT ONLY TAKES ONE SINGLE CELL TO START THE 00:02:46.634 --> 00:02:49.134 CHAIN REACTION TOWARDS CANCER. 00:02:51.972 --> 00:02:54.106 IF IT IS CAUGHT EARLY ENOUGH, THERE ARE OPTIONS. 00:02:56.026 --> 00:02:59.027 BUT CANCER IS CUNNING AND RELENTLESS. 00:02:59.947 --> 00:03:02.731 IT KNOWS HOW TO HIDE AND PROTECT ITSELF. 00:03:12.743 --> 00:03:17.629 DOUG OLSON: I THINK WHAT'S SO TERRIFYING ABOUT CANCER 00:03:17.731 --> 00:03:21.700 IS THAT IT'S YOUR OWN BODY TRYING TO KILL YOU. 00:03:23.671 --> 00:03:25.170 IT'S NOT BACTERIA. 00:03:25.256 --> 00:03:28.473 IT'S NOT A VIRUS. 00:03:28.559 --> 00:03:31.176 IT'S YOUR OWN BODY. 00:03:31.512 --> 00:03:36.014 IT'S PART OF YOU THAT'S BETRAYING YOU. 00:03:39.570 --> 00:03:43.188 IT DEVELOPS WAYS IN WHICH TO FOOL THE SYSTEM THAT'S 00:03:43.274 --> 00:03:45.691 SUPPOSED TO KEEP YOU SAFE. 00:03:46.777 --> 00:03:50.529 AS IF THESE CELLS ACTUALLY THOUGHT ABOUT IT. 00:03:51.749 --> 00:03:55.918 WHAT DO I DO TO ESCAPE THE IMMUNE SYSTEM SO I CAN TAKE 00:03:56.036 --> 00:03:58.203 THIS PERSON DOWN? 00:03:59.790 --> 00:04:01.873 YOU GOT ANY HOT COFFEE THERE? 00:04:02.543 --> 00:04:04.209 SO MY NAME IS DOUG OLSON. 00:04:04.295 --> 00:04:06.428 I'M 69 YEARS OLD. 00:04:06.547 --> 00:04:09.247 WHEN I WAS 49 YEARS OLD, I WAS DIAGNOSED WITH 00:04:09.350 --> 00:04:11.750 CHRONIC LYMPHOCYTIC LEUKEMIA. 00:04:12.219 --> 00:04:17.689 IT WAS JULY OF 1996, AND I WAS FEELING KIND OF PUNK, 00:04:18.192 --> 00:04:22.093 SO I WENT TO AN IMMEDIATE CARE FACILITY TO GET CHECKED OUT. 00:04:22.730 --> 00:04:27.232 THE DOCTOR NOTICED I HAD SWOLLEN LYMPH NODES AND SHE SAID, 00:04:27.735 --> 00:04:29.952 "GEE, THAT SEEMS A LITTLE SUSPICIOUS." 00:04:30.070 --> 00:04:31.870 AND I SAID, "WELL, WHAT COULD THAT BE?" 00:04:31.956 --> 00:04:35.073 AND SHE SAID, "WELL, MAYBE MONO OR IT COULD BE CANCER." 00:04:35.709 --> 00:04:38.043 I THOUGHT, "OKAY." 00:04:39.546 --> 00:04:41.713 SO SHE MADE AN APPOINTMENT FOR ME TO GO 00:04:41.799 --> 00:04:44.800 SEE A SURGEON TO HAVE THE LYMPH NODE BIOPSIED. 00:04:46.420 --> 00:04:49.254 SO I LITERALLY WENT THE NEXT DAY. 00:04:51.091 --> 00:04:53.308 HE ACTUALLY GOT MY BLOOD WORK AND, UH, 00:04:53.427 --> 00:04:56.595 THE WHITE CELL COUNT WAS 10 TIMES WHAT IT SHOULD'VE BEEN. 00:04:59.850 --> 00:05:01.733 BUT HE SAID, "WE PROBABLY SHOULD TAKE THE LYMPH NODE OUT 00:05:01.835 --> 00:05:03.635 AND SEE WHAT'S GOING ON." 00:05:03.737 --> 00:05:05.604 HE SAID, "I COULD ACTUALLY DO IT RIGHT NOW," 00:05:05.689 --> 00:05:07.906 AND I SAID, "OKAY, LET'S DO IT." 00:05:09.860 --> 00:05:12.027 TOOK THE LYMPH NODE OUT AND I TOOK THE SAMPLE 00:05:12.112 --> 00:05:15.814 TO THE HOSPITAL AND I HANDED IT TO THE PATHOLOGIST AND 00:05:15.916 --> 00:05:17.582 HE SAID, "IT'LL PROBABLY BE OKAY." 00:05:17.668 --> 00:05:19.167 AND THEN HE LOOKED DOWN 00:05:19.286 --> 00:05:20.419 AT MY BLOOD WORK AND HE SAYS, 00:05:20.504 --> 00:05:21.920 "ARE THESE, IS THIS YOUR BLOOD WORK?" 00:05:22.006 --> 00:05:25.156 AND I SAID, "YEAH" AND I JUST WATCHED HIS FACE CHANGE, LIKE, 00:05:25.259 --> 00:05:27.793 IT'S NOT GONNA BE GOOD NEWS. 00:05:30.848 --> 00:05:33.465 THEY SAID THERE'S THIS NEW GUY, DAVID PORTER, 00:05:33.550 --> 00:05:35.851 WHO'S JUST DOWN FROM HARVARD. 00:05:38.856 --> 00:05:40.222 DR. DAVID PORTER: MY NAME'S DAVID PORTER. 00:05:40.307 --> 00:05:42.674 I'M THE DIRECTOR OF THE BLOOD AND MARROW TRANSPLANT PROGRAM 00:05:42.776 --> 00:05:44.309 HERE AT THE UNIVERSITY OF PENNSYLVANIA IN 00:05:44.395 --> 00:05:47.029 THE ABRAMSON CANCER CENTER. 00:05:47.147 --> 00:05:50.399 UH, I'VE BEEN HERE A LITTLE OVER 20 YEARS NOW. 00:05:51.435 --> 00:05:53.902 I TAKE CARE OF A LOT OF PATIENTS WITH BLOOD CANCERS. 00:05:54.988 --> 00:05:58.022 AND MY RESEARCH INTEREST IS PRIMARILY FOCUSED IN 00:05:58.125 --> 00:06:00.325 THE FIELD OF BLOOD AND BONE MARROW TRANSPLANT AND 00:06:00.411 --> 00:06:02.527 IN IMMUNOTHERAPY AND IN PARTICULAR, 00:06:02.629 --> 00:06:05.964 PARTICULARLY CELLULAR IMMUNOTHERAPY. 00:06:06.500 --> 00:06:09.868 DOUG OLSON: SO THE NEXT WEEK, I HAD AN APPOINTMENT WITH HIM. 00:06:10.671 --> 00:06:14.139 AND THAT'S WHEN HE TOLD ME THAT I HAD CLL. 00:06:14.842 --> 00:06:17.392 HE DID HIS BEST TO TRY TO GET ME TO THINK ABOUT IT MORE AS 00:06:17.511 --> 00:06:19.311 A CHRONIC DISEASE. 00:06:19.396 --> 00:06:24.066 BUT HAVING SAID THAT, THE PROGNOSIS FOR CLL WAS LIKE 00:06:24.184 --> 00:06:26.818 SOMEWHERE BETWEEN SIX AND FIFTEEN YEARS. 00:06:26.904 --> 00:06:29.738 ALL OF A SUDDEN, I'M SEEING MY LIFE CUT SHORT. 00:06:29.857 --> 00:06:30.989 DR. DAVID PORTER: YEAH. 00:06:31.075 --> 00:06:33.075 DOUG OLSON: I MEAN, THAT, THAT, THAT WAS REALLY THE, 00:06:33.193 --> 00:06:35.694 THE TOUGH PART ABOUT HEARING IT'S NOT CURABLE. 00:06:37.114 --> 00:06:40.248 NARRATOR: CLL IS A FORM OF LEUKEMIA THAT FOLLOWS YOU 00:06:40.367 --> 00:06:42.701 LIKE A STALKER IN THE NIGHT. 00:06:43.370 --> 00:06:46.738 IT CAN LAY LOW INSIDE YOUR BLOODSTREAM FOR YEARS, 00:06:46.840 --> 00:06:49.007 SLOWLY SPREADING UNTIL IT DEFEATS YOU. 00:06:51.011 --> 00:06:54.429 LEUKEMIA IS A COMPLICATED DISEASE. 00:06:54.548 --> 00:06:58.100 IT IS A BLOOD CANCER THAT LIVES IN THE BONE MARROW, 00:06:58.218 --> 00:07:01.419 WHERE BLOOD CELLS AND IMMUNE CELLS ARE MANUFACTURED. 00:07:02.022 --> 00:07:04.773 MUTATIONS IN DNA PRODUCE AN OVERABUNDANCE OF 00:07:04.892 --> 00:07:07.309 DEFECTIVE BLOOD CELLS. 00:07:07.394 --> 00:07:10.094 THE DEFECTIVE CELLS COLLECT IN BONE MARROW AND 00:07:10.197 --> 00:07:13.365 THE LYMPH NODES, CLOGGING THE PRODUCTION OF HEALTHY CELLS. 00:07:14.568 --> 00:07:18.570 IN TIME, THE PROLIFERATION OF THESE CANCEROUS CELLS DAMAGES 00:07:18.655 --> 00:07:20.989 YOUR IMMUNE SYSTEM. 00:07:21.074 --> 00:07:23.708 WITH YOUR NATURAL DEFENSES SHATTERED, 00:07:23.794 --> 00:07:26.611 PATHOGENS ARE FREE TO RAVAGE YOUR BODY. 00:07:27.297 --> 00:07:30.665 IN MOST CASES, CLL IS INCURABLE. 00:07:30.751 --> 00:07:33.385 IN MANY, IT CAN BE MANAGED WITH CHEMOTHERAPY, 00:07:33.470 --> 00:07:36.471 OR IN EXTREME CASES, AN IMMENSELY RISKY BONE MARROW 00:07:36.590 --> 00:07:39.123 TRANSPLANT CAN OFFER REMISSION. 00:07:39.977 --> 00:07:42.227 HOWEVER, IF THE CELLS CONTINUE TO MUTATE, 00:07:42.312 --> 00:07:44.012 THEY CAN BECOME COMPLETELY RESISTANT 00:07:44.097 --> 00:07:46.982 TO TREATMENT, BECOMING FATAL. 00:07:50.154 --> 00:07:53.772 DOUG OLSON: THE FIRST CHEMO WAS NOT ALL THAT VIOLENT. 00:07:53.857 --> 00:07:56.775 I DIDN'T LOSE MY HAIR. 00:07:58.662 --> 00:08:03.281 I HAD TWO ROUNDS AND BLOOD COUNT WENT RIGHT DOWN TO NORMAL AGAIN. 00:08:05.035 --> 00:08:07.953 AND THEN IT WAS ANOTHER FIVE YEARS. 00:08:10.674 --> 00:08:13.792 IT WAS 2006 WHEN I RELAPSED. 00:08:15.679 --> 00:08:17.963 PA: PROCEED WITH CAUTION. 00:08:18.932 --> 00:08:21.266 DON'T FORGET TO ENJOY YOUR LIFE. 00:08:24.771 --> 00:08:26.888 DOUG OLSON: AND DID THIS TREATMENT, 00:08:26.974 --> 00:08:30.375 THAT'S THE BENDAMUSTINE, THAT DIDN'T WORK AT ALL. 00:08:33.063 --> 00:08:37.682 DAVID, HE SAID, "FRANKLY, YOU HAVE THIS MUTATION." 00:08:38.485 --> 00:08:40.785 YOU KNOW, "THE CANCER IS GONNA BECOME HARDER AND 00:08:40.871 --> 00:08:43.205 HARDER TO TREAT. 00:08:43.323 --> 00:08:45.740 WE'RE GONNA SWITCH TO THIS NEW CHEMO. 00:08:45.826 --> 00:08:47.042 WE'LL SEE HOW THAT WORKS." 00:08:47.160 --> 00:08:48.860 AND WHEN IT DIDN'T, SEVERAL TIMES, 00:08:48.962 --> 00:08:50.378 HE SAID, "YOU KNOW, WE'RE GONNA HAVE TO START TALKING 00:08:50.497 --> 00:08:53.164 ABOUT BONE MARROW TRANSPLANT." 00:08:56.053 --> 00:08:58.587 HALF OF MY BONE MARROW WAS CANCER. 