¶ Intro / Opening
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Here's what I'm saying.
as they ever saw them.
Agree with you.
But without the backing of Hezbollah, can peace come to Lebanon? Isabel Young offers a rare glimpse into the militant group in a special report.
You've seen a lot of fighters die. How does that make you feel?
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Then Protesters and officials demand action amid concerns about conditions inside an ICE facility. I speak to NPR correspondent Jasmine Garst and Aaron Reichlin Melnick from the American Immigration Council. Also ahead.
It's possible through bold innovation and scientific risk-taking to revolutionize the treatment for patients living with these common and uh often difficult to treat cancers.
A medical breakthrough that could change the lives of millions. How an experimental pill is offering new hope against the world's deadliest cancer. CEO of the company behind it, Dr. Mark Goldsmith, joins Harrisreen of Austin to discuss the long journey that led to this moment.
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¶ Hezbollah Rejects Ceasefire
A step forward for diplomacy, followed by an immediate step back. Just hours after Israel and Lebanon agreed to a U.S. brokered ceasefire, the leaders of Hezbollah said that they reject the deal. The terms included a complete cessation of Hezbollah fire and the removal of their operatives from southern Lebanon. But the Iran-backed militant group insists that any truce must also require the end of Israel's offensive and the withdrawal of their forces.
So for now, the fighting goes on, casting fresh doubt over whether this latest diplomatic push can produce any real progress. It is the fourth ceasefire announcement in just seven weeks, and the U.S. seeks to clear a major hurdle on the path to a broader agreement to end the war with Iran. And for President Trump, the pressure is on after the House of Representatives backed a resolution to rein in his war powers, his war powers in Iran.
So what will get it what will it take to get Hezbollah on board? For more than four decades, the group has faced repeated attempts to weaken its power Yet it remains a potent force in the region. Correspondent Isabel Young gained rare access inside Lebanon to find out why. Here's her report.
¶ Inside Hezbollah's Stronghold
So we're here in the Becca Valley where Hezbollah still have a very tight grip on control. After months of trying, we've managed to persuade a man who we believe is an arms dealer providing these weapons to Hezbollah to meet with us.
🔊 Vehicle
That's the cup. Which seems to be just off this road.
Thank you.
So we're now just going off a dirt track.
Altyazı M.K.
You can see a building just up here has been struck by an air strike. Let's put the cameras down. Să vă mulțumim pentru vizionare.
You think this is the house?
Thank you.
We were asked to put our cameras down and not to reveal this location or the identity of this arms dealer, who says he's a target for the Israeli military, as they try to stop the flow of weapons entering Lebanon. What is this? Um it's quite a lot of weapons you have here. Who is it you're selling these weapons to? I mean if you're selling to people in the Beccar Valley, I mean could be working for Hezbollah, right?
بيجاوز يكون لحزب الله عم يخدوه بس اني مضاعف عن يبيعه وطيب الاسلاح ويستفل يعمل بندية فيه
You think that these weapons are needed to defend themselves against Israel?
لا يأكيد هل لازم ينحط إحداؤد وما يتخطى البناء ما يشتاح البناء الإسرائيلي بس الآن وعم يدفوت على البناء وعم يدمر ويؤتي العيال
And it never keeps you up at night that these weapons are obviously used to kill people? I mean there is obviously you know a war going on in this country right now. You're not worried that, you know, these weapons are helping to fuel that war?
وأترماني بعيداني تزايد وتعمل بداية الأسلحة
Driving much of the demand for weapons is Hezbollah, the Iran-backed militant group designated a terrorist organization by the US, UK, Canada, and others. Hezbollah is an incredibly secretive group, but we wanted to understand. understand how they're still standing and what they're fighting for. After months of working with contacts on the ground, we gained exclusive access to key parts of the group. And to those most affected by the war.
Hezbollah struck Israel in solidarity with the Hamas October 7th attack, triggering a massive Israeli bombardment across Lebanon, even since the November 2024 ceasefire, accusing Hezbollah of failing to withdraw from the border areas. In March, Hezbollah fired rockets on Israel after Israel and the US attacked Iran.
This sparked a large-scale ground invasion, displacing over a million people and killing more than 3,000, according to Israel's offensive has given has been New Zeal and it has vowed to fight on, despite heavy losses.
Ladies first.
Thanks.
¶ Local Support and Civilian Toll
Uh this his sister and this is sister, this is grandfather and this is mother.
You know a lot of people who have died in here.
I know my another friend is there from three years i think uh in the general
Was he a fighter?
Yes, he's a fighter.
Mohammed from the Bekar Valley says he's not a member of Hezbollah, but he and many others here see the group as their best protection from Israeli aggression. This was your cousin?
Yes.
And he was fighting?
Amen.
Does everyone here support Hezbollah?
