The New York Times Book Review - Mimi Swartz
…artfully traces the history of old and new developments that may have—finally—resulted in an actual cure for the most dreaded of all diseases. If you or a loved one has recently received a cancer diagnosis, or has been living with it as a chronic, if terrifying, condition, this book and the advances it describes offer far more than the usual glimmer of hope…Like many medical stories, it isn't an easy one to tell, thanks to an unlimited supply of jargon and scientific terms that can cause a migraine in the average reader…Graeber does a good job of hacking through it all, interspersing the medical research with interesting accounts of patients and their determined physicians.
Publishers Weekly
09/24/2018
“Hype can be dangerous, just as false hope can be cruel,” journalist Graeber (The Good Nurse) writes in this lucid and informed report on how doctors and medical researchers, advancing beyond a “cut, burn, and poison” approach to fighting cancer, discovered how to use the human immune response to attack mutant cells. Graeber recalls the “crushing failure” cancer immunotherapy suffered in the 1970s, and the giddy over-optimism seen in the 1980s before cancer breakthroughs such as interferon drugs went bust and immunotherapy research was left to a “handful of true believers.” His narrative moves from the grueling stories of research experiments and drug trials—through which pharmaceutical companies “spread their bets” over a variety of potential drugs—to the even more grueling experiences of cancer patients. Graeber focuses on the scientific developments and the “mind-blowing possibilities,” such as cellular therapy, in which living cells are used to fight cancer. Noting there are 940 immunotherapeutic drugs being tested by more than a half million patients, with another 1,064 drugs in the preclinical stage, he predicts the cancer cure lies in the personalized immunotherapy route. Graeber gives readers a basis for both understanding the challenges involved and for cautious optimism that a cure can be found. Agent: Susan Golomb, Writers House. (Nov.)
From the Publisher
"The Breakthrough not only provides good background and good understanding for patients, but is also a wonderful read, a book easily picked up but not easily put down — I'd recommend it for any patient interested in immunology of cancer."—Dr. James L. Gulley M.D. Ph.D., Director of Medical Oncology, Cheif of Immunology, National Cancer Institute (NCI), National Institutes of Health (NIH)
"THE BREAKTHROUGH artfully traces the history of old and new developments that may have — finally — resulted in an actual cure for the most dreaded of all diseases. This book and the advances it describes offer far more than the usual glimmer of hope...Graeber does a good job of hacking through it all, interspersing the medical research with interesting accounts of patients and their determined physicians."—The New York Times
"A gripping chronicle of the 100-year overnight success of Immunotherapy. For myself and millions of other cancer survivors, THE BREAKTHROUGH is a book of immense and essential hope."—Michael Fitzgerald, co-founder and CEO of Submittable and author of Radiant Days
"Only Graeber, one of America's greatest non-fiction writers, could take a subject so complex, dense and sprawling and turn it into a rollicking high-tension medical thriller. Masterful."—Douglas Rogers, award-winning journalist and author of The Last Resort
"There is no villain more ruthless than cancer, which has robbed us all of loved ones who had to endure untold suffering before they succumbed. But after decades of frustration and toil, scientists finally understand how to vanquish the disease by activating the human body's natural defenses. The intimate stories behind this triumph lie at the heart of Charles Graeber's THE BREAKTHROUGH, an expertly crafted and exhilarating account of life-saving ingenuity at its most dazzling. You will never encounter another book so incisive about the art of medical sleuthing, or so poetic about our innate drive to hold on to all that's beautiful in this world for as long as we can."—Brendan I. Koerner, Wired contributing editor and author of The Skies Belong to Us
"Engaging...In Mr. Graeber's hands, the evolution of immuno-oncology is both captivating and heartbreaking. We are immersed in the stories of the brave, desperate patients who try emerging therapies...We can't fail to see ourselves, our friends and our families in these stories."—The Wall Street Journal
"Graeber concisely reviews the science of cancer...The risks of tinkering with an intricate immune system are obviously high, even perilous. But the potential reward is a cure. Exciting reading."—Booklist
"Graeber does it again. He takes a complex topic — this time advances in cancer treatment — and weaves an engaging narrative that engages you to the end. With cancer as a leading cause of illness and death, this book is a timely and important account of the challenges and possibilities for new horizons in cancer treatment."—Diana J. Mason, PhD, Senior Policy Service Professor (George Washington University School of Nursing),Professor Emerita (Hunter College, City University of New York)
"Lucid and informed...Graeber gives readers a basis for both understanding the challenges involved and for cautious optimism that a cure can be found."—Publishers Weekly
"[A] deft, detailed study of cancer immunotherapy...From the once-discredited pioneer William Coley to immunologist and Nobel laureate James P. Allison, they form a brilliant, driven, admirably stubborn group that Graeber brings vividly to life."—Nature
"Crisp and suspenseful...an inspiring medical narrative."—BBC
"Fascinating...[Graeber] weaves human stories with accounts of scientific progress, looking beyond the "cut, burn, and poison techniques" — surgery, radiation, and chemotherapy — to focus on the myriad ways the immune system can attack cancer, and provides hope that a cure might not be beyond imagination."—The National Book Review
"Rare and thrilling...a hopeful, even inspiring, book about cancer."—Minneapolis Star Tribune
Kirkus Reviews
2018-09-02
Imagine a vaccine that could cure cancer. As this book reports, that possibility may not be far off.
Cancer treatment has long relied on "cut, burn, and poison" methods: surgery, which science journalist Graeber (The Good Nurse: A True Story of Medicine, Madness, and Murder, 2013) notes has been with us for thousands of years, coupled with the more modern radiation therapy and chemotherapy. Immunotherapy leverages the body's natural defense systems, made up of hundreds of millions of cells that are constantly "searching [for] and destroying the invaders that make us sick and the body cells that have become infected, mutated, or defective"—all of which describe cancer. Immunotherapy, in short, unlocks the natural-born cancer killer within, which is no easy task, inasmuch as a hallmark of cancer is its ability to lurk within the body undetected until, at least of old, it is too late. As the author chronicles, scientists have yet to completely understand the workings of the T cell "as the serial-killing attacker of foreign cells," but they have figured out what switches that cell on: a system of responses that are "something like how multiple keys are required to unlock a nuclear button or to open a safe deposit box." This helps moderate a constant danger that the immune system responses can sometimes lead to autoimmune diseases, where the cells lock onto the wrong thing; thus the "many redundancies and fail-safe feedback loops built into the immune response." Enough has been learned that previously discarded immunotherapies are being studied to determine whether they would work "with the brakes off," after having been paired with a "checkpoint inhibitor." Graeber reports that immunology researchers are promising more soon—more drugs, more fast-tracking to get therapies into hospitals, more "biomarkers to better describe cancer with molecular specificity." Though sometimes clumsily written, the book offers hope for more effective treatments in the near future.
A readable survey of the emerging field of immunotherapy in cancer treatment.