00:08:58.672 --> 00:09:02.007 I MEAN, I, IT WAS, I MEAN, LITERALLY, UM, 00:09:03.677 --> 00:09:05.760 IT WAS PRETTY SERIOUS AT THAT POINT. 00:09:07.397 --> 00:09:09.898 DR. DAVID PORTER: THESE ARE AWFUL CANCERS AND THERE ARE 00:09:10.017 --> 00:09:13.151 TIMES WHEN TREATMENTS JUST DON'T WORK AND PATIENTS ARE 00:09:13.237 --> 00:09:15.270 SICK AND THEY FEEL AWFUL AND PATIENTS DIE. 00:09:15.739 --> 00:09:19.524 AND THAT'S DEVASTATING. 00:09:19.610 --> 00:09:23.862 BUT HONESTLY, THE WORST WORSE THING IS WHEN WE DON'T HAVE 00:09:23.947 --> 00:09:26.114 ANY OPTIONS FOR SOMEBODY. 00:09:26.199 --> 00:09:29.251 THAT'S THE MOST FRUSTRATING PART FOR ME, 00:09:29.369 --> 00:09:32.203 WHEN WE DON'T EVEN HAVE SOMETHING TO OFFER. 00:09:34.207 --> 00:09:35.740 NARRATOR: DR. CARL JUNE DOES NOT BELIEVE IN 00:09:35.842 --> 00:09:37.792 RUNNING OUT OF OPTIONS. 00:09:40.013 --> 00:09:42.747 ALSO WORKING OUT OF THE UNIVERSITY OF PENNSYLVANIA, 00:09:42.849 --> 00:09:46.268 DR. JUNE HAS BEEN DEVELOPING A NEW TECHNOLOGY TO LEVERAGE 00:09:46.386 --> 00:09:48.937 THE IMMUNE SYSTEM'S T CELLS TO FIGHT AND 00:09:49.056 --> 00:09:52.190 KILL LEUKEMIA IN MICE. 00:10:00.901 --> 00:10:02.767 DR. CARL JUNE: I'VE BEEN THROUGH A LONG JOURNEY. 00:10:02.869 --> 00:10:05.570 SO I WAS A PHYSICIAN AND THEN I GRADUALLY, 00:10:05.656 --> 00:10:07.939 I CAME TO A CONCLUSION THAT I COULD PROBABLY HELP MORE 00:10:08.041 --> 00:10:11.793 PEOPLE THROUGH MY SCIENTIFIC LABORATORY EFFORTS THAN 00:10:11.912 --> 00:10:14.713 ACTUALLY SEEING PEOPLE ONE AT A TIME IN A CLINIC. 00:10:15.582 --> 00:10:17.832 DR. CARL JUNE: AND I TELL MY FAMILY NOW THAT MY "MD" 00:10:17.918 --> 00:10:19.968 STANDS FOR MOUSE DOCTOR. 00:10:20.504 --> 00:10:22.053 NARRATOR: THE IMMUNE SYSTEM PROTECTS YOU 00:10:22.139 --> 00:10:24.339 FROM OUTSIDE INVASION. 00:10:24.424 --> 00:10:27.625 IF A VIRUS, BACTERIA, OR FUNGUS SLIPS INTO YOUR BODY, 00:10:28.595 --> 00:10:31.896 THE IMMUNE SYSTEM RESPONDS WITH A COORDINATED ATTACK THAT 00:10:31.982 --> 00:10:35.066 KILLS THE INVADER, AND ONLY THE INVADER. 00:10:36.687 --> 00:10:38.937 LEAVING YOUR BODY INTACT. 00:10:40.440 --> 00:10:42.657 THIS IS A T CELL. 00:10:42.776 --> 00:10:45.476 THIS IMMUNE CELL'S JOB IS TO KILL INFECTED CELLS BEFORE 00:10:45.579 --> 00:10:47.195 THEY CAUSE MORE DAMAGE. 00:10:47.280 --> 00:10:49.814 IN THEORY, T CELLS CAN BE EXTRAORDINARILY 00:10:49.916 --> 00:10:52.083 POTENT AGAINST LEUKEMIA. 00:10:52.169 --> 00:10:54.652 BUT THERE'S ONE PROBLEM. 00:10:54.755 --> 00:10:58.340 SINCE CANCER IS EFFECTIVELY PART OF YOUR OWN BODY, 00:10:58.458 --> 00:11:01.325 THE IMMUNE SYSTEM SOMETIMES IGNORES THESE ROGUE CELLS, 00:11:01.962 --> 00:11:04.295 ALLOWING THE CANCER TO SPREAD UNCHECKED. 00:11:05.549 --> 00:11:08.266 JUNE AND HIS TEAM HAVE WORKED TIRELESSLY TO FIND A WAY TO 00:11:08.352 --> 00:11:11.703 GET THE IMMUNE SYSTEM TO RECOGNIZE AND DESTROY ALL 00:11:11.805 --> 00:11:13.605 OF THE CANCEROUS CELLS IN THE BODY. 00:11:14.191 --> 00:11:15.673 DR. CARL JUNE: THE THERAPY WE'RE DEVELOPING IS, 00:11:15.776 --> 00:11:17.675 IS MULTIDISCIPLINARY. 00:11:17.778 --> 00:11:20.562 IT INVOLVES LEUKEMIA SPECIALIST. 00:11:21.114 --> 00:11:23.064 DAVID PORTER IS KNOWN AROUND THE WORLD FOR HIS TREATING 00:11:23.150 --> 00:11:25.116 VARIOUS KINDS OF LEUKEMIA. 00:11:25.202 --> 00:11:27.402 IT INVOLVES IMMUNOLOGY EXPERTISE, 00:11:28.622 --> 00:11:33.324 VIRAL VECTOR DESIGN EXPERTISE, AND THEN THE CELL CULTURING 00:11:33.410 --> 00:11:36.360 EXPERTISE THAT BRUCE LEVINE KNOWS MORE ABOUT THAN ANYONE 00:11:36.463 --> 00:11:37.545 IN THE WORLD. 00:11:37.664 --> 00:11:39.130 I'M QUITE SURE. 00:11:39.216 --> 00:11:40.799 DR. BRUCE LEVINE: OKAY. 00:11:40.884 --> 00:11:43.334 I'M A PROFESSOR IN CANCER GENE THERAPY, 00:11:44.671 --> 00:11:47.055 AND I DIRECT THE CLINICAL CELL AND 00:11:47.174 --> 00:11:49.224 VACCINE PRODUCTION FACILITY. 00:11:49.342 --> 00:11:52.894 AND WHAT WE DO IS TO DEVELOP, MANUFACTURE, 00:11:53.013 --> 00:11:56.931 AND TEST CELL AND GENE THERAPIES TO FIGHT CANCER 00:11:57.434 --> 00:12:00.185 USING THE PATIENT'S OWN IMMUNE CELLS THAT 00:12:00.270 --> 00:12:02.687 HAVE BEEN GENETICALLY TARGETED TO CANCER. 00:12:05.075 --> 00:12:07.492 DR. DAVID PORTER: A "CAR" T CELL IS A T CELL THAT IS 00:12:07.577 --> 00:12:10.862 GENETICALLY MODIFIED IN A WAY THAT ALLOWS IT TO SEE AND 00:12:10.947 --> 00:12:13.114 RECOGNIZE A CANCER CELL. 00:12:17.120 --> 00:12:20.004 A "CAR" STANDS FOR CHIMERIC ANTIGEN RECEPTOR. 00:12:20.257 --> 00:12:22.907 IT'S A MOLECULE THAT IS SYNTHETIC. 00:12:23.343 --> 00:12:26.344 WE CAN PUT IT INTO AN IMMUNE CELL AND GENETICALLY CHANGE 00:12:26.446 --> 00:12:29.180 THE IMMUNE CELL TO EXPRESS THE CAR MOLECULE. 00:12:30.550 --> 00:12:34.302 THAT FUNCTION OF BINDING ACTIVATES THE T CELL AND IT 00:12:34.688 --> 00:12:37.472 ALLOWS IT TO BECOME ACTIVE, TO BECOME A KILLER CELL, 00:12:37.557 --> 00:12:40.442 AND TO KILL THE LEUKEMIA. 00:12:47.984 --> 00:12:50.652 NARRATOR: THE UNLIKELY KEY TO UNLOCKING THE POWER OF T CELLS 00:12:50.737 --> 00:12:56.274 AGAINST LEUKEMIA CAME FROM ONE OF THE MOST FEARED VIRUSES, HIV. 00:12:58.612 --> 00:13:01.913 DR. CARL JUNE: BY USING A GUTTED OUT HIV VIRUS AND 00:13:01.998 --> 00:13:03.882 MAKING IT SO IT'S NON-PATHOGENIC, 00:13:03.967 --> 00:13:06.885 MEANING IT CAN'T CAUSE HIV ANYMORE, 00:13:07.921 --> 00:13:11.956 IT STILL RETAINS ITS ABILITY TO TRANSFER GENES INTO T CELLS. 00:13:12.642 --> 00:13:14.843 AND SO WE CAN REPURPOSE THAT VIRUS AND 00:13:14.928 --> 00:13:16.961 USE IT FOR SOMETHING GOOD. 00:13:17.898 --> 00:13:19.797 NARRATOR: THE GENIUS OF DR. JUNE'S GROUP WAS TO 00:13:19.900 --> 00:13:22.233 HARNESS HIV AS A DELIVERY SYSTEM. 00:13:22.903 --> 00:13:26.304 THEY REPLACED HIV'S MALICIOUS CODE WITH A BENEFICIAL ONE 00:13:27.040 --> 00:13:31.276 THAT REPROGRAMS T CELLS TO IDENTIFY AND KILL CANCER CELLS. 00:13:32.279 --> 00:13:34.496 THIS BREAKTHROUGH TRANSFORMS REGULAR T CELLS 00:13:34.614 --> 00:13:36.781 INTO CAR T CELLS. 00:13:37.834 --> 00:13:39.984 DR. CARL JUNE: IN 2004, DAVID PORTER, AND I, 00:13:40.086 --> 00:13:42.954 AND BRUCE LEVINE GOT A $1,000,000 GRANT 00:13:43.039 --> 00:13:46.124 TO DO THE CAR-19 THERAPY THAT WE HAD. 00:13:46.459 --> 00:13:49.511 AT THAT POINT, WE HAD IT WORKING IN MICE AND WE WANNA 00:13:49.629 --> 00:13:51.513 DO ALL THE THINGS IT WOULD TAKE TO TURN IT 00:13:51.631 --> 00:13:53.932 INTO A HUMAN TRIAL. 00:13:54.634 --> 00:13:57.852 NARRATOR: BUT WOULD THIS EXPERIMENTAL TREATMENT GET THE 00:13:57.971 --> 00:14:01.272 SAME POSITIVE RESULTS IN THE INFINITELY MORE COMPLEX 00:14:01.358 --> 00:14:03.808 HUMAN IMMUNE SYSTEM? 00:14:09.274 --> 00:14:11.391 NARRATOR: TOILING FOR OVER A DECADE, 00:14:11.477 --> 00:14:15.061 DR. CARL JUNE'S RESEARCH TEAM REPROGRAMMED HIV, 00:14:15.164 --> 00:14:18.398 ONE OF THE MOST TERRIFYING MONSTERS OF THE 20TH CENTURY, 00:14:18.867 --> 00:14:21.785 AND TRANSFORMED IT INTO A HERO OF THE 21ST. 00:14:22.204 --> 00:14:23.787 DR. CARL JUNE: IT'S A TECHNOLOGY TRANSFER, 00:14:23.872 --> 00:14:27.040 THE KNOWLEDGE WE LEARNED ON WHAT THE HIV VIRUS DOES AND 00:14:27.126 --> 00:14:29.259 ITS PATHOGENICITY DISEASE CAUSING, 00:14:29.378 --> 00:14:31.812 LED TO A TREATMENT FOR LEUKEMIA. 00:14:32.765 --> 00:14:35.515 NARRATOR: THIS BREAKTHROUGH TRANSFORMS REGULAR T CELLS 00:14:35.601 --> 00:14:38.685 INTO SUPERCHARGED NEW CELLS CALLED CAR T CELLS. 00:14:39.888 --> 00:14:42.139 DR. CARL JUNE: A CAR T CELL THAT HAS AN ANTIBODY AGAINST 00:14:42.224 --> 00:14:45.108 A TUMOR CELL WILL STICK LIKE FLYPAPER. 