Vielen Dank.
أكيد ودم الشهده ما حيروح حاضر بإذن الله
Perhaps Hezbollah's greatest strength are the thousands of fighters willing to sacrifice their lives for the group. They rarely give interviews to Western media. We have managed to secure a meeting with a member of Hezbollah who's been fighting in the south of Lebanon for the last few months and he's agreed to meet us in a very remote location which we're heading towards right now. สวัสดีสวัสดี Why did you join Hezbollah?
Thank you.
إسرائيل ما خل عيلي إلا ما ضربه وعم تروح عالم مش عالم عالم بريئة مخصة موضة بياخد أرضي هو بدي فوقت ياخد ارضه عنده خطة يعني لو بدي ياخد الارض حتى يصل لشيء
You've seen a lot of fighters die. How does that make you feel?
استشهد وعلي هاشو هدي مفتخر فيها هلا هادي عايدي مشين عليها
Do you think that's a good idea? firing towards Israel and Israeli troops is going to create a safer Lebanon? I mean surely that puts Lebanese people at more risk knowing that w what the Israelis will hit back with. But I guess it doesn't feel like that to a lot of people. It feels like Hezbollah is, you know, triggering and creating more war rather than peace.
Not everyone agrees. Recent polls suggest that while most Lebanese view Israel as an enemy, even more are critical of Iranian involvement in Lebanon.
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Amen.
Among those forced to flee their home is Mona Jahame, a Shia Muslim schoolteacher from the southern city of Tia. So many displaced people across the whole of the world. It's crazy.
It's the most miserable displacement ever. That happened in Lebanon.
This is an Israeli drone overhead?
I can't
see it.
With uh we hear it.
You can hear it.
In 2024 my house was almost devastated. It took me a year to reconstruct it, to redo everything. I haven't even took a deep breath then Another war? This is too much. This is too much for the people of Lebanon.
You know, Israel are the ones who have, you know, displaced people, destroyed entire neighborhoods, let killed thousands of people.
We know that Israel is a very hostile and aggressive country and it is highly and technologically armed. Nobody has doubts about this. Take this example.
Thank you.
There is a ferocious lion. I tell you, Keep your hand away from the lion. He might bite you. He will bite you. Okay? But you keep on teasing him. So he bites you and more than that, you release the lion against everyone around you. Okay, this is what his bundla has done. Let the lion stay in its place.
What is your message to the Hezbollah leader?
Let us live! In peace. You want to fight for Iran, go to Iran. But let us live in peace.
¶ Hezbollah's Power and Legitimacy
Lebanon's government has tried to contain Hezbollah and to stop it from attacking Israel. But its ability to do that is limited. Many fear that a direct confrontation with Hezbollah risks igniting sectarian strife and even civil war.
on ne cherche pas la confrontation avec le Hezbollah, au contraire. Moi j'aimerais pouvoir éviter la confrontation avec le Hezbollah, mais croyez moi, on ne va pas se laisser intimider.
Thank you.
For decades Hezbollah has stepped in where the state has failed, providing healthcare, social services, security. Hezbollah officials like Ibrahim Musawi even hold seats in parliament. The US and Israel want Hezbollah disarmed. The Lebanese government itself also wants Hezbollah disarmed. What would happen if the Lebanese government, the Lebanese military tried to do that?
هذا لا يحدث. أستطيع أن نحن نحن نحن نحن نحن نحن نحن نحن نحن نحن نحن نحن نحن نحن
Bulla decided to enter this war on March the second, you know, you knew before starting this war that the Israeli response would be huge, that thousands of people were likely to die, which they have.
I don't want to go into the philosophy of life and death here. The Israelis continue to carry aggression, so there was one point when we have to respond to all of these aggressions. One the Israeli-American war again, they started the war against Iran. We felt this is a proper window to respond.
Hezbollah strikes have killed several people in Israel. They've caused some civilian harm. They've also been targeting some civilian areas. That has triggered a huge Israeli response, and we've seen thousands of Lebanese people killed, we've seen over a million people displaced.
İzlediğiniz için teşekkür ederim.
Do you take any responsibility?
Do you know why?
I'm just gonna ask you.
Do you take any responsibility? Take it.
Well your actions on March the second triggering.
Do you take any responsibility? Does your government take any responsibility? Does the American government take any responsibility for unleashing the Israeli full mighty power of killing and making genocide? Do they do this? We're defending ourselves. I'm asking you about it.
You acted on March the second. I'm asking if your actions on March the second
When Trump is capable to restrain the Israelis, the criminals, I believe the American administration holds the first and excessively responsibility for all of the killings that happened.
But apart from appeasing Iran What else has this war actually achieved? Sous-titrage Société Radio-Canada
Using you're using the same equation but in journalistic terms. Never think to defend yourself again. Never think to stand up for the Israeli mighty force I want to break this cycle.
