Book Review: Lung Cancer Therapy Annual 2000

In an era of information"overload" for the practicing oncologist, keeping up with the latesttherapies for the many distinct clinical scenarios that arise in daily practicecan be quite a challenge. Thus, a concise synthesis of the current knowledge ina field, such as provided in Lung Cancer Therapy Annual 2000 by Drs.Heine Hansen and Paul Bunn, can be quite useful. These authors, whose clinicalexpertise and contributions to lung cancer therapy are internationallyacknowledged, offer a complete review of the literature pertaining to lungcancer therapy from the year 1999, including a review of abstracts from majormeetings. A brief summary is provided at the end, outlining standard, acceptedstrategies based on histologic and stage-by-stage criteria. This text serves asa reference that summarizes the major existing literature, evaluates thestrength of the evidence, and makes reasonable recommendations on how to proceedwith clinical care.

The book is divided into 10 chapters ranging from epidemiologyand screening/early detection to treatment of small-cell and non-small-celllung cancer. Written in an easy-to-read format from the viewpoint of the medicaloncologist, the chapters are broken down in a clear, logical manner by stage,treatment modality, and strength of trial evidence. For instance, the lengthydiscussion of non-small-cell lung cancer treatment addresses diverse butimportant issues such as early-stage disease, postoperative adjuvant therapy,preoperative neoadjuvant therapy, and chemoprevention, as well as chemotherapyregimens (single agent, combination "doublets" and"triplets") for metastatic disease.

Within each topic, data are well organized and broken down intorandomized phase III vs nonrandomized phase II trials. Special topics, such astreatment of elderly patients, those with poor performance status, and thosewith brain metastases, are addressed separately. Despite the massive amount ofinformation being discussed and the somewhat dry nature of the topic, the readeris able to extract conclusions from each section regarding currently acceptedtherapies and questions yet to be answered through ongoing clinical trials.

The multiple tables that summarize the pertinent studies in eachsection of a given chapter are particularly useful. They provide references, thestage of disease being treated, the therapy administered, the number of patientsstudied, response rates, median survival, and frequently, long-term survivalrates. This level of detail allows the reader to use the book as a quickreference.

While the major chapters on the treatment of small-cell lungcancer, non-small-cell lung cancer, and mesothelioma are comprehensive, someof the other chapters are less useful. The text contains occasionalinaccuracies, such as defining stage IIB as T2N0M0 or including the bcl-2oncogene in a table on tumor-suppressor genes while discussing it at length inthe section on dominant oncogenes. The chapter on staging is confusing at times,and the chapter on biological therapy focuses more on the prognostic value ofabnormalities in protein expression than on therapies addressing theseabnormalities.

The essential task regarding a text such as this one is todetermine who its audience is. The focus of this book is to summarize the mostrecent literature with the understanding that the reader is alreadyknowledgeable about lung cancer therapeutics. Most busy practioners are notlikely to pick up a textbook to obtain this information; however, if they do,they will find it easy to be up-to-date (that is, up-to-1999) on a variety ofspecial topics pertinent to the care of patients with lung cancer. These days,dissemination of important information on treatment sometimes precedespublication in peer-reviewed journals, and it is increasingly difficult to beaware of all the latest data necessary for patient care. For those willing totake advantage of it, the targeted reviews of specific clinical scenariosprovided in this book will ultimately save time.