00:14:45.761 --> 00:14:48.161 AND THAT CAR T CELL WILL STAY THERE ON THE CANCER CELL UNTIL 00:14:48.263 --> 00:14:49.930 THE CANCER CELL IS DEAD. 00:14:50.032 --> 00:14:53.900 IT CAN TAKE A FEW MINUTES TO SOMETIMES AN HOUR FOR THE 00:14:54.002 --> 00:14:56.303 CAR T CELL TO KILL THE TUMOR CELL. 00:14:56.405 --> 00:14:58.705 WHEN THE T CELL KNOWS THAT THE TUMOR CELL IS DEAD, 00:14:58.807 --> 00:15:02.642 IT DISENGAGES AND LOOKS AND FINDS OTHER CANCER CELLS. 00:15:04.580 --> 00:15:07.881 A CAR T CELL WILL GO FROM ONE CANCER CELL, KILL IT, 00:15:07.983 --> 00:15:09.249 GO TO ANOTHER AND TO ANOTHER. 00:15:09.351 --> 00:15:11.885 SO THEY'RE CALLED SERIAL KILLER CELLS. 00:15:22.531 --> 00:15:24.264 AND IT'S THE FIRST TIME IN HISTORY THAT WE'VE 00:15:24.349 --> 00:15:26.766 HAD LIVING DRUGS. 00:15:32.741 --> 00:15:35.808 NARRATOR: UP UNTIL THIS POINT, CAR T CELL THERAPY HAD ONLY 00:15:35.911 --> 00:15:39.779 BEEN ATTEMPTED IN PETRI DISHES AND LABORATORY MICE. 00:15:40.282 --> 00:15:42.949 MAKING THE LEAP TO HUMANS IS INFINITELY MORE 00:15:43.035 --> 00:15:45.619 COMPLEX AND TREACHEROUS. 00:15:47.172 --> 00:15:50.790 DR. CARL JUNE: CANCER IS MUCH MORE COMPLEX IN HUMANS THAN 00:15:50.876 --> 00:15:52.425 IT IS IN MICE. 00:15:52.511 --> 00:15:53.960 LAB EMPLOYEE: I MEAN, THIS IS ALL. 00:15:54.046 --> 00:15:56.046 DR. CARL JUNE: WHEN YOU START FROM AN INITIAL TRIAL IN 00:15:56.131 --> 00:15:58.331 HUMANS, THERE'S A MUCH HIGHER FAILURE RATE THAN THERE IS IN 00:15:58.433 --> 00:16:00.350 OTHER DISCIPLINES IN MEDICINE. 00:16:00.469 --> 00:16:02.502 LAB EMPLOYEE: THE PROBLEM IS IT DOESN'T WORK AS WELL SO THE 00:16:02.604 --> 00:16:04.304 TUMOR GROWS AND THIS IS A VERY RAPIDLY GROWING. 00:16:04.389 --> 00:16:05.856 DR. CARL JUNE: YEAH. 00:16:05.974 --> 00:16:08.225 DR. DAVID PORTER: IN 2006, IS WHEN WE FIRST STARTED TO WRITE 00:16:08.310 --> 00:16:10.193 OUR FIRST CLINICAL TRIAL USING THESE 00:16:10.312 --> 00:16:12.863 GENETICALLY MODIFIED T CELLS. 00:16:15.284 --> 00:16:17.684 FOLKS HERE AT PENN, CARL JUNE, BRUCE LEVINE, 00:16:18.120 --> 00:16:20.370 WE'RE ALL DEVELOPING METHODS WHERE THIS WAS GOING TO BE 00:16:20.489 --> 00:16:21.905 ABLE TO BE SCALED UP. 00:16:21.990 --> 00:16:25.242 THAT WE COULD DO THIS WITH HUMAN T CELLS AND THAT WE WERE 00:16:25.327 --> 00:16:27.327 GOING TO BE ABLE TO GROW ENOUGH OF THESE T CELLS TO 00:16:27.412 --> 00:16:30.497 ACTUALLY GIVE TO A, A PERSON. 00:16:31.300 --> 00:16:33.533 DOUG OLSON: MY GOAL FROM THE BEGINNING WAS STAY ALIVE LONG 00:16:33.619 --> 00:16:36.386 ENOUGH FOR SOMEBODY TO COME UP WITH A CURE FOR THIS THING. 00:16:36.505 --> 00:16:40.674 THAT'S WHAT I REALLY WANTED TO DO IS TO JUST TRY TO STAY AS 00:16:40.759 --> 00:16:44.010 HEALTHY AS I COULD AND, UM, YOU KNOW, 00:16:44.096 --> 00:16:47.180 TRY TO KEEP SURVIVING THIS THING UNTIL THERE WAS A BETTER 00:16:47.266 --> 00:16:50.901 OPTION THAN BONE MARROW TRANSPLANT. 00:16:51.019 --> 00:16:53.520 I MEAN, THIS LOOKED CURATIVE. 00:16:53.605 --> 00:16:56.389 YOU KNOW, IT WAS TARGETED TO THE CANCER INSTEAD OF 00:16:56.491 --> 00:17:00.393 BLASTING, YOU KNOW, THE BODY WITH POISON THAT, 00:17:00.495 --> 00:17:05.332 THAT PREFERENTIALLY KILLS CANCER CELLS BUT ALSO WHACKS 00:17:05.417 --> 00:17:09.586 A LOT OF THE, UH, HEALTHY TISSUE. 00:17:11.039 --> 00:17:13.456 SO I SIGNED UP. 00:17:14.543 --> 00:17:16.509 YOU KNOW, THEY TELL YOU ALL THE THINGS THAT COULD GO WRONG 00:17:16.595 --> 00:17:18.244 AND THE, AND THE PROTOCOL AT THE SAME TIME, 00:17:18.347 --> 00:17:19.629 AND YOU HAVE TO SIGN FORMS, OF COURSE, 00:17:19.715 --> 00:17:21.181 THAT SAYS THAT YOU'RE AWARE THAT, YOU KNOW, 00:17:21.266 --> 00:17:23.099 THINGS COULD GO BAD. 00:17:23.218 --> 00:17:26.853 BUT, YOU KNOW, IN A CLINICAL TRIAL, IT'S, IT'S LITERALLY, 00:17:26.939 --> 00:17:30.056 YOU'RE MAKING A LEAP FROM MICE TO HUMANS. 00:17:31.226 --> 00:17:33.226 NARRATOR: DOUG WAS ONE OF THREE PATIENTS ENTERING 00:17:33.328 --> 00:17:35.462 UNCHARTED TERRITORY IN THE EXPERIMENTAL 00:17:35.564 --> 00:17:38.098 CAR T CELL THERAPY. 00:17:38.200 --> 00:17:40.133 DOUG OLSON: TAKING THE WHITE CELLS WAS THREE HOURS 00:17:40.235 --> 00:17:41.635 SITTING IN A CHAIR. 00:17:41.737 --> 00:17:44.938 THEN THE CELLS GO OFF TO A LAB. 00:17:47.175 --> 00:17:49.743 DR. BRUCE LEVINE: WE GET A BAG OF CELLS AND WE ISOLATE THE 00:17:49.828 --> 00:17:52.412 CELLS THAT WE WANT, THE T CELLS. 00:17:55.751 --> 00:17:59.619 AND THEN AFTER A FEW DAYS, WE LOAD THEM INTO THIS BIOREACTOR 00:17:59.921 --> 00:18:02.589 SO THIS IS EVERYTHING THAT A CELL NEEDS. 00:18:03.759 --> 00:18:07.060 THE LIQUID END HAS NUTRIENTS AND ALLOWS THE CELLS TO 00:18:07.145 --> 00:18:08.979 GROW AND DIVIDE. 00:18:09.097 --> 00:18:10.814 THEY LOVE THIS ENVIRONMENT. 00:18:10.932 --> 00:18:14.184 WE CAN PUT IN A FEW TENS OF MILLIONS AND WE 00:18:14.269 --> 00:18:16.853 GET OUT BILLIONS. 00:18:17.572 --> 00:18:19.773 WE PUT THE GENE ENCODING THE CHIMERIC ANTIGEN RECEPTOR 00:18:19.858 --> 00:18:21.491 IN THE T CELLS. 00:18:21.610 --> 00:18:23.943 WE'VE CROWD-PRESERVED THEM. 00:18:24.029 --> 00:18:26.613 AND I'LL SHOW YOU WHAT THE CELLS LOOK LIKE. 00:18:27.282 --> 00:18:31.368 NOW THAT'S THE LIQUID NITROGEN VAPOR AND IN HERE ARE 00:18:31.453 --> 00:18:33.820 RACKS WITH CANISTERS. 00:18:33.922 --> 00:18:39.158 IT IS IN HERE AND THEY'RE AT MINUS 190 AND THEY'RE IN THESE 00:18:39.261 --> 00:18:41.628 BAGS IN THE CANISTERS. 00:18:42.798 --> 00:18:44.831 AND THEY HAVE A LABEL ON THEM. 00:18:44.933 --> 00:18:49.052 OKAY, SO NOW, YOU CAN SEE WHY THEY CALL THEM WHITE CELLS. 00:18:50.472 --> 00:18:54.524 SO THIS TINY BAG HAS SEVERAL HUNDRED MILLION CELLS. 00:18:56.311 --> 00:18:58.778 IN THE EYES OF REGULATORY AUTHORITIES, 00:18:58.864 --> 00:19:01.398 IN THE EYES OF THE FDA, WE REALLY ARE A PHARMACY. 00:19:01.700 --> 00:19:04.284 WE'RE MAKING A DRUG, EVEN THOUGH IT'S THE 00:19:04.386 --> 00:19:06.486 PATIENT'S OWN CELLS. 00:19:07.155 --> 00:19:08.872 DOUG OLSON: THESE TWO YOUNG WOMEN CAME INTO THE TREATMENT 00:19:08.990 --> 00:19:11.491 ROOM WITH A BIG FLASK OF NITROGEN, 00:19:11.576 --> 00:19:14.994 WHICH HAD THIS LITTLE PACKAGE OF MY CELLS. 00:19:15.914 --> 00:19:18.581 IT TURNS OUT THESE WERE THE TWO PEOPLE THAT ACTUALLY WERE 00:19:18.667 --> 00:19:21.000 RESPONSIBLE FOR MANUFACTURING THESE CELLS. 00:19:21.086 --> 00:19:25.138 AND I THINK, I THINK THEY WERE AS EXCITED AS I WAS, YOU KNOW, 00:19:25.590 --> 00:19:28.508 'CAUSE THEY KNEW HOW HUGE THIS WAS. 00:19:29.811 --> 00:19:32.345 THEN A NURSE, THEY THAWED THE CELLS, 00:19:32.431 --> 00:19:35.148 AND HOOKED IT UP TO AN IV AND TURNS THE VALVE, 00:19:35.233 --> 00:19:38.068 AND BAG EMPTIES. 00:19:39.187 --> 00:19:41.354 THEY KEPT ME AROUND FOR A FEW HOURS TO SEE IF I HAD 00:19:41.440 --> 00:19:43.556 ANY REACTION TO IT. 00:19:43.658 --> 00:19:45.742 NOTHING HAPPENED. 00:19:56.004 --> 00:20:01.708 ¶ ¶ 00:20:03.512 --> 00:20:06.679 I CAN'T IMAGINE WHAT IT MUST HAVE BEEN LIKE IN DAVID'S PART, 00:20:06.782 --> 00:20:09.081 AND CARL JUNE'S PART, AND THE SCIENTIST THAT 00:20:09.184 --> 00:20:10.600 HAVE DONE THIS. 00:20:10.719 --> 00:20:12.552 ANYONE WHO STARTS A CLINICAL TRIAL WILL TELL YOU THEY DON'T 00:20:12.637 --> 00:20:14.253 KNOW WHAT'S GONNA HAPPEN. 00:20:14.356 --> 00:20:15.421 THEY KNOW WHAT SHOULD HAPPEN, 00:20:15.524 --> 00:20:18.224 BUT THE BIOLOGICAL SYSTEM'S VERY COMPLICATED. 00:20:21.363 --> 00:20:23.196 DR. CARL JUNE: ABOUT TWO WEEKS AFTER HE WAS TREATED, 00:20:23.281 --> 00:20:25.115 THEN HE STARTED HAVING FEVERS. 