What would you say to the parents of the hundreds of kids who have died? What do they die for?
I believe this question you should uh say to Donald Trump and to Benjamin Netanyahu, we are defending our people. Go back to the people who are in the funerals and ask them, you're in Lebanon now and you can see.
¶ Children: War's Youngest Victims
Since March, around two hundred children have been killed in Lebanon. Just absolutely heartbreaking scene uses body after body after body. Tiny little bodies.
Yeah.
These ones having to be carried on the bed because there's just only part Parts and remnants and pieces of them left. In just one strike in March, five children were killed. Six year old Yasmina, nine year old Malika, eleven year old Sadiq. twelve year old Zahra and thirteen year old Zainab.
في شوارة من الحزب نحن عائلة نحن عائلة و أهل الجنوب مبير النوم
These kids obviously have been out of school since the beginning of the war and this group now is trying to do some activities with them, try to have some semblance of normalcy in their lives which have obviously been completely disrupted.
سحر وبلش يتربفه نحنا كانت أنا خايفة أنا خايفة أنا خايفة نحنا يمتل معه يستشهد لنا
As the Trump administration tries to rein in both sides, the people of Lebanon are trapped between a diehard militant force backed by a newly emboldened Iran. And the Israeli military waging a brutal war. What would you say to the people who have power over this war right now?
الله خرقك مش كما تعمل والله حرم لولادنا عم تقدر تكفي علمه ولا عم تقدر تعمل شي خرب طولنا حياتنا
Yeah.
With no ceasefire in sight now, it's ordinary Lebanese citizens who are paying the highest price. So what will it take to bring the fighting to an end? And is there anything the Lebanese government can do to rein in Hezbollah's grip on power? Let's bring back in Isabel Young joining the show from London. First of all, just such an important and moving piece there, Isabel. Thank you so much for all the work that you did and for taking the time.
to speak w with so many there on the ground, uh those uh who are fighting for Hezbollah, those who are caught in the middle of it all, and then of course uh the youngest victims, obviously, the children.
¶ Analyzing Ceasefire Challenges
This is as we noted the fourth ceasefire that that's being discussed now in some seven weeks time. I'm just wondering given all of your time there speaking with those civilians and those Hezbollah members. Is there a sense that this time could be a a final deal?
I mean, I think it's extremely difficult. You know, this is the third time in just in the last couple of years that we've seen an attempted deal between these two countries back in twenty twenty four, earlier this year, and of course now. And I mean obviously the sticking point here is Hezbollah. I mean, we have seen that for this deal to to actually happen and for a ceasefire to actually be implemented
Then you know both sides would obviously have to stop firing at each other. Le uh Hezbolla would have to withdraw from certain areas of the south, and they'd also have to give up their arms. And, you know, as you saw, we spoke to various members of Hezbollah throughout our time in Lebanon, and they are absolutely adamant that that cannot happen and that they will not be dictated to by the US.
And you've got to remember that, you know, Hezbollah's very justification for existing is to defend L uh Lebanon and they see themselves as the protectors of Lebanese people. And, you know, as we've seen the Israeli military occupy southern Lebanon since March, it's very, very difficult to imagine Hezbollah actually laying down their arms whilst Israeli troops remain in their country.
Hezbollah uh as an organization is deemed by most western countries as a terrorist organization. It is deeply ingrained in Lebanon, uh in society there and its political system. as well. And as you note, um per polling, it does seem that something has changed. The tide has turned, especially with Lebanon's uh with Hezbollah's decision to enter this war now between Israel, the United States
in Iran. It was uh fascinating to hear that school teacher tell you that uh if these fighters want to go fight for Iran, they should go to Iran. D does that give in your view the Lebanese government more uh power, more opportunity? To uh stand up to Hezbollah as they've been claiming that they have a mandate to do now, to de weapon to t to make sure that they dearm and to sign uh potential ceasefire deals with Israel.
I mean it's difficult to know. I mean, obviously we have seen Hezbollah take a a real battering over the last few years of in twenty twenty four and again obviously this year. You know, the Israeli military have gone after Hezbollah key infrastructure. They've as as you saw in our piece, they've killed many fighters. They've also
gone after key commanders. In fact we were supposed to meet with one of them but uh as well I was so concerned that the Israelis would find out the location of some of their few remaining commanders that we weren't able to. But you know, Hezbollah still does have several strengths. You know, they have access to these weapons. We know that they still have a stockpile of weapons. We know that they are still smuggling weapons over those borders.
and that they are using and manufacturing, you know, drones, fiber optic drones that they've been quite effectively, to the surprise of some in Israel, targeting the Israeli military with. you know, domestically, as you as you said that we have seen polls that suggest that, you know, the popularity of Hezbollah is questionable.
