WEBVTT

1
00:00:00.661 --> 00:00:07.869
It's the diagnosis no one wants to hear, but each year another 14 million people worldwide will be told they have cancer.
這是沒人想聽到的診斷結果，但全世界每年都會有一千四百萬人被告知他們罹患癌症。

2
00:00:08.506 --> 00:00:12.168
In the fight against this disease, our greatest weapon may lie within,
在對抗這種疾病的戰爭中，最有效的武器可能就存在我們體內，

3
00:00:12.629 --> 00:00:16.232
in the system already designed to fight for our bodies and our health.
在一套原本就為了捍衛我們的身體與健康而設計的系統當中。

4
00:00:16.870 --> 00:00:23.346
Maureen was diagnosed with stage-four lung cancer in January, 2009. It had spread to her adrenal glands and liver.
莫琳在二○○九年一月被診斷出肺癌第四期，癌症已擴散到她的腎上腺與肝臟。

5
00:00:23.954 --> 00:00:26.992
It was inoperable, so she needed other options.
她的狀況無法動手術治療，所以她需要其他選項。

6
00:00:27.610 --> 00:00:34.194
Maureen started chemotherapy treatments. The first round didn't work, and neither did the second or the third.
莫琳開始接受化療。第一次治療不見效果，第二次與第三次也都一樣。

7
00:00:34.485 --> 00:00:39.360
Maureen's options were running out. Her disease wasn't responding to the chemo.
莫琳的選項愈來愈少。她的病症對於化療毫無反應。

8
00:00:39.792 --> 00:00:50.009
Maureen had metastatic squamous cell carcinoma of the lung with disease in her liver, in her adrenal. She had a heart metastasis.
莫琳的肺部出現了轉移性鱗狀細胞癌，肝臟與腎上腺也有癌細胞，還轉移到心臟。

9
00:00:50.158 --> 00:00:55.634
She had just diffuse disease, and at that point her prognosis was on the order of a few months.
她的癌症四處擴散，當時她的預後預期壽命大約只剩幾個月。

10
00:00:56.131 --> 00:00:59.983
We decided it really wasn't working and I asked him if he had anything else.
我們認為治療根本無效，於是我問他有沒有其他方法。

11
00:01:00.547 --> 00:01:09.530
And I must have been at [in] the right place at the right time, because he had said he had two trials coming up, and one of them was immunotherapy.
我一定是碰對了時間地點，因為他說他即將展開兩項試驗，其中一項是免疫治療。

12
00:01:10.324 --> 00:01:14.714
Immunotherapy uses parts of the body's own immune system to fight the cancer.
免疫治療是利用人體本身的某些免疫系統對抗癌症。

13
00:01:15.163 --> 00:01:19.962
There are a few different types of immunotherapy, including vaccines and boosters for the immune system.
免疫治療有幾種不同類型，包括疫苗以及免疫系統增強素。

14
00:01:20.845 --> 00:01:25.889
The trial at Yale uses lab-made antibodies, which target specific molecules.
耶魯大學進行的試驗採用實驗室製造的抗體，專門對抗特定分子。

15
00:01:26.352 --> 00:01:27.337
Here's how it works.
以下就是這種療法的原理。

16
00:01:27.743 --> 00:01:33.321
The T-cells of the immune system help fight for our bodies, eliminating germs and preventing disease,
免疫系統的 T 細胞協助保衛我們的身體，會消除病菌以及預防疾病，

17
00:01:33.814 --> 00:01:39.480
but cancer cells, which start as normal cells in the body before mutating, evade the immune system.
但癌細胞在突變之前原本是體內的正常細胞，所以會躲過免疫系統。

18
00:01:39.783 --> 00:01:47.712
Specific molecules form a barrier around the cancer cells, sending out a signal that convinces the T-cells there's nothing abnormal.
特定分子會在癌細胞周圍形成一道屏障，送出一種訊號，讓 T 細胞以為一切正常。