00:20:25.233 --> 00:20:27.099 AND EVERY DAY, IT WOULD CREEP UP A LITTLE BIT. 00:20:27.202 --> 00:20:29.819 DOUG OLSON: I LITERALLY WOKE UP ON A MONDAY MORNING WITH 00:20:29.905 --> 00:20:33.606 FEVERS, AND, AND, AND CHILLS, AND FELT LIKE I HAD THE FLU. 00:20:36.995 --> 00:20:39.412 DR. DAVID PORTER: SO I REMEMBER THIS, THIS PART QUITE VIVIDLY. 00:20:39.748 --> 00:20:41.664 I WAS WALKING ACROSS CAMPUS. 00:20:41.750 --> 00:20:43.249 I HAD A PAGER AT THAT TIME. 00:20:43.351 --> 00:20:45.919 MY PAGER WENT OFF AND IT WAS THE LABORATORY AND IT SAID, 00:20:46.021 --> 00:20:48.805 "WE HAVE SOME CRITICAL LABS ON YOUR PATIENT, DOUG OLSON." 00:20:48.924 --> 00:20:50.256 THERE WERE A WHOLE BUNCH OF THINGS 00:20:50.342 --> 00:20:51.975 THAT WERE OUT OF WHACK. 00:20:52.093 --> 00:20:55.812 UM, YOUR CALCIUM, YOUR, YOUR KIDNEY TESTS. 00:20:55.931 --> 00:20:57.814 AND I WRITE IT DOWN AND SAID, "THANK YOU," AND I HANG UP. 00:20:57.933 --> 00:21:00.099 AND I'M SITTING OUTSIDE THIS RECEPTION ROOM 00:21:00.185 --> 00:21:01.434 JUST KIND OF LOOKING AT IT. 00:21:01.520 --> 00:21:03.653 AND I SAID, "YOU KNOW, THIS IS WHAT YOU SEE IN A PATIENT WHO 00:21:03.772 --> 00:21:06.305 HAS TUMOR LYSIS SYNDROME." 00:21:06.408 --> 00:21:07.941 DR. CARL JUNE: THE CAR T CELLS 00:21:08.026 --> 00:21:10.643 WERE ATTACKING THE TUMOR SO VIOLENTLY THAT THE PATIENTS 00:21:10.745 --> 00:21:14.113 COULD GET FEVERS OF 103 TO 106 DEGREES FAHRENHEIT. 00:21:14.749 --> 00:21:16.482 VERY HIGH FEVERS. 00:21:16.585 --> 00:21:18.785 DOUG OLSON: AND IT TURNED OUT THAT THE, 00:21:18.870 --> 00:21:23.089 THE PROBLEM WAS THAT THERE'S SO MANY TUMOR CELLS DYING, 00:21:23.175 --> 00:21:25.542 THEY'RE JUST DUMPING ALL OF THEIR CELLULAR CONTENTS 00:21:25.627 --> 00:21:26.926 INTO MY BLOODSTREAM. 00:21:27.028 --> 00:21:28.511 DR. CARL JUNE: SO LATER, WE WERE ABLE TO 00:21:28.630 --> 00:21:29.996 PUT THAT TOGETHER. 00:21:30.098 --> 00:21:31.664 THAT WHAT WE WERE SEEING WAS ACTUALLY GOOD NEWS. 00:21:31.766 --> 00:21:33.416 DOUG OLSON: THEY ESTIMATED SOMETHING ON THE ORDER OF 00:21:33.501 --> 00:21:35.051 THREE OR FOUR POUNDS OF CELLS WERE BEING 00:21:35.136 --> 00:21:39.189 WIPED OUT IN A MATTER OF, OF, OF PROBABLY A WEEK. 00:21:40.308 --> 00:21:43.693 DR. CARL JUNE: THAT WAS, UM, BECAUSE, YOU KNOW, SO WE THEN, 00:21:43.812 --> 00:21:47.814 UM, WITNESSED WHAT WAS THE CYTOKINE-RELEASE SYNDROME BUT 00:21:47.899 --> 00:21:51.684 IT WAS, IT GAVE US THE PROOF THAT IT REALLY WORKS. 00:21:52.320 --> 00:21:55.187 SO BECAUSE WE HAD INFUSED THESE CELLS THREE WEEKS 00:21:55.290 --> 00:21:56.923 BEFORE AND NOTHING HAPPENED. 00:21:57.025 --> 00:22:01.694 AND THEN THREE WEEKS LATER, HE WAS NOW FULL OF THESE T CELLS. 00:22:01.796 --> 00:22:04.230 I MEAN, WE COULD MEASURE THAT. 00:22:05.917 --> 00:22:07.967 AND THEN HE GOT THE FEVER AND THE TUMOR WENT AWAY. 00:22:08.053 --> 00:22:11.504 SO IT GAVE US THE SCIENTIFIC MECHANISM OF ACTION. 00:22:12.257 --> 00:22:15.925 HE, IN THAT ONE PATIENT, GAVE US THE PROOF THAT THIS WORKED. 00:22:16.511 --> 00:22:19.062 AND, AND SO THAT GAVE US A REAL CONFIDENCE THAT THE, 00:22:19.180 --> 00:22:21.264 THE CELLS WERE WORKING AS WE WOULD HOPE. 00:22:21.349 --> 00:22:23.883 THAT IT'S ASSOCIATED WITH THEIR PROLIFERATION AND THEN 00:22:23.985 --> 00:22:28.104 THEIR, THEIR FUNCTIONS AS CAR CELLS. 00:22:30.759 --> 00:22:33.726 WITHIN THREE PATIENTS, WE KNEW IN ADULTS IT WORKED. 00:22:33.828 --> 00:22:35.862 DR. DAVID PORTER: AND IT MIGHT HAVE BEEN THAT MORNING 00:22:35.947 --> 00:22:38.748 THAT I CAME TO SEE YOU IN THE HOSPITAL. 00:22:38.867 --> 00:22:41.167 STARTED LOOKING FOR SOME LYMPH NODES, 00:22:41.253 --> 00:22:43.202 THE ONES YOU ALWAYS FEEL WHEN YOU'RE SHAVING. 00:22:43.288 --> 00:22:44.454 AND, AND THEY WEREN'T THERE. 00:22:44.539 --> 00:22:45.755 DOUG OLSON: UH-UH. 00:22:45.874 --> 00:22:47.290 DR. DAVID PORTER: RIGHT? 00:22:47.375 --> 00:22:48.875 THEY, THEY WERE, THEY WERE GONE. 00:22:48.960 --> 00:22:51.210 DOUG OLSON: I FORGET THE, THEY DIDN'T USE THE WORD CURE. 00:22:51.296 --> 00:22:54.080 THEY, UM, IT WAS SOMETHING CLOSE TO IT THOUGH. 00:22:54.766 --> 00:22:58.084 SCIENTISTS, CANCER, SCIENTISTS TEND TO, 00:22:58.186 --> 00:23:00.386 TEND TO BE AND NEED TO BE VERY CONSERVATIVE 00:23:00.472 --> 00:23:03.106 ABOUT MAKING CLAIMS. 00:23:04.859 --> 00:23:07.860 YOU KNOW, THE NEXT WEEK, I WENT BACK, UH, 00:23:07.946 --> 00:23:09.946 FOR MY CHECK UP WITH DAVID AND, AND HE, 00:23:10.065 --> 00:23:11.597 THAT'S WHEN HE TOLD ME, HE SAID, 00:23:11.700 --> 00:23:14.534 "WE CAN'T FIND A CANCER CELL ANYWHERE. 00:23:14.619 --> 00:23:15.702 NOT IN YOUR BONE MARROW. 00:23:15.787 --> 00:23:17.937 NOT IN YOUR BLOOD." HE SAID, "WE DID THIS, 00:23:18.039 --> 00:23:20.940 THIS REALLY SENSITIVE TEST." 00:23:21.042 --> 00:23:23.910 HE SAID, "THE CANCER'S COMPLETELY GONE." 00:23:26.081 --> 00:23:29.615 SO I STILL HAVE THESE CAR T-19 CELLS, 00:23:29.718 --> 00:23:31.968 UM, SO I'M SORT OF IMMUNIZED AGAINST THE 00:23:32.087 --> 00:23:34.887 CANCER IF IT WERE EVER TO COME BACK. 00:23:34.973 --> 00:23:40.343 IT, IT CAN'T, UM, BECAUSE THESE, UM, 00:23:43.398 --> 00:23:45.398 WHAT THEY CALL THE KILLER CELLS, THE T CELLS, 00:23:45.483 --> 00:23:48.985 RECOGNIZE THIS TYPE OF CELL AND WILL KILL IT IMMEDIATELY. 00:23:55.360 --> 00:23:59.028 THIS SEPTEMBER 13TH WILL BE SIX YEARS CANCER-FREE. 00:24:02.667 --> 00:24:05.034 ZERO CANCER. 00:24:15.130 --> 00:24:20.800 ¶ ¶ 00:24:20.885 --> 00:24:24.721 YOU KNOW, TO HAVE YOUR LIFE SAVED IN THAT WAY IS JUST, 00:24:26.141 --> 00:24:28.608 IT'S HARD TO WRAP YOUR HEAD AROUND IT. 00:24:28.693 --> 00:24:31.227 I STILL HAVEN'T, YOU KNOW. 00:24:42.824 --> 00:24:45.124 NARRATOR: DESPITE THESE MIRACULOUS RESULTS, 00:24:45.210 --> 00:24:48.378 DR. JUNE'S RESEARCH FACED AN UNCERTAIN FUTURE. 00:24:52.133 --> 00:24:54.000 DR. CARL JUNE: THAT WAS VERY DIFFICULT TO GET FUNDING FOR 00:24:54.552 --> 00:24:56.753 AND IT WAS ONLY FROM PHILANTHROPY THAT WE'RE 00:24:56.838 --> 00:24:58.221 GONNA MAKE ENDS MEET. 00:24:58.339 --> 00:25:01.674 WE HAD, BASICALLY, A MOM AND POP OPERATION HELD TOGETHER 00:25:01.760 --> 00:25:04.977 BARELY BY, BARELY BY THE SHOESTRING TO PAY FOR 00:25:05.063 --> 00:25:06.979 EVERYTHING FROM THE CLINICAL TRIALS, 00:25:07.065 --> 00:25:08.848 TO MAKING THESE VIRAL VECTORS, 00:25:08.933 --> 00:25:12.101 TO THE CELL MANUFACTURING, UH, FACILITY. 00:25:13.405 --> 00:25:18.191 DR. BRUCE LEVINE: IN 2010, WE TREATED THREE PATIENTS WITH 00:25:18.276 --> 00:25:23.029 ADVANCED LEUKEMIA WITH CHIMERIC ANTIGEN RECEPTOR T CELLS. 00:25:23.114 --> 00:25:27.450 WE SAW DRAMATIC RESPONSES WHERE POUNDS OF LEUKEMIA 00:25:27.535 --> 00:25:29.869 MELTED AWAY OVER SEVERAL WEEKS. 00:25:30.505 --> 00:25:31.570 AND WE RAN OUT OF MONEY. 00:25:31.673 --> 00:25:34.290 DR. CARL JUNE: SO DAVID PORTER AND I MET ONE DAY IN THE 00:25:34.375 --> 00:25:36.626 COFFEE SHOP ACTUALLY DOWN RIGHT BELOW THIS BUILDING. 00:25:36.711 --> 00:25:39.912 IT WAS IN JANUARY, ABOUT THREE MONTHS, 00:25:40.014 --> 00:25:41.914 FOUR MONTHS AFTER THEIR FIRST THREE PATIENTS HAD BEEN 00:25:42.016 --> 00:25:45.184 TREATED AND TO STRATEGIZE WHAT COULD WE DO. 00:25:45.270 --> 00:25:47.603 DR. BRUCE LEVINE: AND MADE A DECISION TO PUBLISH THE 00:25:47.722 --> 00:25:50.589 RESULTS OF THOSE FIRST THREE PATIENTS. 00:25:51.192 --> 00:25:53.759 DOUG OLSON: NORMALLY, YOU DON'T PUBLISH ON THREE PATIENTS. 00:25:53.862 --> 00:25:55.445 THAT'S UNUSUAL. 00:25:55.563 --> 00:25:58.281 UM, AND THEY WEREN'T SO SURE THAT THE MANUSCRIPT WOULD 00:25:58.399 --> 00:25:59.982 EVEN BE ACCEPTED. 