But I would say that, you know, as this war has dragged on, you know, it started out that many people were very resentful of Hezbollah, but experts that we've spoken to Would suggest that, you know, Hezbollah is now starting to and has successfully started to reposition themselves again as the defenders of Lebanon.
And that makes things uh more challenging not only in terms of a ceasefire, but for the Lebanese government itself. Uh Isabel Young, thank you so much. Really appreciate your reporting. And stay with CNN. We'll be right back after the break.
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Listen to CNN's terms of service wherever you get your podcasts.
Got news for your ears. I am your host, Michael Ian Black. His latest thing, you see this yesterday, was he finds the peace talk.
Boring.
Uh-huh.
Not my favorite guy, but I gotta be honest with you. I know exactly what he's talking about
He's not negotiating. He's not in the room.
But how do you think he receives the information?
Uh sir, because they also Sir Would you like to hear the latest update?
They should make like a comic strip out of it.
Have I got news for your ears? Check us out on Apple, Amazon Music, wherever you get your podcasts. Even better, you can watch the vodcast on Spotify.
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¶ Crisis in Immigration Detention
Next, held without conviction, fed maggot-infested meals with limited access to medical care and no idea when they will be free. According to many of the sixty thousand people currently held in immigration detention across America, this is the reality of daily life. Some are as young as five years old. That's why hundreds of detainees at Delaney Hall Detention Center in New Jersey have reportedly been on hunger strike.
Outside the facility, protests escalated into clashes with ICE officers using tear gas to get tear gas against demonstrators refusing to disperse. Now, Senate Republicans are pushing ahead with a package that would provide billions of dollars in new funding for immigration enforcement.
For more on this, I'm joined by Jasmine Garst, Immigration Correspondent for NPR, and Aaron Reichlin Melnick, Senior Fellow at the American Immigration Council. Welcome both of you. Jasmine, what do we actually know? uh about the conditions now a at Delaney Hall.
I mean what I can tell you about is what I've been hearing which is uh insufficient um medical attention uh food not only um in it it's not enough to say in bad state. I mean we've heard reports of food with maggots in it. Um and again, lack of attention uh to medical conditions. And and I should be clear, you know, I've been reporting on conditions in ICE detention uh since Trump took office. This is nothing new.
Uh the this is pretty much the what I've been hearing from different detention centers. Um, you know, and I've been hearing it from uh children as young as five years old and so uh I would venture to say that it is more often than not that I hear about these pretty horrific conditions while in ICE detention.
And what are conditions like outside of the facility? We had been reporting on a number of protests that continued to escalate. Newark police uh were confronting uh protesters this week. Last night, two press protesters were taken into custody. How much concern is there that outside of this detention center, things could turn even more chaotic?
Well, I mean I think there's been uh a lot of criticism uh for over uh you know the decision to send state police and, you know, whether or not this could turn into Minneapolis two point oh. I mean I think people are hearing about these horrific conditions inside. Um and and there's ample concern about it. And you know, this isn't just, you know, the food is in bad state. Uh right now, you know, in ICE detention facilities we have seen a historic
uh number of deaths. There have been fifty-one deaths uh in ICE detention uh in the last year alone. And that is a number we have never seen before. So these conditions have consequences.
¶ Legal Battles and ICE's Response
Aaron, I want to bring you in here because New York's Attorney General has filed a lawsuit against the private company that's operating uh Delaney Hall, that is the GEO group, and demanding access for health funds. In April, the City of Newark also filed a lawsuit against this same group. Does New Jersey have a legal right to r to inspect this private facility?
Well this is one of the most contested aspects of this case because legislators and others have been trying to get inside Delaney Hall since it opened last year. The facility opened with a number of problems already within its first two months. There were protests inside the facility and a breakout, one of the first ever from an ICE detention facility, as people protested against inadequate food and medical care just last year.
The federal government says that state uh governments have no authority to regulate ICE detention centers, and there have been a number of court cases over this, so this is something that we'll have to see play out in court.
Why do you think the federal government, whether or not this becomes a legally mired question, why do you think the federal government won't just let inspectors in now given all of the headlines and negative press that this has generated?
What we've seen this administration do is refuse to back down. In a number of very high profile incidents, the administration has said that absolutely nothing is wrong inside its detention centers. Their official line is that people in ICE detention are being treated better than any lawbreaker in human history. And that is not something that will hold up to inspections, which may be a reason that they are trying to keep people out.
Well here's how ICE has responded on X and let's pull up the graphic if we have it. The facts are the following. All detainees are provided with three meals a day, clean water, clothing, bedding, shower, soap, and toiletries. Illegal aliens also have access to phones to communicate with their family members and lawyers. Certified dietitians evaluate meals. In fact, ICE has higher detention standards than most U.S. prisons that hold actual U.S. citizens.