19
00:01:48.413 --> 00:01:54.019
By blocking these molecules, the cancer is then exposed, and the T-cells can do their job.
藉由封阻這些分子，癌症就會暴露出來，於是 T 細胞即可善盡其職。

20
00:01:54.619 --> 00:01:59.303
In a lab at Yale Cancer Center, Dr. Lieping Chen meets with his researchers.
在耶魯大學癌症研究中心的一間實驗室裡，陳列平博士與他的研究人員會面。

21
00:01:59.861 --> 00:02:02.745
In the battle against cancer, this is the front line.
這裡正是對抗癌症的戰爭前線。

22
00:02:03.226 --> 00:02:10.012
He's the man who discovered PD-L1. That's one of the protein molecules that help shield cancer from the immune system.
他就是發現了 PD-L1 蛋白的人。PD-L1 蛋白是協助屏蔽癌症不受免疫系統察覺的蛋白質分子之一。

23
00:02:10.627 --> 00:02:15.539
For well over a decade, he worked on developing anti-PD-L1 to combat the protein.
在這十幾年來，他一直致力於研發抗 PD-L1 抗體來對付這種蛋白質。

24
00:02:16.348 --> 00:02:22.804
This effect [is] tentatively long-lasting, meaning if it [the] patient responds, they responds [respond for] years.
這種效力會暫時持續一陣子，也就是說如果對病患產生作用，效果可達數年。

25
00:02:23.586 --> 00:02:25.853
[The] immune system still continue[s] [to] attack the cancer.
免疫系統仍然會繼續攻擊癌症。

26
00:02:27.208 --> 00:02:31.864
This is one of Maureen's scans from June 2010, before starting the immunotherapy.
這是莫琳在二○一○年六月拍攝的其中一張掃描片子，當時還沒開始進行免疫治療。

27
00:02:32.578 --> 00:02:37.795
You can see the large mass in her lung. And this is from just a few months later. 
各位可以看見她肺裡的一大團腫塊。而這張是僅僅過了幾個月後的掃描結果。

28
00:02:38.183 --> 00:02:43.483
The mass, which had not responded to chemotherapy, significantly shrunk, almost gone.
那團對化療沒有反應的腫塊，現在已經顯著縮小，幾乎消失了。

29
00:02:43.985 --> 00:02:47.791
And critically, there were no signs of new growth in other areas of the body.
最重要的是，身體其他部位沒有長新腫瘤的跡象。

30
00:02:48.433 --> 00:02:51.816
And now it's two years after she finished her two years of therapy.
她完成兩年的治療之後，至今已經過了兩年。

31
00:02:52.064 --> 00:02:58.445
So, it's four years since she started Nivolumab, and at that point she had a prognosis again of a few months,
所以，自從她開始接受 Nivolumab 治療至今已有四年，而當時她的預後預期壽命是只有幾個月。

32
00:02:58.860 --> 00:03:03.218
and we recently did a PET scan just to see, and we saw nothing.
但我們最近做了正子掃描來瞭解她的狀況，結果什麼都沒看到。

33
00:03:03.451 --> 00:03:04.856
There was no activity at all.
她體內的癌細胞沒有任何活動。

34
00:03:05.325 --> 00:03:09.062
Immunotherapy doesn't work for every patient or every cancer.
免疫治療並非對每個病患或每種癌症都有效。

35
00:03:09.536 --> 00:03:11.758
That's what Dr. Chen and others are working on now --
這正是陳博士和其他人正在研究的內容——

36
00:03:12.022 --> 00:03:19.015
to find out why, for instance, not everyone expresses the PD-L1 protein, and what other proteins might exist.
例如找出為什麼不是每個人都會出現 PD-L1 蛋白的原因，以及可能還有其他什麼蛋白質存在。

37
00:03:19.685 --> 00:03:25.265
Combining immunotherapy with traditional treatments like chemo and radiation appear to be the way of the future.
結合免疫治療與傳統療法，例如化療與放射治療，顯然是未來會採行的做法。