00:26:00.068 --> 00:26:01.934 DR. CARL JUNE: BUT OUR REPORT WAS ACCEPTED BY THE 00:26:02.036 --> 00:26:03.569 NEW ENGLAND JOURNAL OF MEDICINE, 00:26:03.655 --> 00:26:06.622 WHICH IS ONE OF THE MOST AUGUST AND RESPECTED JOURNALS. 00:26:06.741 --> 00:26:08.908 AND THEN IT TRIGGERED A FIRESTORM. 00:26:08.993 --> 00:26:11.377 I HAD THOUSANDS AND THOUSANDS OF INQUIRIES. 00:26:11.463 --> 00:26:14.497 PEOPLE OFFERING MONEY TO NOW MAKE SURE THE TRIAL 00:26:14.582 --> 00:26:15.915 WOULD GO FORWARD. 00:26:16.000 --> 00:26:17.917 AND THEN EVERYTHING COMPLETELY CHANGED. 00:26:18.419 --> 00:26:19.785 NEWSCASTER: THERE IS SOME GOOD NEWS TO REPORT IN THE 00:26:19.888 --> 00:26:20.953 FIGHT AGAINST CANCER. 00:26:21.055 --> 00:26:23.306 AN EXPERIMENTAL TREATMENT FOR LEUKEMIA IS HAVING 00:26:23.424 --> 00:26:26.676 EXTRAORDINARY RESULTS BEYOND ANY EXPECTATIONS. 00:26:27.428 --> 00:26:29.562 HOW OFTEN DO WE GET TO SAY THAT? 00:26:30.598 --> 00:26:32.315 PRESIDENT OBAMA: TODAY, THE DISCOVERIES TAKING PLACE IN 00:26:32.433 --> 00:26:35.351 OUR FEDERALLY FINANCED LABS AND UNIVERSITIES COULD LEAD TO 00:26:35.436 --> 00:26:38.020 NEW TREATMENTS THAT KILL CANCER CELLS, 00:26:38.106 --> 00:26:40.439 BUT LEAVE HEALTHY ONES UNTOUCHED. 00:26:40.525 --> 00:26:41.991 NEWSCASTER: HOW GOOD WERE THOSE RESULTS COMPARED 00:26:42.110 --> 00:26:43.576 TO YOUR EXPECTATIONS? 00:26:43.661 --> 00:26:45.745 DR. CARL JUNE: THE RESULTS EXCEEDED OUR EXPECTATIONS 00:26:45.830 --> 00:26:47.947 QUITE A BIT. 00:26:48.032 --> 00:26:49.749 DR. DAVID PORTER: THIS THERAPY AS IT IS RIGHT 00:26:49.834 --> 00:26:53.085 NOW REMAINS COMPLICATED. 00:26:53.171 --> 00:26:56.589 EVERY DOSE IS UNIQUE FOR AN INDIVIDUAL PATIENT. 00:26:57.125 --> 00:27:00.510 IT IS THE EPITOME OF PERSONALIZED MEDICINE. 00:27:00.628 --> 00:27:03.546 AND SO UNLIKE SOME OTHER DRUG THERAPIES THAT GET FDA 00:27:03.631 --> 00:27:06.382 APPROVAL AND THEN THEY'RE IN THE PHARMACY FOR ANYBODY TO 00:27:06.467 --> 00:27:09.385 PRESCRIBE AND USE, I THINK THESE ARE GOING TO BE 00:27:09.470 --> 00:27:13.556 THERAPIES THAT HAVE TO BE USED BY SPECIALIST PROVIDERS. 00:27:14.809 --> 00:27:18.144 IF I HAD TO COMPLETELY GUESS AT WHAT MIGHT BE COMING IN THE 00:27:18.246 --> 00:27:21.230 FUTURE, ONE COULD ENVISION THAT THE MANUFACTURING 00:27:21.316 --> 00:27:24.033 PROCESS BECOMES MORE AND MORE AUTOMATED. 00:27:24.152 --> 00:27:28.037 AND THERE IS A LOT OF INTEREST IN TRYING TO DEVELOP THESE 00:27:28.156 --> 00:27:32.691 CAR T CELLS THAT ARE UNIVERSAL, A MORE ONE SIZE FITS ALL, 00:27:32.794 --> 00:27:37.213 SO YOU COULD GENERATE A LARGE NUMBER OF THESE CELLS, 00:27:37.332 --> 00:27:39.966 FREEZE THEM AWAY IN THE PHARMACY, 00:27:40.051 --> 00:27:41.500 AND THEN WHEN A PATIENT COMES IN, 00:27:41.586 --> 00:27:44.036 YOU WILL HAVE PREMADE CELLS THAT COULD BE USED 00:27:44.138 --> 00:27:45.888 FOR MANY PATIENTS. 00:27:46.007 --> 00:27:47.974 NARRATOR: UNIVERSAL DONOR T CELLS COULD HELP 00:27:48.076 --> 00:27:50.893 MILLIONS OF PEOPLE, 00:27:51.012 --> 00:27:53.479 ESPECIALLY CHILDREN WHOSE CANCER TREATMENTS 00:27:53.565 --> 00:27:56.148 ARE OFTEN COMPLICATED. 00:27:57.101 --> 00:27:59.952 THE PROBLEM IS, RIGHT NOW, T CELL THERAPIES ARE 00:28:00.054 --> 00:28:02.554 LIKE ORGAN TRANSPLANTS. 00:28:02.657 --> 00:28:05.608 THEY REQUIRE COMPATIBILITY BETWEEN DONOR AND PATIENT, 00:28:06.661 --> 00:28:09.495 OR BOTH THE HOST BODY AND THE DONATED CELLS WILL 00:28:09.581 --> 00:28:11.731 REJECT THE TRANSFUSION. 00:28:11.833 --> 00:28:14.733 IN THE WORST-CASE SCENARIO, THE DONATED IMMUNE CELLS WILL 00:28:14.836 --> 00:28:18.237 MISTAKE EVERY CELL AND TISSUE IN THE RECIPIENT'S BODY AS A 00:28:18.339 --> 00:28:21.407 FOREIGN PATHOGEN, AND THEY WILL MELT THE PATIENT FROM 00:28:21.509 --> 00:28:23.342 THE INSIDE-OUT. 00:28:23.428 --> 00:28:26.295 BUT WHAT IF WE COULD GENETICALLY REPROGRAM DONOR 00:28:26.381 --> 00:28:29.632 T CELLS SO THEY COULD WORK ON ANYONE? 00:28:37.624 --> 00:28:42.644 [SCREAMING] 00:28:48.101 --> 00:28:51.770 [SCREAMING] 00:28:59.580 --> 00:29:03.198 NARRATOR: DR. ANDRE CHOULIKA FOUNDED CELLECTIS IN 1999, 00:29:04.384 --> 00:29:05.951 WITH THE SOLE PURPOSE OF CREATING 00:29:06.036 --> 00:29:08.453 A GENOME ENGINEERING TECHNOLOGY. 00:29:09.022 --> 00:29:12.357 AT THE TIME, IT WAS CONSIDERED PURE SCIENCE FICTION. 00:29:27.641 --> 00:29:30.942 BY 2014, CELLECTIS HAD THE TOOLS TO EDIT INDIVIDUAL 00:29:31.028 --> 00:29:33.111 SEQUENCES OF DNA. 00:29:33.197 --> 00:29:35.947 THEY CAN ADD, TURN OFF, OR CORRECT ANY ATTRIBUTE 00:29:36.049 --> 00:29:37.649 IN A GENETIC CODE. 00:29:37.734 --> 00:29:40.318 SCIENCE FICTION HAD BECOME SCIENCE FACT. 00:29:42.072 --> 00:29:43.738 DR. ANDRE CHOULIKA: WE STARTED THE COMPANY AS A 00:29:43.824 --> 00:29:45.123 GENE EDITING COMPANY. 00:29:45.209 --> 00:29:47.659 GENE EDITING IS THE WAY TO MODIFY GENES AND CELLS. 00:29:47.744 --> 00:29:50.745 IT MEANS YOU CAN GO, EDIT A GENE LIKE YOU WOULD EDIT 00:29:50.831 --> 00:29:54.633 NORMAL TEXTS, TEXT, BUT THIS IS DONE REAL UNDER MOLECULE OF 00:29:54.718 --> 00:29:57.586 LIFE INSIDE THE CELLS WHERE WE CAN, FOR EXAMPLE, 00:29:57.671 --> 00:30:01.339 REMOVE PORTION OF THE DNA THAT IS MALFUNCTIONING 00:30:01.425 --> 00:30:04.342 AND REPLACE IT BY SOMETHING THAT WORKS WELL. 00:30:05.546 --> 00:30:08.063 WITH GENE EDITING, YOU CAN MODIFY GENES TO UNDERSTAND 00:30:08.181 --> 00:30:09.648 HOW DNA FUNCTIONS. 00:30:09.733 --> 00:30:12.901 SO FOR RESEARCH PURPOSES, YOU CAN MODIFY GENES TO CREATE NEW 00:30:13.020 --> 00:30:17.355 SPECIES LIKE NEW CROPS OR YOU CAN MODIFY GENES FOR PEOPLE 00:30:17.441 --> 00:30:19.858 THAT ARE ILL, THAT HAVE GENETIC DEFECTS. 00:30:20.527 --> 00:30:24.362 SO THE INITIAL CONCEPT WAS DEFINITELY NOT CANCER. 00:30:24.781 --> 00:30:27.415 TEN YEARS AFTER WE STARTED THE COMPANY, 00:30:27.534 --> 00:30:29.734 MY CHIEF SCIENTIFIC OFFICER, FRED, 00:30:29.836 --> 00:30:31.620 CAME IN MY OFFICE AND SAID, 00:30:31.705 --> 00:30:35.239 "ANDRE, I DISCUSSED WITH TWO VERY BRILLIANT SCIENTISTS. 00:30:35.342 --> 00:30:39.044 ONE WAS CALLED CARL JUNE, FAMOUS GUY IN THE CAR T SPACE, 00:30:39.546 --> 00:30:42.764 AND THE SECOND ONE WAS, IS CALLED MICHEL SADELAIN, 00:30:42.883 --> 00:30:45.767 ALSO ANOTHER VERY FAMOUS SCIENTIST IN THE CAR T SPACE." 00:30:45.886 --> 00:30:48.603 AND ME AT THIS TIME, 2010, I'VE NEVER HEARD 00:30:48.722 --> 00:30:52.857 THE WORD CAR OR T, SO FRED STARTED EXPLAINING, 00:30:52.943 --> 00:30:56.594 CAR IS CHIMERIC ANTIGEN RECEPTOR PUT IN T CELLS AND 00:30:56.697 --> 00:30:59.364 YOU USE THE T CELLS TO DESTROY CANCER CELLS. 00:31:00.000 --> 00:31:02.817 AND THE CAR DRIVES THE T CELLS AGAINST CANCER CELLS. 00:31:04.404 --> 00:31:08.490 THIS IS THE THING WHERE GENE EDITING CAN BE TRANSFORMATIVE 00:31:08.575 --> 00:31:12.777 BECAUSE YOU CAN CONVERT A CELL INTO REAL THERAPY THAT CAN BE 00:31:12.879 --> 00:31:15.330 USEFUL AND UNIVERSAL. 00:31:15.415 --> 00:31:17.999 AND WE SIGNED UP FOR THIS. 00:31:18.085 --> 00:31:20.618 NARRATOR: IN A LEAP OF FAITH, CELLECTIS PIVOTED THEIR GENE 00:31:20.721 --> 00:31:25.056 EDITING TECHNOLOGY TO RECODE THE DNA OF DONATED T CELLS 00:31:25.142 --> 00:31:28.009 INTO UNIVERSAL CAR T CELLS 00:31:28.095 --> 00:31:31.513 THEORETICALLY FIT FOR ANY RECIPIENT. 00:31:32.566 --> 00:31:35.299 AFTER THE INITIAL EFFORT PROVED A SUCCESS, 00:31:35.402 --> 00:31:38.687 THEY PREPARED FOR YEARS OF CLINICAL TRIALS. 00:31:40.657 --> 00:31:42.607 DR. ANDRE CHOULIKA: WE DIDN'T HAVE ANY INTENTION OF 00:31:42.693 --> 00:31:45.810 INJECTING THESE TYPE OF VIALS TO PATIENTS BECAUSE 00:31:45.912 --> 00:31:48.312 WE NEEDED A LOT OF VIALS TO BE ABLE TO FILE 00:31:48.415 --> 00:31:50.031 OUR CLINICAL TRIAL APPLICATION. 