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Lung Cancer
LUNG CANCER Lung
Cancer
14 (1996)
373-374
Book review
Lung Cancer Desmond N. Carney, (Editor) E. Arnold, London. 1995; 280 pages This book focuses on recent advances in the diagnosis and understanding of the biology of lung cancer. Although it addresses additional clinical and therapeutic issues, it constitutes primarily a series of selected reviews of new developments in the above areas, rather than a comprehensive standard work on lung cancer. The authors are well-known authorities in their fields, and, in most cases, they have produced well-written overviews on topics that are the focus of interest in current research and development. According to the editor, the target group is clinical oncologists, radiation therapists and respiratory physicians. The first section deals with clinical and therapeutic issues, and includes papers on screening and early detection, chemoprevention, pathology, radiology, staging, and various aspects of non-surgical treatment of lung cancer. Mulshine and co-workers present a well-structured analysis of the problems associated with screening for lung cancer. Immunocytochemical approaches raise hopes for the future, although clinical efficiency and cost-effectiveness have to be proven in prospective studies. Retrospective studies have shown a protective effect of high intake of vegetables (or increased risk from low intake) on the development of lung cancer. Based on these data, and on assumptions that field cancerization and multistep carcinogenesis are general phenomena in cancer development, Huber and Lee discuss chemoprevention strategies. Their views are perhaps somewhat optimistic, considering the results of two large-scale prospective randomized trials that were recently completed or interrupted, which implied that chemoprevention with B-carotene may in fact increase the risk of having lung cancer. The chapter on radiography by Murray and Breatnach is a well-structured overview of visualizing investigations with emphasis on the clinical usefulness in pre-operative staging. It has immediate clinical implications, and should be useful for clinical decision-making. Related issues are reviewed by Richardson and Ihde in a paper on staging of small cell lung cancer. The authors discuss a differentiated 0169..5002/96/%15.00 0 1996 El sevier PII SO169-5002(96)00563-6
Science
Ireland
Ltd.
All
rights
reserved
374
Book
retieby
/ Lung
Carlcer
14f1996)
373-374
strategy related to the purpose of investigation (investigational vs. clinical) which may also be useful for decision-making. One odd detail is that they don’t advocate fibre-optic bronchoscopy as part of routine screening investigations, which diverges from clinical practice. Smit and Postmus summarize and comment in a meritorious way the extensive literature on chemotherapy and combined treatment modalities in both small cell and non-small cell lung cancer. Although the introduction of a few new drugs, such as the taxanes and gemcitabine, raise some hope for improvement of results, t&e need for new treatment strategies in metastatic lung cancer is urgent. The supplementary use of cytokines, especially in combination with peripheral blood progenitors, as well as biological response modifiers provide new and exciting options in the treatment of small cell lung cancer, as reviewed by Bishop, Woll and Thatcher. In locally advanced non-small cell cancer, induction chemotherapy or chemoradiotherapy may have a curative role in combination with surgery, a treatment approach that is currently under investigation in a number of trials. Considering the experimental nature of this combined treatment, and that most of the published trials to date demonstrate the feasibility rather than the efficacy of the approach, the view by Cameron and Ginsberg is felt to be too detailed. Turrisi presents an overview of radiotherapy options in lung cancer, with special reference to limited small cell lung cancer. His focus is on methodological issues rather than on clinical results. The debated issue of prophylactic cranial irradiation is not mentioned at all, which is a bit surprising. The second section of the book deals with the biology of lung cancer, and comprises a series of interesting, well-written and informative papers on molecular genetics, growth factors, monoclonal antibodies, mechanisms of drug resistance, and clinical applications of in vitro studies of resistance patterns. As a clinical trialist and representative of the average oncology conference participant, I find this part particularly useful for the understanding of problems associated with lung cancer treatment. Also, the increasing insight into biological events in carcinogenesis and tumor response opens up doors to potentially new treatments, such as broad-spectrum antagonists to neuropeptide growth factors in SCLC, monoclonal antibodies to membrane antigens, and gene therapy. Rozengut’s paper on neuropeptide growth factors, Stahel’s systematic overview of monoclonal antibodies, and Kelley and Johnson’s chapter on molecular genetics are all well-written and interesting documents. Twentyman’s review of mechanisms of drug resistance is informative, and the link to clinical applications by Jensen and co-workers is felt to be valid and useful. In summary, this is a book that can be recommended to senior clinicians with a special interest in lung cancer, who don’t follow in detail the extensive literature in this field but still want to be updated in selected research areas, especially with reference to staging and lung cancer biology.