Jasmine, do you want to respond to those those those those statements?
Sure. I mean here's some other facts. Uh the facts also are that there are an unprecedented number of immigrants in detention, around sixty thousand consistently. The facts also are that Around 70% of those people have no criminal conviction. And immigration lawyers I've spoken to have told me that they believe. these conditions in ICE detention are meant to break people into opting for uh voluntary leave. Uh in other words that the immigrant themselves
PZ.
to be sent away. And, you know, we've seen that. We've seen a skyrocketing of people who are essentially tapping out because conditions are so bad. It's been n around ninety thousand people have asked for voluntary departure in uh the last i during this Trump administration. That is seven times what we have seen uh during the last uh year of the Biden administration. So conditions are so horrific in these places that I mean, I've spoken to people who have very intense fears of going back home.
that who have told me, you know, I I think I could be killed if I go back home and who have still said, you know what, I cannot do another twelve months of this. I I cannot do it.
You mentioned the unprecedented uh statistics here in reality, Jasmine. Um Aaron, uh ICE detention centers drew complaints uh under the Obama d under the Obama and Biden administrations as well. What is the difference this?
Yeah, that's right. You know, at the American Immigration Council we have filed complaints about conditions inside detention centers for many years, including under the Obama administration, the Trump administration, and even the Biden administration. But we are seeing a scale and pace of detention that is totally unprecedented. Since taking office, the Trump administration expanded detention by over 75%, rising from an average of 40,000 people in custody.
per day on average at the start of his term to a peak of over seventy-three thousand people in custody in early January during the height of Operation Metrosurge in Minneapolis. and the internal watchdogs and agencies whose job it is to ensure that the standards are followed have been pushed out. The Office of Immigration Detention Ombudsman, has been slashed and eliminated entirely. DHS's internal civil rights and civil liberties watchdog.
has been pushed out and the message from on high is that if there are abuses in detention, the administration is going to turn a blind eye to it. And that has led to conditions that appear to be far worse than anything we've seen before.
And as we've noted, as you've noted, Jasmine, this extends beyond just Delaney Hall. I mean you visited some of these other detention centers as well. Can you give us a sense of what you saw and what you heard from detained?
Right. So I've spoken to detainees. Uh I've been speaking to detainees at these facilities uh since uh President Trump took office and I can tell you that this is nothing new. You know, I can tell you stories about people who have very serious medical conditions and who have not been given medical attention.
Probably, you know, the one that has stuck most with me uh as a journalist uh was was the story of a family I interviewed who spent around 320 days uh at the uh Dilly Detention Center in Texas. And this family, it was a mother, it was two teenagers, a nine-year-old, and two five-year-old twins.
And the conditions they were describing were quite similar. A lack of medical attention, a lack of not just lack of proper nutrition, food with worms. At one point one of the kids told me about finding a human fingernail in their food. um lack of access to education. And I think just to piggyback on what Erin was uh saying just now. You know, within this whole process of massive expansion of the the tension system, I think it's really important to highlight the amount of money.
hand over fist profits that are being made off of this. So for example the facility um Delaney in New Jersey. That facility is owned by one of the major contractors, which is Geo Group. Between 2024 and 2025, Geo Group had a 700% profit increase. So, when we're talking about this massive expansion and the system that is being built to funnel people, most of whom do not have criminal convictions. into these detention centers, it is important to talk about how much money is being made.
¶ Funding and Scope of ICE Detention
Yeah, and it's also worth noting that ICE alone, ICE's budget over the last two years has gone from ten billion dollars to fifty eight billion dollars. And just today the Senate is debating a seventy billion dollar funding bill that would fund ICE border patrol and DHS agencies. That's uh on top of the seventy five billion dollars that was included in last year's big beautiful bill. Jasmine, Aaron, I I don't know w which one of you i is best to ask this question, but where is that money going?
Well, right now we are seeing a large portion of this funding go to detention centers, and the Trump administration has reportedly allocated about seventy five percent of the seventy five billion dollars it got already. Of that money, forty-five billion is going to immigration detention.
They've used a significant portion of that to increase the beds from forty thousand up to seventy thousand, though right now we know it's closer to sixty thousand as they have quieted down a little bit in the aftermaths of the killings of Renee Good and Alex Predy in Operation Metro Surge. But we know right now that they've spent one billion dollars already in purchasing commercial warehouses that they fully intend to convert into massive detention centers.
And while this plan is getting off the ground a little bit slower than they expected, it seems the administration wants to expand to as many as twenty-four warehouse detention centers, some that could hold upwards of eight. thousand people, which would each make them individually the largest federal prisons in US in the entire United States system, bigger than any federal prison and uh bigger than indeed any state or local prison that exists in the country right.
And ICE officials continue to describe these date detainees as those uh the worst uh of the worst, those who have committed heinous crimes. Aaron, your organization actually tracks who um ICE is detaining. Does that match up with their description?
It really doesn't. ICE actually publishes some data on who it's detaining and it breaks down the data. between who has no criminal record whatsoever, who has a pending criminal charge for any kind of offense, and who has been convicted of any offense, no matter how small. And what we know is that only about 14% of people that ICE has even arrested have any sort of serious violent offense.
And right now the majority of people being held in detention have no criminal record at all. And indeed, when we look back during the peak of ICE arrests in Minneapolis, Forty-seven percent of people that ICE was arresting nationwide had never been arrested for any offense. And those who had did have some interaction with the criminal justice system, the most common offenses were low-level misdemeanors, traffic offenses, And things that certainly don't make anyone the quote worst of the worst.
Jasmine, you spend time outside Delaney Hall. We should note the upcoming uh World Cup kicking off in just days. Um How much concern is there of the role ICE will have during these this World Top?
¶ Immigration Fear and World Cup
Yeah, I mean I thought, you know, I I it just kept coming to mind, you know, uh that how close Delaney Hall is to where the World Cup final is going to be played and it's something that has always been on my mind. Now Uh ICE officials have said that uh these games are not going to be places where they're going uh to be doing roundups, that that's not the goal, that DHS is going to have
A presence as it would at any other international major event being held on US soil. You know, but nevertheless, I mean I think there is I I it's not that I think. I know there is a climate of of fear around fans and in certain communities uh who happen to love soccer, who happen to love football. um and who, you know, uh listen, I've spent the last year or so um talking to people who are afraid to uh s go pick up their kids at school, who are afraid to go um, you know, to the supermarket.
And so why wouldn't they be afraid to go to a soccer match or to a soccer watch party? I think it's very significant uh that this World Cup is happening. simultaneously uh as um you know we're we're seeing this.
That is a good uh point to make. Uh we'll have to leave the conversation there. Thank you so much for the time, Jasmine Garst and Aaron Reichlin Melnick. We appreciate it. And we'll be right back after this short break.
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¶ Pancreatic Cancer Treatment Hope
Now to a medical breakthrough that is doubling the survival time for patients with one of the most aggressive forms of cancer. A new pill taken daily to treat pancreatic cancer has shown positive findings in a study with 500 patients. Scientists found the drug reduced the risk of death by 60 percent compared to chemotherapy. Dr. Mark Goldsmith, the CEO of the biotech company which funded this development, joins Harisrinavasin to discuss the landmark treatment.
Bianna, thanks. Dr. Mark Goldsmith, thanks so much for joining us. You're the CEO of Revolution Medicines. It's a biotech company. According to the American Cancer Society, the five-year survival rate for people with pancreatic cancer. It's about thirteen percent and it's about three percent for where that cancer is already spread to other parts of the body. And so before I guess we get into what is kind of
¶ Understanding RAS Proteins and Cancer
interesting and important about your medicine. Tell us a little bit about why pancreatic cancer is so difficult to beat.
Thank you, Hari. It's really a pleasure to be on with you. Uh this is a very important moment uh in for patients who are living with cancers caused by something called RAS proteins. They're the most common cause of human cancers. And the results that uh we're talking about today uh are of such significance that I think they really do demonstrate that it's possible through bold innovation and scientific risk taking
uh to revolutionize the treatment for patients living with these common and uh often difficult to treat cancers. Pancreatic cancer is one of those. Most patients when they are diagnosed with pancreatic cancer already have a relatively advanced disease and that makes it very difficult to try to unwind. And really the only treatments for the most part that we've had for most patients with pancreatic cancer, uh particularly those with metastatic uh pancreatic cancer, uh is standard chemotherapy.
And it has just not performed at the level that uh any patient or their family or uh physician would like. And so there's been a an enormous push to try to find new ways to tackle the underlying causes of the cancer, not just to try to use uh chemicals to uh to kill tumors.
What is this? protein do to a healthy cell? And I guess what does your medicine do to that protein?
Yes, RAS proteins are absolutely essential to every normal cell in the human body. They act as a switch. They control normal cell growth. So we're happy and feeling good when RAS proteins are doing what they should do. Uh unfortunately, in twenty to thirty percent of human cancers, that switch can get stuck in the on position, meaning that uh a genetic change in the gene and coding for a RAS protein.
causes the RAS protein to stay in the on position and to have trouble toggling to off. And as a result, it's sending signals within the cell. to grow uh and then to con uh to grow uncontrollably and that can lead to uh a malignancy. Pancreatic cancer is one disease which is almost entirely caused by RAS proteins. Nearly everybody who has uh pancreatic cancer has uh altered RAS proteins within the tumor.
And therefore trying to target those RAS proteins seems like the most logical uh way to go about things, but that's been difficult over many decades.