00:31:50.117 --> 00:31:52.500 AND THIS WAS PLANNED TO BE DONE 00:31:52.619 --> 00:31:55.253 WITH UNIVERSITY COLLEGE LONDON. 00:31:59.343 --> 00:32:01.543 NARRATOR: BEFORE ANY NEW MEDICATION OR THERAPY IS 00:32:01.628 --> 00:32:05.263 CONSIDERED SAFE AND EFFECTIVE, IT MUST FIRST BE RIGOROUSLY 00:32:05.349 --> 00:32:08.550 TESTED THROUGH CLINICAL TRIALS. 00:32:11.471 --> 00:32:13.671 THESE TRIALS ARE FUNDAMENTAL IN DETERMINING AN 00:32:13.774 --> 00:32:16.841 EXPERIMENTAL TREATMENT'S DOSAGE AND SAFETY AND 00:32:16.943 --> 00:32:20.228 TO IDENTIFY ANY POSSIBLE SIDE EFFECTS. 00:32:20.731 --> 00:32:22.614 AT THE UNIVERSITY COLLEGE LONDON, 00:32:22.699 --> 00:32:25.450 GREAT ORMOND STREET INSTITUTE OF CHILD HEALTH, 00:32:25.535 --> 00:32:28.403 PROFESSOR WASEEM QASIM WAS WORKING WITH CELLECTIS AS THE 00:32:28.488 --> 00:32:32.123 PRINCIPAL INVESTIGATOR, TAKING THE UNIVERSAL CAR T CELLS 00:32:32.209 --> 00:32:34.876 FROM THE LAB TO TRIALS. 00:32:34.995 --> 00:32:37.328 NORMALLY, THIS PROCESS CAN TAKE OVER A DECADE, 00:32:37.414 --> 00:32:40.198 WITH NEARLY ENDLESS LAYERS OF APPROVAL. 00:32:40.584 --> 00:32:42.917 PROF WASEEM QASIM: SO OUR QUESTIONS WERE WHAT DO YOU DO 00:32:43.003 --> 00:32:45.637 IF YOUR PATIENT IS ALREADY SO UNWELL THAT YOU CAN'T COLLECT 00:32:45.722 --> 00:32:47.889 CELLS, HAS HAD SO MUCH CHEMOTHERAPY THAT THERE'S NO 00:32:48.008 --> 00:32:50.308 WHITE BLOOD CELLS LEFT TO COLLECT THAT YOU THINK 00:32:50.394 --> 00:32:51.709 ARE GONNA BE USEFUL? 00:32:51.812 --> 00:32:54.479 UM, HOW DO YOU DO THIS PROCESS IN A WAY THAT 00:32:54.564 --> 00:32:57.215 CAN BE DONE QUICKLY AND DELIVERED BACK TO THE PATIENT 00:32:57.317 --> 00:32:58.483 IN A TIMELY MANNER? 00:32:58.568 --> 00:33:02.937 AND THE ANSWER TO THAT IS PERHAPS BEING ABLE TO USE A, 00:33:03.607 --> 00:33:07.442 A PRODUCT, TO SELL PRODUCT THAT'S BEING MADE BEFOREHAND 00:33:07.527 --> 00:33:10.228 THAT CAN BE GIVEN BACK TO MULTIPLE PATIENTS. 00:33:10.330 --> 00:33:12.113 NOW IN ORDER TO DO THAT, WE HAVE TO OVERCOME 00:33:12.199 --> 00:33:14.232 THE BARRIER OF TRANSPLANTATION. 00:33:14.334 --> 00:33:19.421 WHICH MEANS, IF I PUT MY CELLS INTO A NON-MATCHED INDIVIDUAL, 00:33:20.373 --> 00:33:23.425 THE CELLS, FIRSTLY, WILL WANT TO REACT AGAINST THAT 00:33:23.543 --> 00:33:25.744 INDIVIDUAL BECAUSE THEY'LL KNOW THE INDIVIDUAL'S FOREIGN, 00:33:25.846 --> 00:33:28.379 AND SECONDLY, THE PERSON RECEIVING THE CELLS WILL TRY 00:33:28.465 --> 00:33:30.348 AND REJECT THEM BECAUSE THEY KNOW THAT THE 00:33:30.434 --> 00:33:32.684 CELLS ARE NOT THEIR OWN. 00:33:32.769 --> 00:33:34.969 NARRATOR: IN AFFILIATION WITH PROFESSOR QASIM, 00:33:35.055 --> 00:33:38.022 DR. PAUL VEYS WORKS ON THE FRONTLINE WITH PATIENTS WHO 00:33:38.108 --> 00:33:41.259 DESPERATELY NEED NEW CANCER TREATMENT OPTIONS. 00:33:41.361 --> 00:33:42.777 DR. PAUL VEYS: I'LL HAVE TREATED WELL OVER 00:33:42.896 --> 00:33:46.397 3,000 PATIENTS AND AT LEAST 600 OF THOSE WILL HAVE GONE WRONG. 00:33:47.117 --> 00:33:49.818 SO THERE'S A LOT OF PATIENTS THAT WE LOSE, IT'S UNSUCCESSFUL. 00:33:50.904 --> 00:33:54.072 AND YOU'VE GOT TO BE ABLE TO COME IN THE NEXT DAY. 00:33:58.462 --> 00:34:02.497 EVEN FROM OUR FAILURES, WE'VE LEARNED LOTS. 00:34:03.049 --> 00:34:06.000 AND IF WE HADN'T GONE THROUGH THOSE FAILURES, 00:34:06.086 --> 00:34:08.586 WE WOULDN'T BE HAVING SOME OF THE SUCCESSES WE HAVE TODAY. 00:34:08.672 --> 00:34:09.954 HAS YOUR CHEST ALWAYS BEEN GOOD? 00:34:10.056 --> 00:34:11.339 YOU'VE NOT HAD ANY BIG CHEST INFECTIONS? 00:34:11.424 --> 00:34:12.456 WOMAN: NO, NOT AT ALL. 00:34:12.559 --> 00:34:14.809 DR. PAUL VEYS: NO. 00:34:16.429 --> 00:34:17.628 LET'S WARM IT UP. 00:34:17.731 --> 00:34:20.515 SIT FORWARD AGAIN, PERFECT. 00:34:21.485 --> 00:34:24.402 OKAY, BIG BREATHS. 00:34:26.773 --> 00:34:29.240 NARRATOR: ONE OF THE MOST TRYING CASES PAUL VEYS EVER 00:34:29.326 --> 00:34:31.943 FACED WAS 12-MONTH-OLD LAYLA RICHARDS. 00:34:33.446 --> 00:34:34.863 MOTHER: WHEN SHE WAS THREE MONTHS OLD, 00:34:34.948 --> 00:34:37.499 WE TOOK HER TO THE DOCTOR'S AND JUST TOLD THEM, 00:34:37.617 --> 00:34:39.284 SHE JUST WASN'T HERSELF. 00:34:39.369 --> 00:34:41.619 HER HEARTBEAT WAS A BIT FAST, HER, 00:34:41.705 --> 00:34:45.390 SHE HAD A HIGH PITCHED CRY, AND SHE HAD GONE OFF OF 00:34:45.492 --> 00:34:46.891 HER MILK COMPLETELY. 00:34:46.993 --> 00:34:50.044 AND WITHIN HALF AN HOUR, WE WERE TOLD SHE HAD LEUKEMIA AND 00:34:50.130 --> 00:34:52.163 THERE WAS A CATS AMBULANCE COMING TO TAKE US TO GREAT 00:34:52.265 --> 00:34:55.049 ORMOND STREET HOSPITAL TO START TREATMENT IMMEDIATELY. 00:34:55.969 --> 00:34:57.852 FATHER: THEY SAID IT WAS A VERY AGGRESSIVE LEUKEMIA AND 00:34:57.971 --> 00:35:01.973 WE'RE GONNA TELL YOU INFORMATION BIT BY BIT. 00:35:03.527 --> 00:35:06.177 DR. PAUL VEYS: SHE HAD A TERRIBLE LEUKEMIA. 00:35:06.279 --> 00:35:10.148 WE CALL IT, UH, AN INFANT LEUKEMIA AND INFANT LEUKEMIA 00:35:10.483 --> 00:35:12.183 IS ALWAYS BAD NEWS. 00:35:12.285 --> 00:35:14.819 AND HER DISEASE WAS PARTICULARLY BAD NEWS BECAUSE 00:35:14.905 --> 00:35:18.489 EVEN BEFORE A MONTH HAD PASSED AFTER HER TRANSPLANTS, 00:35:18.575 --> 00:35:21.859 UH, WE COULD SEE HER DISEASE COMING BACK. 00:35:22.913 --> 00:35:25.630 SO WE WERE THEN IN A VERY, VERY DIFFICULT POSITION AND 00:35:25.715 --> 00:35:28.883 WE'VE NEVER MADE ANYBODY BETTER FROM 00:35:29.002 --> 00:35:31.252 THAT POINT PREVIOUSLY. 00:35:31.638 --> 00:35:34.538 SO IF YOU RELAPSE VERY EARLY AFTER TRANSPLANTS, 00:35:34.641 --> 00:35:37.926 USUALLY THE RIGHT DECISION IS TO TRY AND GET THEM HOME. 00:35:38.011 --> 00:35:40.311 SOMETIMES, WITH SOME GENTLE TREATMENTS, 00:35:40.397 --> 00:35:43.815 BUT MAINLY TREATING THEIR, THEIR PAIN OR THEIR SICKNESS. 00:35:43.900 --> 00:35:45.716 FATHER: FOR ME, AS A PARENT, THAT'S NOT AN OPTION. 00:35:45.819 --> 00:35:47.602 MOTHER: DIDN'T AGREE WITH GOING HOME TO DO NOTHING. 00:35:47.687 --> 00:35:49.220 WE WANTED TO TRY IT. 00:35:49.322 --> 00:35:50.989 IT WAS, WE DIDN'T WANT NO WHAT IFS. 00:35:51.074 --> 00:35:53.858 WE WANNA KNOW THAT WE'VE TRIED EVERYTHING FOR HER. 00:35:53.944 --> 00:35:55.994 DR. PAUL VEYS: AND WITH THE, WITH THE PARENTS ABSOLUTELY 00:35:56.079 --> 00:36:00.114 REFUSING REPEATEDLY, I ASKED OUR COLLEAGUES IN THE LAB, 00:36:00.200 --> 00:36:04.786 PROFESSOR QASIM, WHETHER HE HAD ANY THIRD PARTY T CELLS 00:36:04.871 --> 00:36:07.755 THAT WE MIGHT BE ABLE TO USE IN THIS SITUATION. 00:36:08.258 --> 00:36:09.507 DR WASEEM QASIM: AND SO HE RANG ME AND SAID, 00:36:09.593 --> 00:36:12.243 "WELL, IS THAT NEW THERAPY YOU GUYS ARE WORKING ON, 00:36:12.345 --> 00:36:15.296 THE UNIVERSAL THERAPY, HOW LONG WILL IT BE BEFORE IT'S 00:36:15.382 --> 00:36:16.714 READY FOR USE?" 00:36:16.816 --> 00:36:18.349 I SAID, "WELL, LOOK, ACTUALLY THE, THE, 00:36:18.435 --> 00:36:21.219 THE TRIAL IS PROBABLY STILL A YEAR AWAY BECAUSE WE HAVE TO 00:36:21.304 --> 00:36:24.856 COMPLETE, UH, VARIOUS TESTING ON THE PRODUCTS WE'VE MADE, 00:36:24.941 --> 00:36:27.591 WE HAVE TO GO TO THE REGULATOR TO GET APPROVAL. 00:36:27.694 --> 00:36:30.612 REALISTICALLY, YOU'RE TALKING 12 MONTHS, MAYBE LONGER." 00:36:30.730 --> 00:36:32.096 DR. PAUL VEYS: WE HAVE WHAT'S CALLED A 00:36:32.198 --> 00:36:34.532 SPECIALS LICENSE HERE, WHICH IS FAIRLY UNUSUAL, 00:36:34.618 --> 00:36:36.200 WHICH ALLOWS US TO DO THESE VERY, 00:36:36.286 --> 00:36:39.787 VERY EXPERIMENTAL PROCEDURES OFF A FORMAL STUDY. 