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Clinical Associate Professor of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL
Published Online, October 17, 2006. www.theannals.com, DOI 10.1345/aph.1H259
Audience: This text will be of interest to pharmacists, oncologists, pharmacologists, and molecular biologists who are investigating in the laboratory the mechanisms of resistance to anticancer drugs. As stated in the preface, the intended audience is "scientists of diverse specialties with interests relating to the response of malignant disease to current and experimental therapies."
Purpose: The text aims to present the current state of knowledge of cancer cells' resistance to treatments, describing multiple mechanisms that involve genetic and epigenetic changes, cellular biochemistry, tumor physiology, and host metabolic and immune status.
Content: Cancers are quite resourceful, finding ways to escape the actions of anticancer agents seemingly as fast as these agents are developed. While the result of resistance is clinical disease progression or lack of response, the mechanisms of resistance are often not well understood. The text of Cancer Drug Resistance is composed of 31 chapters in 5 parts. The first 4 parts of the text concentrate on laboratory findings that describe mechanisms of resistance to various drugs or drug classes. These mechanisms are broadly categorized as physiological resistance, biological resistance, biochemical resistance, and resistance related to hormones, growth factors, and oncogenes. Some of the chapters in these sections attempt to relate the laboratory findings to the clinic—others do not. The fifth part includes 3 chapters that discuss clinical aspects of resistance.
Usability: The book is fairly easy to use. The chapters are understandable and the index provides a better guide to finding information about a particular drug than does the table of contents.
Highlights: Several of the chapters outline elegant experiments that identify potential mechanisms of resistance. A case is made for cross-resistance (or lack thereof) between different agents based on shared mechanisms of resistance.
Limitations: Each chapter has a short summary at the beginning, consisting primarily of the first sentence or 2 from the major sections of the chapter. An expanded introductory chapter would be helpful.
Readers are likely to read only 1 or 2 chapters of this text, depending on their area of interest and research. Some chapters do a better job than others of describing the clinical applicability of the basic scientific information and in differentiating between what has been confirmed versus what is hypothesized. In at least one case, the hypotheses in 2 different chapters seem to be conflicting. If a reader only reads 1 or 2 chapters, it may be more difficult to place the information in context. This is particularly true for readers who are primarily clinicians.
There are multiple grammatical errors (eg, incorrect tense) throughout the text, but they do not obscure the meaning.
Understandably, the sections that describe clinical applications are not up-to-date in terms of drugs that have received FDA approval. In addition, 2 drugs for which response and resistance have been well studied and for which the clinical relevance of laboratory findings is significant (gefitinib, imatinib) are discussed only briefly.
Summary: I recommend the acquisition of Cancer Drug Resistance for libraries. The diverse chapters make it likely that a researcher will only concentrate on 1 or 2 chapters. A clinician may not find enough practical application. An educator will find the book helpful in understanding and explaining different concepts surrounding response and resistance to various anticancer drugs.
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