¶ Diraxon Rasib: Mechanism and Efficacy
Okay, so how did your medicine work or wh what is the what is the sort of Key here because if these proteins are important for all of our healthy cells, how do you target the ones, just the ones that are defective, and keep pushing this on switch instead of going on and off?
Yes, that's uh a a a really important and and and subtle scientific uh topic that you're raising. Um well first it's been a challenge to bind a small molecule to any RAS protein and for decades Uh since the nineteen eighties when RAS were identified as the first human cancer causing uh genes and proteins, uh it's been uh very difficult to drug these RAS proteins.
uh in the last ten to fifteen years we've seen some progress in that regard. We found a way, standing on the shoulders of many others who came before us to design molecules that can essentially glue uh onto, uh sort of like Velcro, bind onto the surface of a RAS protein, and attach it to another protein that smothers it. And keeps it from functioning within the cell. Now you've asked about can we direct that specifically only to the mutant form or the genetically altered form that drives cancer.
And it is possible to do that. We have a number of molecules like that in our pipeline that are very specific for the mutant. The reason that uh Diraxon Rasib, the investigational drug that uh uh might have led to this discussion today, the reason that that molecule is so different from everything else is it not only uses this glue mechanism,
But it binds to the active or on form very selectively. It doesn't bind to the off form, so it's specifically going after the oncogenic or active form that's found in the tumors.
It does.
uh attack or bind or target uh essentially all forms of RAS, including the normal RAS proteins. We now know from the results of the Rasulut 302 phase three clinical trial that were just read out uh at ASCO. This was a global randomized trial of 500 patients who received either Diraxon RACIB or standard of care chemotherapy.
uh that we saw uh significant, unprecedented improvements across many different measures that are typically used in studies of cancer drugs. That included uh a sixty percent reduction in the risk of death. uh which is of course uh the most important thing that we uh go after, but similar reductions across a variety of different measures. In fact, those same patients actually reported that they saw stabilization of their quality of life.
and preservation of that quality of life greater than did those who received chemotherapy. So longer life, preserved quality of life. It indicates that it is possible to do that.
In a clinical trial with about 500 patients, your medicine nearly doubled the lifespan compared to someone who was just taking chemotherapy. That average was about 6.7 months, and with your medicine it went up to 13.2 months.
It also reduced the risk of death by sixty percent in patients that were taking your medicine versus just chemotherapy. Uh w what is that quality of life like? W what is this doing that's allowing them I don't know, uh s something better than what the standard of care is today.
Well, two limitations of standard of care chemotherapy you touched on. One is that it's it's not as effective as it needs to be. It often provides very short increments in survival. And the experience of taking chemo taking chemotherapy, going to an infusion center regularly, the severe side effects, often hospitalization, and some patients even die while they're receiving chemotherapy.
We need to address both of those. And we believe Diraxon RACIB does that based on the results that we just reported. And we know that patients receiving Diraxon RACIB in general have been able to take that drug continuously. Uh sometimes they require short breaks, short vacations, many holidays from the drug, but for the most part have been able to take it and continue benefiting from its suppression of the RAS protein that's causing cancer.
We know and in addition to that uh survey that patients take during the course of their uh of the RasLUT 302 trial, we also know anecdotally uh directly from patients, from many physicians who have experienced treating a patient with Diraxon Rasib that it is not uncommon for patients within a fairly short period of time to feel better and for their life to be able to
to be improved to the point where they can actually experience life, be with their family, take care of some things that they'd very much like to take care of uh while they're also having a longer life. But I also want to acknowledge something really important here, Hari. Um for the most part, Draxon Rascip doesn't cure most people's cancers.
¶ Broader Applications and Access
So we have more work to do and we continue to design to improve upon Diraxon Rasib in a variety of different ways and to bring new molecules to the clinic with the hope that we will convert pancreatic cancer and other cancers caused by RAS into more chronically managed diseases and eventually into true cures.
So doctor, if these RAS mutations show up in colorectal cancers, in small cell lung cancers, and they account for almost a third or more of the deaths. Can this medicine be used in those other cancers as well?
Yeah. That's a great point. Um m more than ninety percent of pancreatic cancers caused by a ras protein. Fifty percent of colorectal cancer is caused by a RAS protein and thirty percent of non small cell lung cancer, and that's just the short list of the most uh of the most common and and deadly cancers uh that can be caused by RAS.
Uh so you're right. And we are very interested in and very active uh in studying a Draxon RACIB in patients with these other tumor types. In fact, uh we published Uh uh we have reported uh data on Diraxon RASIB in lung cancer in patients uh with a RAS cancer driver. uh encouraging early data and we're currently running a global phase three trial in non small cell lung cancer in those patients who carry a RAS uh carry a RAS variant that's causing their tumor.