00:36:39.906 --> 00:36:43.607 IT ALLOWS YOU TO TREAT ONE OR TWO PATIENTS OFF THESE STUDIES 00:36:43.710 --> 00:36:45.944 BECAUSE TO GET IT THROUGH ON A FORMAL STUDY WOULD'VE 00:36:46.046 --> 00:36:47.462 TAKEN MANY MONTHS. 00:36:47.580 --> 00:36:51.182 AND LAYLA, YOU KNOW, SHE HAD DAYS OR WEEKS. 00:36:51.284 --> 00:36:53.685 UH, SO I SAID, "LOOK, DO YOU HAVE ANYTHING THAT'S EVEN 00:36:53.787 --> 00:36:58.256 VAGUELY CLOSE TO BEING USED IN THE CLINICAL SITUATION?" 00:36:58.925 --> 00:37:01.309 AND THAT WAS JUST A VERY SHORT EMAIL I SENT. 00:37:01.428 --> 00:37:03.845 EXPECTING OF COURSE, DON'T BE SILLY. 00:37:04.264 --> 00:37:06.464 DR WASEEM QASIM: AND I, I REMEMBER RESPONDING TO HIM AND 00:37:06.566 --> 00:37:08.232 SAYING, "ACTUALLY, IT'S NOT A MAD IDEA. 00:37:08.318 --> 00:37:12.487 IT'S A VERY CALCULATED, STRATEGIC WAY OF DOING THIS 00:37:12.605 --> 00:37:13.855 TYPE OF TREATMENT. 00:37:13.940 --> 00:37:16.741 AND AS IT HAPPENS, THE CELLS WE'VE MADE ARE READY, 00:37:16.826 --> 00:37:20.745 BUT WE'LL NEED TO GO AND ASK THE PERMISSION OF THE SPONSOR," 00:37:20.830 --> 00:37:23.481 WHICH IS, WAS CELLECTIS AT THAT TIME. 00:37:23.917 --> 00:37:24.999 DR. ANDRE CHOULIKA: SO WE STARTED THINKING, 00:37:25.118 --> 00:37:26.451 WHAT SHOULD WE DO? 00:37:26.536 --> 00:37:28.536 HE TRIES IT AND WE'LL KNOW IF IT WORKS OR NOT. 00:37:28.621 --> 00:37:30.204 MAYBE THE VIAL CAN BE TOXIC. 00:37:30.290 --> 00:37:32.490 MAYBE CAN KILL THE GIRL BECAUSE OF COURSE ALL THE 00:37:32.592 --> 00:37:36.827 WARNINGS WERE YOU MIGHT INDUCE THIS GRAFT-VERSUS-HOST DISEASE 00:37:36.930 --> 00:37:39.497 THAT CAN MELT DOWN THE PATIENT FROM THE INSIDE AND KILL HIM. 00:37:39.599 --> 00:37:43.935 A NINE-MONTH-OLD BABY, IMAGINE THIS, YOU DON'T WANNA DO THIS. 00:37:44.020 --> 00:37:45.053 DR. PAUL VEYS: THERE WERE MANY OTHERS THAT SAID, 00:37:45.138 --> 00:37:46.187 "DON'T DO THIS. 00:37:46.306 --> 00:37:50.191 THIS IS TOO EXPERIMENTAL, REPUTATIONS WERE AT RISK." 00:37:50.310 --> 00:37:52.777 DR. ANDRE CHOULIKA: WE'VE BEEN INVESTING ALL OUR ENERGY. 00:37:52.862 --> 00:37:56.197 15 YEARS HERE TO TRY TO SAVE PEOPLE. 00:37:57.117 --> 00:38:00.618 IF FOR THE FIRST OCCASION WE SAY NO, 00:38:00.704 --> 00:38:03.020 THEN WHY ARE WE DOING THIS? 00:38:03.123 --> 00:38:04.288 SO I SAID YES. 00:38:04.374 --> 00:38:07.658 THE BOARD TOOK THE DECISION TO BACK THIS UNANIMOUSLY 00:38:07.744 --> 00:38:09.026 IN THE COMPANY. 00:38:09.129 --> 00:38:11.662 EVERYONE WAS SAYING, "SURE, THIS IS OUR MISSION IS 00:38:11.748 --> 00:38:13.297 TO TRY TO SAVE PEOPLE." 00:38:13.383 --> 00:38:14.999 DR. PAUL VEYS: SO BECAUSE THESE, 00:38:15.085 --> 00:38:18.086 THESE CELLS WERE COMPLETELY UNIVERSAL AND NOT MATCHED TO 00:38:18.171 --> 00:38:20.888 LAYLA AT ALL, WE WERE VERY WORRIED ABOUT THESE, 00:38:21.007 --> 00:38:22.590 THESE CELLS REJECTING IMMEDIATELY WHEN WE 00:38:22.675 --> 00:38:23.891 PUT THEM IN. 00:38:24.010 --> 00:38:27.178 SO WE HAD TO REMOVE ANY REMNANTS OF LAYLA'S IMMUNE SYSTEM. 00:38:27.680 --> 00:38:28.930 SHE DIDN'T HAVE MUCH BECAUSE, OF COURSE, 00:38:29.015 --> 00:38:31.048 SHE'D JUST BEEN THROUGH TRANSPLANTS AND 00:38:31.151 --> 00:38:32.049 SO MUCH TREATMENT. 00:38:32.152 --> 00:38:33.901 BUT THERE WAS STILL PARTS ENOUGH LEFT THERE, 00:38:34.020 --> 00:38:36.270 SO WE HAD TO GIVE SOME, SOME DRUGS, 00:38:36.356 --> 00:38:40.024 SOME CHEMOTHERAPY TO REMOVE ANY REMAINING IMMUNITY 00:38:40.276 --> 00:38:41.359 THAT SHE HAD. 00:38:41.444 --> 00:38:43.694 THAT TAKES ABOUT A WEEK. 00:38:44.798 --> 00:38:47.115 THE IDEA WAS SHE HAD NO RESISTANCE, 00:38:47.200 --> 00:38:50.568 AND THEN THE CELLS WERE GIVEN, IT'S JUST ONE VIAL. 00:38:50.670 --> 00:38:53.788 COMES TO THE BEDSIDE, IT'S DEFROSTED, GOES IN. 00:38:53.873 --> 00:38:56.457 UH, AND THEN WE WAIT. 00:38:57.544 --> 00:39:00.428 NARRATOR: THE TEAM WATCHED FOR ANY SIGN OF THE HIGH FEVERS 00:39:00.547 --> 00:39:02.847 AND OTHER SIDE EFFECTS THEY EXPECTED TO COME AFTER 00:39:02.932 --> 00:39:06.100 INJECTING THE ENGINEERED T CELLS. 00:39:06.469 --> 00:39:08.469 BUT NOTHING HAPPENED. 00:39:08.555 --> 00:39:09.720 HAD IT FAILED? 00:39:15.270 --> 00:39:21.441 ¶ ¶ 00:39:25.831 --> 00:39:27.414 DR WASEEM QASIM: BEEN QUITE A TENSE MONTH. 00:39:27.499 --> 00:39:31.785 BEEN TENSE BECAUSE WE WERE EXPECTING SIDE EFFECTS. 00:39:31.870 --> 00:39:33.920 WE HAD ON OUR BLOOD TEST EVIDENCE THAT WE COULD SEE THE 00:39:34.006 --> 00:39:36.322 CELLS IN THE BLOOD SYSTEM, BUT WHY WASN'T 00:39:36.425 --> 00:39:37.657 SHE GETTING MORE UNWELL? 00:39:37.759 --> 00:39:39.960 SHE SHOULD BE DEVELOPING TEMPERATURES. 00:39:40.045 --> 00:39:42.212 DR. PAUL VEYS: WE KNOW THAT SOMETIMES IF CHILDREN HAVE 00:39:42.297 --> 00:39:45.515 THESE SORT OF THERAPIES WITH A LOT OF DISEASE, UH, 00:39:45.634 --> 00:39:48.969 WITHIN FOUR, FIVE, SIX DAYS, THEY CAN GET VERY SICK AS THE 00:39:49.054 --> 00:39:52.505 CELLS START TO ATTACK, RASHES, FEEL VERY UNWELL. 00:39:53.442 --> 00:39:56.109 AND SOMETIMES REQUIRED TO GO TO INTENSIVE CARE, UM, 00:39:56.562 --> 00:39:59.479 JUST TO GET OVER THAT WHAT WE CALL CYTOKINE STORM. 00:39:59.565 --> 00:40:01.031 THAT DIDN'T HAPPEN IN LAYLA. 00:40:01.149 --> 00:40:02.399 DR WASEEM QASIM: UH, BECAUSE NONE OF THAT HAPPENED, 00:40:02.484 --> 00:40:04.234 WE WERE ANXIOUS THAT MAYBE THERE HADN'T BEEN 00:40:04.319 --> 00:40:05.518 AN ANTI-LEUKEMIC EFFECT. 00:40:05.621 --> 00:40:08.855 SO THE FIRST TIME POINT WE WERE REALLY SURE THAT THE 00:40:08.957 --> 00:40:11.875 CELLS HAD REMOVED THE REMAINING LEUKEMIA CELLS WAS 00:40:11.994 --> 00:40:14.661 WHEN WE LOOKED IN THE BONE MARROW AT THE ONE MONTH MARK 00:40:14.746 --> 00:40:16.162 AND DIDN'T FIND ANY. 00:40:16.248 --> 00:40:18.331 DR. PAUL VEYS: WE, WE WERE PRETTY EXCITED BY THAT POINT, 00:40:18.417 --> 00:40:21.301 UM, BECAUSE AS WELL AS DETECTING NO DISEASE, 00:40:21.386 --> 00:40:23.870 WE ALSO COULD SHOW THAT THE CELLS WERE STILL PRESENT. 00:40:24.590 --> 00:40:27.206 THEY HADN'T BEEN REJECTED, AND IF THEY WEREN'T REJECTED, 00:40:27.309 --> 00:40:30.093 IT MEANS THEY WERE SORT OF WHIZZING AROUND HER 00:40:30.178 --> 00:40:32.395 DOING THE JOB. 00:40:32.514 --> 00:40:37.567 FATHER: SHE WAS SO WEAK BEFORE THIS TREATMENT AND 00:40:37.686 --> 00:40:38.818 IT'S JUST HORRIBLE. 00:40:38.904 --> 00:40:40.353 IT'S HORRIBLE AND I'M JUST THANKFUL. 00:40:40.439 --> 00:40:41.821 IT'S A MIRACLE. 00:40:41.907 --> 00:40:43.907 DR. PAUL VEYS: THERE WERE MANY, MANY CHALLENGES, 00:40:44.026 --> 00:40:45.909 BUT THINGS JUST SEEM TO GO OUR WAY. 00:40:46.028 --> 00:40:48.945 AND LAYLA IS JUST SO TOUGH. 00:40:50.699 --> 00:40:54.200 SO I GUESS SHE ALSO HAS THE, THE PARENTS' DETERMINATION 00:40:54.286 --> 00:40:55.252 AND WILL POWER. 00:40:55.370 --> 00:40:56.870 MOTHER: THERE'S ALWAYS GOT TO BE A FIRST. 00:40:56.955 --> 00:40:58.288 WE BEGGED THEM TO TRY SOMETHING. 00:40:58.373 --> 00:41:01.341 HOW WOULD YOU KNOW IF YOU NEVER TRY AND HERE'S THE FIRST. 00:41:01.426 --> 00:41:03.209 YEAH. 00:41:05.514 --> 00:41:06.913 DR. ANDRE CHOULIKA: IT BROUGHT ME TEARS. 00:41:07.015 --> 00:41:08.882 IT WAS SO MUCH, LIKE, EMOTION FOR ME BECAUSE I SAID, 00:41:08.967 --> 00:41:10.433 "OKAY, WELL, WE TOOK THE RIGHT DECISION." 00:41:10.552 --> 00:41:15.639 SHE'S HERE AND LIKE, UH, LAUGHING AROUND AND, LIKE, 00:41:15.724 --> 00:41:17.941 REALLY IT'S AN IMPORTANT THING FOR ME. 00:41:18.060 --> 00:41:20.393 AND SAY, "OKAY, WELL, EVEN IF IT WORKED ONE TIME, 00:41:20.479 --> 00:41:23.363 I THINK THAT ALL MY LIFE WORTH SOMETHING IF SHE HAVE A LIFE." 00:41:23.815 --> 00:41:25.649 TWO THINGS IMPORTANT IN LIFE. 00:41:25.734 --> 00:41:27.951 GOOD HEALTH, HAPPINESS, PERIOD. 