I am a breast cancer survivor-- although not of the aggressive type that the title drug of this book was developed to fight.
My cancer was hormone positive, and treatable by the drug Tamoxifen, but this book chronicles the development from root research to submission of approval to the FDA of Herceptin.
Most breast cancers are tested for two major things: hormone receptor status and HER/neu over expression. If you get hormone positive and her negative, that's a "good diagnosis." Up until Herceptin was developed, the opposite (er-/her positive) was not so good. There was nothing for oncologists to try if your cancer proved chemo-resistant.
What was interesting to me as a breast cancer survivor in this book was the detailed analysis of the tricky, complicated path Herceptin took to get into the hands of cancer patients who most needed it to live.
It took literally an army of players over years to make Herceptin-- one of the star players of cancer treatment not because its mostly non-toxic, a targeted antibody therapy instead of "mass-destruction" chemo, and has easily demonstrable tumor-shrinking results--available to patients.
Players that not only included cell biologoists, oncologist researchers, Revlon, Breast Cancer Advocates, Genentech, and the federal government, but also a slew of breast cancer patients who would not admit defeat even when told there were no options or they weren't eligible for trials by their own doctors.
The lesson to be learned here is that ultimately, breast cancer survivors and patients do best when we are responsible for keeping up to date on developments in oncology ourselves, and also to question and push our doctors to think beyond standard treatments when those treatments fail. (Because truthfully, except for surgery, the cancer treatments standard today like radiation and chemo are mostly a crap shoot.)
The other lesson to be learned here is to be grateful for the series of coincidences and luck that lead to Herceptin not stalling out due to lack of money during primary research (thank you Revlon) or being lost to poorly designed clinical trials (thanks to Genentech for sticking with it!) or never being able to be submitted for FDA approval due to lack of enrollees in the trials (antibody based treatments were a new thing and so breast cancer patients had to be truly desperate) or any of a number of things. How many other targeted drugs get lost or never come to market because of the financial or political issues surrounding drug development?
An eye-opener for me was the information regarding how hard lobbyists and activists both in Breast CAncer and AIDS had to work in order to get a compassionate-use program (when drug companies allow desperate patients access to a drug still undergoing clinical trials) for Herceptin that paved the way for other drugs to be distributed for compassionate use. It seemed a no brainer, but was in fact much more complicated.
If you have a HER-positive cancer, this book is invaluable in understanding the science behind your own cancer, anecdotal cases of women whose HER-positive cancer was controlled by Herceptin, as well as the different combinations of chemo plus Herceptin that oncologists have tried. For anyone else like myself without the HER-positive cancer, but who experienced a life-threatening disease, its a clearly written, readable account about the science and politics of treating disease in the United States.
There does seem to be a bit of a complicated rush at the end of the book when describing key players and some of their rivalries and gripes, but this is a minor criticism on my part.