The Breakthrough: Immunotherapy and the Race to Cure Cancer

This important and well-written book describes the efforts of brilliant and dedicated researchers to find new treatments against cancer, using immunotherapy, which offers great promise. It is hard to believe now, but the human immune system was once considered almost irrelevant to treating cancer, because of the disease's remarkable ability to avoid (at the cellular level) detection and action by our natural defenses. The author traces the courageous efforts of a few scientists and doctors to uncover some key secrets about the inner workings of our (incredibly complex) immune system. The "breakthrough" discoveries are clearly described, and make for fascinating reading. In simple terms, cancers often inhibit the "gas pedals" of our immune defenses, as well as activate the "brake pedals" which naturally exist to prevent excessive immune responses. Based on these discoveries, there are now numerous pioneering drugs being tested which hopefully will prevent and/or treat many kinds of cancers by enabling effective action by our immune system. This book reads like an exciting medical novel, but is all the more compelling because of the literally life or death stakes involved.

I wanted to read about the drugs I am taking for breast cancer. This was perfect. It is extremely well written. He takes complex material and methodically walks the reader through the history of breast cancer research and the new targeted drugs in a very readable and enjoyable way. Highly recommend for anyone in breast cancer treatment.

The highest compliment one can pay to a book about cancer is that it’s able to explain complex science in the same comprehensible, thrilling, humanistic way as Siddhartha Mukherjee’s Emperor of the Maladies. Graeber more than merits that praise in his immensely readable history of an important theatre of the war on cancer that Mukherjee omitted.

History, background and context are provided by the author along with the very human stories of innovation. The author has taken a very complex subject and explained it so well along with the relevant science. Readers will get a solid understanding of Checkpoint Inhibitors, CAR-T cell therapy and TILs and their role in the fight against “The Emperor Of Maladies”!

Some of the best parts of this book are in the chapter, “Glimmers in the Darkness.” In this chapter, Graeber lays the building blocks of the immune system and how the deep understanding of the system came about piecemeal over time, not in one eureka moment. More importantly, this chapter enlightens us on how researchers had to deal with skeptics. A telling example is from a time when a researcher first presented information on the immune system comprising T cells in addition to B cells. He was mocked in public with the comment that “B” and “T” were the first and last letters of the word, “bulls—t.” It is a very revealing moment that shows us that the barriers to advancements aren’t always financial, logistical or scientific.The aforementioned chapter also details, with much incision and perspicacity, the need to disseminate information responsibly. As much as there is a need to lucidly share important advances beyond the scientific community with the general public, of equal importance is balanced representation. Nowhere is this more evident in the book than the section on Dr. Steve Rosenberg and the IL-2 news coverage in 1985. A week before results from a small trial were due to be published in a journal, a Fortune magazine cover screamed, “Cancer Breakthrough.” While the medicine itself marked definite progress in the field, the results of the trial did not actually measure up to the kind of hype it generated and worse, the blind hope that the headline offered patients and caregivers. Seen one way, this book, especially this chapter, is not only a lesson in science but a lesson around science.The latter portions of the book offer insight into the game-changing discoveries in the field of checkpoint inhibition starting from CTLA-4 to anti-PD-1s/PD-L1s. (In light of what I just said, “game-changing” was a choice of term that I weighed carefully and used here only after being convinced of the enormity of the impact of these treatments.) Let me hasten to add that these are not technically dense chapters. As much as there is information on the science, there is an equal emphasis on how some patients stood (and continue to stand) to benefit from these newer treatments. There are some deeply moving stories, some of delight, others of despair. Even in his choice of the real-world stories, Graeber ensures that rays of light are appropriately tempered by clouds of unpredictability that continue to exist in the disease and its treatment.

Makes science read like a detective story.

This is the best book on immunotherapy I've read, not too advanced, not too simplified. The author breaks down the development of immunotherapy in oncology historically, weaving in patient and doctor anecdotes. I was pretty thrilled to see a dr I know show up as one of the immunotherapists. The book does require a bit of basic oncology knowledge, but otherwise breaks down the concepts, particularly the battle to make the body's immune system recognize cancer as "other" rather than part of the body. I highly recommend the book, it's even better than the Cancer: Emperor of Maladies book, being more concise with better explanations.

Explains immunotherapy in an entertaining and understandable format. Would be good for medical students.

I really enjoyed this book, especially the first few chapters. Very good history on a class of medications that have changed cancer therapy.

Great author . The way he presents everything is very good . A good book for anyone from a common man to a medical graduate searching for new treatment options for cancers.

Buen artículo

My wife has medullar thyroid cancer and our son has MS. The Breakthrough is an essential read for anyone suffering from cancer or any autoimmune disease such as MS. It offers hope by explaining the remarkable recent progress of research into immunotherapy achieved by thousands of dedicated scientists and physicians around the world.Graeber tackles this complex subject with incredible clarity, from the earliest years of work by tenacious physicians in the face of fierce criticism from colleagues, to the modern discoveries of B-Cells, T-Cells and their receptors and checkpoint inhibitors. And he patiently reminds the reader when revisiting a particular topic, to help reinforce how the immune system works when fighting cancerous cells.But this is not just a very well researched book of science. It combines the true story of the amazing work by so many scientists and doctors with real experiences of cancer patients. Some of the stories are truly uplifting and inspiring. A few are desperately sad. His extraordinarily sensitive narrative had me in tears several times.The Breakthrough is a page-turning story of scientific discovery, throughout which he cleverly weaves intensely emotional real patient experiences.

More a nice story than a scientific book. History is told only in part, and the book is too much a romance.