00:41:28.320 --> 00:41:30.987 NOTHING ELSE. 00:41:33.241 --> 00:41:35.108 DR. CARL JUNE: AT THIS POINT IN THE UNITED STATES, 00:41:35.210 --> 00:41:39.212 ONLY ABOUT 10% OF ADULTS GO ON CLINICAL TRIALS FOR CANCER 00:41:40.215 --> 00:41:42.582 BECAUSE IT COSTS THEM MONEY TO BE ON THE TRIAL. 00:41:42.684 --> 00:41:45.635 SOMETIMES PEOPLE COME ACROSS COUNTRY AND THEY HAVE TO STAY 00:41:45.754 --> 00:41:47.971 HERE REALLY FOR A MONTH ON OUR TRIAL. 00:41:48.090 --> 00:41:49.973 AND SOME OF THEM HAVE COME IN RVS AND JUST SLEPT 00:41:50.092 --> 00:41:51.624 IN OUR PARKING LOT. 00:41:51.727 --> 00:41:58.098 IT'S, UM, UH, SO, UM, UM, BUT THE SYSTEM DOESN'T HAVE 00:41:58.767 --> 00:42:00.317 TO BE THAT WAY. 00:42:00.435 --> 00:42:04.154 WHICH IS MOST PATIENTS ARE NOT ON CANCER, UH, TRIALS, UM, 00:42:04.272 --> 00:42:06.305 EVEN THOUGH MOST PATIENTS ARE DESTINED TO DIE. 00:42:06.692 --> 00:42:08.641 I MEAN, IF IT'S, YOU KNOW, A METASTATIC TUMOR. 00:42:08.744 --> 00:42:11.578 SO THEY SHOULD BE ON TRIALS. 00:42:11.663 --> 00:42:13.479 NARRATOR: EVEN WITH THE INITIAL SUCCESS OF 00:42:13.582 --> 00:42:16.616 PERSONALIZED AND UNIVERSAL CAR T CELLS, 00:42:16.702 --> 00:42:19.619 THERE IS STILL THE CRUEL REALITY THAT DELIVERING THESE 00:42:19.705 --> 00:42:22.956 TREATMENTS FROM THE LAB TO PATIENTS IN CLINICAL TRIALS 00:42:23.041 --> 00:42:26.209 REMAINS MONUMENTAL, BUT NOT IMPOSSIBLE. 00:42:28.380 --> 00:42:29.846 DR. CARL JUNE: I MEAN, I HATE CANCER. 00:42:29.965 --> 00:42:32.832 I THINK ALMOST EVERYONE HAS HAD SOME, YOU KNOW, 00:42:32.934 --> 00:42:36.136 INVOLVEMENT EITHER FRIENDS OR LOVED ONES. 00:42:36.221 --> 00:42:38.171 MY DAD DIED OF LUNG CANCER A FEW YEARS AGO, 00:42:38.273 --> 00:42:42.642 BUT MY FIRST WIFE AT AGE 41, UM, HAD OVARIAN CANCER. 00:42:43.612 --> 00:42:46.212 AND SO I, I ACTUALLY TOOK CARE OF HER FOR ABOUT FIVE YEARS, 00:42:46.314 --> 00:42:49.249 UM, AND SHE PASSED AWAY IN 2001. 00:42:50.569 --> 00:42:53.653 AND IT CHANGED MY LIFE FOREVER, I'LL TELL YOU THAT. 00:42:54.289 --> 00:42:58.241 UM, IT, UH, AND PROBABLY FOR THE GOOD. 00:42:59.327 --> 00:43:01.211 UM, THERE'S A BIG SILVER LINING. 00:43:01.329 --> 00:43:04.130 UM, IT MADE ME MORE COMPASSIONATE. 00:43:04.633 --> 00:43:07.333 BECAUSE AT THAT TIME, I WAS WORKING ON CANCER 00:43:07.419 --> 00:43:11.054 IMMUNOTHERAPY AS WELL AS OUR HIV THERAPY AND I FOUND OUT 00:43:11.173 --> 00:43:13.973 HOW HARD IT WAS TO GET THAT INTO TRIALS THAT WOULD TREAT 00:43:14.059 --> 00:43:15.475 MY WIFE, CINDY. 00:43:15.560 --> 00:43:18.711 WHEN YOU ACTUALLY WANNA TREAT A PATIENT AND DO THAT AS A 00:43:18.814 --> 00:43:21.681 TEST, DOES SOMETHING WORK OR NOT, IT'S A LOT HARDER. 00:43:22.150 --> 00:43:23.650 WOMAN: SAMPLE, YOU CAN SEE. 00:43:23.735 --> 00:43:26.686 DR. CARL JUNE: THERE WERE MANY, MANY BARRIERS TO 00:43:26.772 --> 00:43:27.854 EARLY STAGE TRIALS. 00:43:27.939 --> 00:43:31.191 IT TAKES A LOT OF COMMITMENT AND YEARS OF LASER FOCUS. 00:43:35.247 --> 00:43:36.863 MICHAEL MROZ: SO I THINK THE REGULATORY SYSTEM 00:43:36.948 --> 00:43:38.998 THAT WE'RE TRYING TO WORK ON... 00:43:42.621 --> 00:43:46.423 DR. DAVID PORTER: THERE ARE LIKELY TO BE SOME CANCERS THAT 00:43:46.541 --> 00:43:49.426 RESPOND TO ACTIVATING THE IMMUNE CELLS AND THERE ARE 00:43:49.544 --> 00:43:52.011 LIKELY TO BE SOME CANCERS WHERE THAT'S, 00:43:52.097 --> 00:43:53.913 THAT'S NOT THE WAY TO KILL THEM. 00:43:54.015 --> 00:43:57.267 THE IMMUNE CELLS AREN'T GOING TO KILL EVERY TYPE OF CANCER. 00:43:58.303 --> 00:44:00.520 FOR THOSE WHERE IT'S EFFECTIVE, 00:44:00.605 --> 00:44:03.973 IT'S, IT'S BEEN JUST AN INCREDIBLE ADVANCE. 00:44:04.609 --> 00:44:06.926 WE NOW HAVE EFFECTIVE THERAPIES WHERE 00:44:07.028 --> 00:44:09.629 THERE WAS NOTHING. 00:44:09.731 --> 00:44:12.649 BUT IT WON'T WORK FOR EVERY TYPE OF CANCER CERTAINLY. 00:44:13.869 --> 00:44:16.736 I DEAL WITH LEUKEMIA EVERY DAY AND IT'S AWFUL AND IT'S LOUSY. 00:44:17.706 --> 00:44:18.872 WOMAN: GOOD? 00:44:18.957 --> 00:44:20.606 MAN: GRAB MY (INAUDIBLE) IN HERE, PLEASE. 00:44:20.709 --> 00:44:22.608 MICHAEL MROZ: I TELL 'EM FROM THE VERY BEGINNING, 00:44:22.711 --> 00:44:23.626 JUST BE FRANK WITH ME. 00:44:23.745 --> 00:44:24.627 JUST COME RIGHT OUT AND TELL ME EVERYTHING. 00:44:24.746 --> 00:44:26.796 DON'T HOLD NO PUNCHES, JUST GIVE IT TO ME. 00:44:27.415 --> 00:44:28.998 DR. DAVID PORTER: FEEL ANYTHING. 00:44:29.084 --> 00:44:31.634 I DEAL WITH PEOPLE WHO ARE IN THIS VERY DARK PLACE. 00:44:31.753 --> 00:44:34.287 SOMETIMES THEY FEEL VERY ALONE. 00:44:34.389 --> 00:44:36.306 NARRATOR: MICHAEL HAS BEEN FACING THAT DARKNESS WITH 00:44:36.424 --> 00:44:39.225 CONVENTIONAL TREATMENT FOR NEARLY TWO DECADES. 00:44:39.928 --> 00:44:42.979 HE IS NOT SICK ENOUGH FOR HIS DOCTORS TO RISK GIVING HIM THE 00:44:43.098 --> 00:44:45.398 STILL EXPERIMENTAL NEW T CELL THERAPIES. 00:44:46.601 --> 00:44:47.934 MICHAEL MROZ: YOU'RE, YOU'RE THE ONLY ONE THAT KNOWS 00:44:48.019 --> 00:44:49.302 HOW YOU FEEL. 00:44:49.404 --> 00:44:52.939 IT, IT, IT CAN BE PRETTY BAD WHEN YOU'RE CONSTANTLY SICK. 00:44:53.692 --> 00:44:55.158 YOU KNOW, WHEN YOU'RE CONSTANTLY JUST 00:44:55.277 --> 00:44:56.776 SICK AND SICK AND SICK. 00:44:58.146 --> 00:44:59.496 DR. DAVID PORTER: HOLLER IF YOU NEED ANYTHING, OKAY? 00:44:59.614 --> 00:45:00.980 MICHAEL MROZ: I SURE WILL, THANK YOU. 00:45:01.082 --> 00:45:02.315 DR. DAVID PORTER: TELL MONICA HI. 00:45:02.417 --> 00:45:04.200 MICHAEL MROZ: YOU KNOW, I MEAN, HOPEFULLY, ONE DAY, 00:45:04.286 --> 00:45:05.451 THERE'LL BE AN END TO ALL THIS. 00:45:05.537 --> 00:45:07.253 HOPEFULLY, YOU KNOW, MAYBE ONE OF OUR PATIENTS, 00:45:07.339 --> 00:45:08.838 THEY MIGHT FIND SOMETHING IN US AND BE LIKE, 00:45:08.957 --> 00:45:10.123 "OH, WE GOT A BREAKTHROUGH, WE JUST, 00:45:10.208 --> 00:45:11.657 WE CAN TREAT THIS AND CURE THIS." 00:45:11.760 --> 00:45:15.378 WE'LL, THEY'LL HAVE THAT 100% CURE RATE FOR, YOU KNOW, 00:45:15.463 --> 00:45:17.630 EVERYBODY WILL BE CURED OF IT ONE DAY. 00:45:18.300 --> 00:45:19.265 WOMAN: SEEMS LIKE THAT'S. 00:45:19.351 --> 00:45:21.217 MICHAEL MROZ: THEY'RE GETTING THERE, YEAH. 00:45:21.303 --> 00:45:23.636 I BELIEVE THEY'RE REALLY, REALLY CLOSE, I DO. 00:45:27.025 --> 00:45:29.192 DOUG OLSON: HOW CAN ANYBODY BE SO LUCKY? 00:45:31.696 --> 00:45:37.483 YOU KNOW, TO ME, THE, THE, THE MIRACLE IS, YOU KNOW, 00:45:42.123 --> 00:45:44.624 THREE OUT OF MILLIONS, YOU KNOW, THAT, 00:45:44.709 --> 00:45:47.093 THAT GOT INTO THAT TRIAL. 00:45:47.996 --> 00:45:50.196 DR. DAVID PORTER: YOU KNOW, THE IDEA THAT I CAN BE PART OF 00:45:50.298 --> 00:45:52.632 SOMETHING TO HELP DEVELOP THESE NEW THERAPIES AND, 00:45:52.717 --> 00:45:56.302 AND MAKE THESE AVAILABLE TO ALL THESE PATIENTS WHO REALLY 00:45:56.388 --> 00:45:59.505 HAVE NO OTHER TREATMENT OPTIONS HAS BEEN, UM, GOSH, 00:45:59.591 --> 00:46:01.841 THE MOST ABSOLUTELY REWARDING THING THAT 00:46:01.927 --> 00:46:03.760 I'VE DONE IN MY CAREER. 00:46:03.845 --> 00:46:06.646 AND IT'S EXCITING, IT'S EXCITING TO COME TO WORK EVERY DAY, 00:46:06.731 --> 00:46:10.600 AND IT'S EXCITING TO, TO SEE THESE TREATMENTS WORK, 00:46:10.719 --> 00:46:13.987 AND TO SEE THEM GET BETTER, AND MODIFIED, AND ALTERED, 00:46:14.072 --> 00:46:16.906 UH, AND BECOME MORE AND MORE EFFECTIVE. 00:46:17.025 --> 00:46:20.860 AND HOPEFULLY, WE CAN APPLY THEM TO MORE AND MORE PEOPLE. 00:46:22.581 --> 00:46:27.283 [SCREAMING] 00:46:30.422 --> 00:46:36.376 ¶ [MUSIC PLAYS THROUGH CREDITS] ¶