Uh we are also studying colorectal cancer and we have, as I alluded to earlier, a deep pipeline uh of of molecules based on this same technology, based on this same strategy where we've benefited from A virtuous cycle of observation in the clinic, scientific innovation in the laboratory, more observation in the clinic. improved innovation in the laboratory. And this is something we're deeply committed to for the long term to continue trying to address these tumors on behalf of patients.
You're talking about drug development in general, taking anywhere from, I don't know, or let's say average a dozen years. And most people That's part of the hopelessness that they feel, that even if you've got something in the lab today, it's going to take forever by the time that it can actually impact my life. So in this particular case, this is a very truncated timeline. How did that happen?
Yeah, we uh first uh brought Dirac Son Rasib into a clinical study in twenty twenty two and here we are in twenty twenty six and we've completed um what should be uh appears to be the definitive study that demonstrates this benefit in pancreatic cancer and we are actively working to bring the information from that trial to the FDA
uh so that they can review it and make a decision about whether all it it should be made uh more widely available through an approval. That's a very short period of time. Uh once the early results were seen in uh twenty twenty three patients were clamoring. to get access to Dirac on Rasib because they they smelled what we smelled, which is a real opportunity here to have make a difference. Dirac on Rasib, we hope, will be made available
uh broadly that will be subject to uh the review process that we need to go through uh with the FDA. In the meantime, we have opened an expanded access program. that allows physicians who are caring for patients with pancreatic cancer to apply for drug on behalf of their patients even before uh it is approved by the FDA and the FDA has endorsed uh this expanded access program and we're now shipping drug
to doctors on behalf of their patients. Uh secondly, receiving DiracSon RASIB may buy people time to allow for additional innovation. And that's that's already been occurring. uh that patients now see real opportunity. to continue their lives. We hope to have lives that are uh uh satisfying to them and to their families, but also hope that the next generation of molecules will come along and we're pushing those as fast as as we can.
We have this evidence that there's a class and a category of medicines that will actually be really helpful to a very large swath of people. And the cost is a significant hurdle. So here you are, you've spent the time, the resources, the money in developing this drug. And you wanna increase access, you wanna make sure that anybody with pancreatic cancer or any of the other cancers it works on gets access to it. You bake that into the process.
Well you're right. It's very expensive to uh develop drugs. We've spent uh even as a small biotech company, we've spent billions of dollars already uh even before we had the kind of evidence that we have with the Raslut three oh two trial and we're currently uh running or about to initiate another seven of these phase three trials which are extraordinarily expensive. Um so it does uh cost a lot of money to do this. That's just inherent in uh providing good, compliance, safe.
uh uh management of patients during the course of a clinical trial and it requires large trials that take uh sometimes a couple of years to do. Um that investment has to be recouped since that capital comes from uh comes from investors and and that has something to do with pricing. I think the other aspect of it um is that uh drugs that have great effects. probably deserve to be priced at a higher uh price point than drugs that that don't. And that's built into the system, the payers.
uh, including the federal government, use the outcomes of the clinical trials as one of the ways in which they decide what's a an appropriate price and appropriate trade off. But the question you're asking is a is a very uh big one that has to do with how do we pay for health care in general. Uh drugs are a relatively small component of the overall cost of
medical care, hospitalizations, physician time, uh infusion centers. There are many, many things that contribute to that high cost of medicine. and uh we'll do our best to deliver the drug on behalf of patients and make it possible even for those uh who can't afford it through various mechanisms that are available.
CEO of Revolution Medicines, Doctor Mark Goldsmith. Thanks so much for your time.
Thank you, Hari.
¶ Tribute to Marjane Satrapi
And finally, we remember Iranian artist and activist Marjan Satrapi, who has died at the age of 56, a powerful voice who brought the story of her homeland struggles to a global audience. Satrapy was best known for her acclaimed graphic novel and film Persephone. She was a vocal critic of the Iranian regime and a longstanding women's rights campaigner, including during the 2022 Women Life Freedom Movement.
She left Iran for good in 1994, but remained deeply connected to its people and culture throughout her life. In 2020, she spoke to Christiane about her own experience as a refugee and what it means to live with loss and compassion.
Nobody leaves their own country because uh they think it's fun. Everybody loves the the the place they are born, they love the food they they they they eat, they love the geography of the place that they they are. If we go there is because we don't have any choice and the moment
that people they have this empathy and the compassion to understand that and see in front of them not an abstract notion of the migrant but a human being who is in need of freedom and in need just to survive, then probably we have made a a step forward, but I think 2020 is kind of really late to start thinking about this thing. It should have been long time ago.
An important life lost far too soon. May she rest in peace. That is it for now. Please remember you can always catch us online, on our website, and all over social media. Thanks so much for watching and goodbye from New York.
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