The Philadelphia Chromosome

February 11, 2013
In this meticulously detailed chronicle, science writer Wapner recaps the remarkable development of Gleevec, a cutting-edge drug capable of beating the typically fatal cancer of white blood cells known as chronic myeloid leukemia (CML). But the story of Gleevec’s progress also illuminates how a “minute chromosome”—discovered in Philadelphia in 1959—led scientists on a journey to the genetic roots of cancer and “the modern era of personalized medicine.” Gleevec’s triumph—a 2012 study conducted of patients who had taken the drug 10 years ago showed a 68% survival rate—ultimately overcame the daunting unwillingness of Big Pharma and oncologists to accept a lab-synthesized “molecularly targeted medicine.” “In eighteen years,” Wapner writes, “a vision had been wrestled into reality.” Her gracefully written history skillfully combines both the science and humanity of this fascinating search for a cure for CML, including the heartbreaks of Gleevec-pioneering M.D. Brian Druker, thwarted efforts to get the drug into trials, jealousies between scientists, the love story of a reporter and Druker, and the compelling accounts of the patients themselves, who bravely tested the drug and ultimately reclaimed their lives. 8-page photo insert. Agent: Russell Galen, Scovil Galen Ghosh Literary Agency.

May 15, 2013

Freelance science writer Wapner has created a well-rounded work about the discovery of the Philadelphia chromosome, the causes of chronic myeloid leukemia (CML), and the development of the drug Gleevec to treat CML. Wapner does an excellent job of describing the many stages of basic, nonhuman, nonclinical research needed (some of which at first seemed to have no connection with the disease) that led to the knowledge necessary to treat CML. The book also illuminates the process of drug development and the tug of war between caution about side effects and the desire to cure cancer. The story also calls into question regulations that inhibit some industry/academic collaborations. VERDICT A refreshingly balanced view of the topic compared to the one-sided optimism found in Daniel Vasella and Robert Slater's Magic Cancer Bullet (2003). An excellent book for those who want to learn more about how medical discoveries are made and those interested in recent medical history, as well as those whose lives are affected by CML.--Margaret Henderson, Midlothian, VA

Copyright 2013 Library Journal, LLC Used with permission.

March 1, 2013
Science writer Wapner uses the development of a successful cure for a once-fatal form of leukemia to illustrate the application of genetic engineering to the frontiers of current medical practice. The discovery of the structure of DNA unleashed the potential to use genetically engineered pharmaceuticals in the treatment of cancer. It took longer than the succeeding 10 years for phrases like "genetic mutation" and "chromosomal abnormality" to become part of the scientific vernacular. By 1959, when the available investigative tools were still primitive by today's standards, a researcher at the University of Pennsylvania discovered an abnormality in the relative sizes of two chromosomes. Ultimately, this led to an understanding of the role of oncogenes, but first a marriage had to take place. The prevailing theory, based on the study of chicken tumors, was that since cancers were contagious, they were caused by viral infection. After virologists determined the genetic makeup of viruses, they opened a second trajectory for the research. They made the remarkable discovery that a normal, proto-oncogenetic chicken gene was temporarily assimilated into an "infecting" virus where it mutated. Normally, the proto-oncogenes were also found in healthy humans, as well as chickens and other animals. Now that the gene was identified, a similar process was discovered in the Philadelphia Chromosome. In this case, a mutated oncogene was located at the point where two specific chromosomes split and interchanged positions before their parts were rejoined. The next problem was to establish the gene's role in normal cell regulation and how to block its functioning after it had mutated. Wapner weaves together the basic and applied science with the stories of the dedicated researchers, the broader supporting superstructure of modern medicine and the process of bringing pharmaceuticals to market. An absorbing, complex medical detective story.

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