Berzgt Bergman, M.D. Department of Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
Cancer
14 (1996)
373-374
Book review
Lung Cancer Desmond N. Carney, (Editor) E. Arnold, London. 1995; 280 pages This book focuses on recent advances in the diagnosis and understanding of the biology of lung cancer. Although it addresses additional clinical and therapeutic issues, it constitutes primarily a series of selected reviews of new developments in the above areas, rather than a comprehensive standard work on lung cancer. The authors are well-known authorities in their fields, and, in most cases, they have produced well-written overviews on topics that are the focus of interest in current research and development. According to the editor, the target group is clinical oncologists, radiation therapists and respiratory physicians. The first section deals with clinical and therapeutic issues, and includes papers on screening and early detection, chemoprevention, pathology, radiology, staging, and various aspects of non-surgical treatment of lung cancer. Mulshine and co-workers present a well-structured analysis of the problems associated with screening for lung cancer. Immunocytochemical approaches raise hopes for the future, although clinical efficiency and cost-effectiveness have to be proven in prospective studies. Retrospective studies have shown a protective effect of high intake of vegetables (or increased risk from low intake) on the development of lung cancer. Based on these data, and on assumptions that field cancerization and multistep carcinogenesis are general phenomena in cancer development, Huber and Lee discuss chemoprevention strategies. Their views are perhaps somewhat optimistic, considering the results of two large-scale prospective randomized trials that were recently completed or interrupted, which implied that chemoprevention with B-carotene may in fact increase the risk of having lung cancer. The chapter on radiography by Murray and Breatnach is a well-structured overview of visualizing investigations with emphasis on the clinical usefulness in pre-operative staging. It has immediate clinical implications, and should be useful for clinical decision-making. Related issues are reviewed by Richardson and Ihde in a paper on staging of small cell lung cancer. The authors discuss a differentiated 0169..5002/96/%15.00 0 1996 El sevier PII SO169-5002(96)00563-6
Science
Ireland
Ltd.
All
rights
reserved
374
Book
retieby
/ Lung
Carlcer
14f1996)
373-374
strategy related to the purpose of investigation (investigational vs. clinical) which may also be useful for decision-making. One odd detail is that they don’t advocate fibre-optic bronchoscopy as part of routine screening investigations, which diverges from clinical practice. Smit and Postmus summarize and comment in a meritorious way the extensive literature on chemotherapy and combined treatment modalities in both small cell and non-small cell lung cancer. Although the introduction of a few new drugs, such as the taxanes and gemcitabine, raise some hope for improvement of results, t&e need for new treatment strategies in metastatic lung cancer is urgent. The supplementary use of cytokines, especially in combination with peripheral blood progenitors, as well as biological response modifiers provide new and exciting options in the treatment of small cell lung cancer, as reviewed by Bishop, Woll and Thatcher. In locally advanced non-small cell cancer, induction chemotherapy or chemoradiotherapy may have a curative role in combination with surgery, a treatment approach that is currently under investigation in a number of trials. Considering the experimental nature of this combined treatment, and that most of the published trials to date demonstrate the feasibility rather than the efficacy of the approach, the view by Cameron and Ginsberg is felt to be too detailed. Turrisi presents an overview of radiotherapy options in lung cancer, with special reference to limited small cell lung cancer. His focus is on methodological issues rather than on clinical results. The debated issue of prophylactic cranial irradiation is not mentioned at all, which is a bit surprising. The second section of the book deals with the biology of lung cancer, and comprises a series of interesting, well-written and informative papers on molecular genetics, growth factors, monoclonal antibodies, mechanisms of drug resistance, and clinical applications of in vitro studies of resistance patterns. As a clinical trialist and representative of the average oncology conference participant, I find this part particularly useful for the understanding of problems associated with lung cancer treatment. Also, the increasing insight into biological events in carcinogenesis and tumor response opens up doors to potentially new treatments, such as broad-spectrum antagonists to neuropeptide growth factors in SCLC, monoclonal antibodies to membrane antigens, and gene therapy. Rozengut’s paper on neuropeptide growth factors, Stahel’s systematic overview of monoclonal antibodies, and Kelley and Johnson’s chapter on molecular genetics are all well-written and interesting documents. Twentyman’s review of mechanisms of drug resistance is informative, and the link to clinical applications by Jensen and co-workers is felt to be valid and useful. In summary, this is a book that can be recommended to senior clinicians with a special interest in lung cancer, who don’t follow in detail the extensive literature in this field but still want to be updated in selected research areas, especially with reference to staging and lung cancer biology.
Berzgt Bergman, M.D. Department of Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden