The Breakthrough: Immunotherapy and the Race to Cure Cancer

by Charles Graeber

Overview

New York Times bestselling author Charles Graeber details the astonishing scientific discovery of the code to unleashing the human immune system to fight -- and possibly even cure -- cancer, in this "captivating and heartbreaking" (The Wall Street Journal) book, featuring interviews with 2018 Nobel Prize in Medicine award-winners James P. Allison and Tasuku Honjo.
For decades, scientists have puzzled over one of medicine's most confounding mysteries: Why doesn't our immune system recognize and fight cancer the way it does other diseases, like the common cold?
As it turns out, the answer to that question can be traced to a series of tricks that cancer has developed to turn off normal immune responses-tricks that scientists have only recently discovered and learned to defeat. The result is what many are calling cancer's "penicillin moment," a revolutionary discovery in our understanding of cancer and how to beat it.
In THE BREAKTHROUGH, New York Times bestselling author of The Good Nurse Charles Graeber guides readers through the revolutionary scientific research bringing immunotherapy out of the realm of the miraculous and into the forefront of twenty-first-century medical science. As advances in the fields of cancer research and the human immune system continue to fuel a therapeutic arms race among biotech and pharmaceutical research centers around the world, the next step-harnessing the wealth of new information to create modern and more effective patient therapies-is unfolding at an unprecedented pace, rapidly redefining our relationship with this all-too-human disease.
Groundbreaking, riveting, and expertly told, THE BREAKTHROUGH is the story of the game-changing scientific discoveries that unleash our natural ability to recognize and defeat cancer, as told through the experiences of the patients, physicians, and cancer immunotherapy researchers who are on the front lines. This is the incredible true story of the race to find a cure, a dispatch from the life-changing world of modern oncological science, and a brave new chapter in medical history.
"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

Product Details

ISBN-13:	9781455568499
Publisher:	Grand Central Publishing
Publication date:	11/13/2018
Sold by:	Hachette Digital, Inc.
Format:	eBook
Sales rank:	737,922
File size:	24 MB
Note:	This product may take a few minutes to download.

About the Author

Charles Graeber is the Edgar Award-nominated, New York Times bestselling author of The Good Nurse. Winner of the Overseas Press Club award for outstanding international journalism, he has contributed to numerous publications, including Wired, GQ, The New Yorker, New York Magazine, Bloomberg Businessweek, and The New York Times. His work has been included in The Best American Science Writing, The Best American Crime Writing, and other anthologies. Born in Iowa, he's now based out of Brooklyn, NY.

Table of Contents

Preface xi

Introduction 1

Chapter 1 Patient 101006 JDS 9

Chapter 2 A Simple Idea 36

Chapter 3 Glimmers in the Darkness 60

Chapter 4 Eureka, Texas 92

Chapter 5 The Three E's 109

Chapter 6 Tempting Fate 137

Chapter 7 The Chimera 166

Chapter 8 After the Gold Rush 179

Chapter 9 It's Time 184

Acknowledgments 195

Appendix A Types of Immunotherapies Now and Upcoming 199

Appendix B The Breakthrough, in Brief 205

Appendix C A Brief Anecdotal History of Disease, Civilization, and the Quest for Immunity 211

Further Reading 227

Notes 229

Index 289

About the Author 303

Editorial Reviews

…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.

The New York Times Book Review - Mimi Swartz

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.)

Publishers Weekly

"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

From the Publisher

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.

Kirkus Reviews