Eiomed. & Phormocofher., 43 (1989) 69-70 8 Elsevier, Paris

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Immunotoxins. Cancer Treatment and Research. A.E. Krankel. Martinus Nijhoff Publishing, The Hague, i988.

Compartmentalization of immunotoxin experiments into discrete crisciplines and the publication of these experiments in many different journals has led many observers to perceive the field as simply consisting of a number of applied research projects for pharmaceuti- cal development. The main goal of this book is to provide an integrated presentation of the research problems, so that the reader can see the basic scientific questions in the field of immunotoxins in an organized manner. Further, the individual research topics have been dealt with in adequate detail to serve both as a source for techniques as well as a stimulus for new hypotheses and experiments.

Bringing many different approaches together in one volume will hopefully generate new interdisciplinary approaches to immunotoxin research problems. In the area of molecular biology, work on both the genetic engineering and X-ray crystallography of immuno- toxins is addressed. In biochemistry, work on enzyme chemistry, membrane chemistry, ribosome structure and function and protein purification is included. Organic chemistry has been represented by linker synthesis and application.

Pzclidcal hypcrthermia. Recent Results in Cancer Research, Vol. 109. W. Hinkelbein, G. Bruggmoser, R. Engelhardt, M. Wannenmacher. Springer Verlag, Berlin, Heidelberg, New York, 1988.

In this volume, physicians and biologists present their experimental work in the field of hyperthermia, paying particular attention to its relevance in clinical situa- tions. Principles of heat action and combined treatment modalities are explained. The main topics discussed are the effects of such treatment on normal tissues, animal tumors, malignant cell lines and human tumors.

A guide to bone marrow transplantation. H.J. Deeg, H.G. Klingemann, G.L. Phillips. Springer Verlag, Berlin, Heidelberg, New York, 1988.

This book provides a comprehensive survey of trans- plantation including pre-transplant considerations, the tra splant procedure, acute and delayed transplant re’ ied problems, and an assessment of future dev- elc,*,.nents.

‘he authors have addressed the principles involved in n ‘urow transplantation. Thus, this text should help prac, ::ing hematologists, oncologists and other physi-

cians - dents -

as well as physicians in training and stu- to develop an idea as to when bone marrow

transplantation should be considered, what steps need to be taken to make it possible, what the costs are, how a donor can be selected and so forth. It also reviews potential complications and side-effects, aspects parti- cularly useful for the physician who assumes the care of patients after their return from a transplant center.

Knowledge of various areas under discussion should allow smoother communication between pri- mary care physicians and transplant physicians, thus optimizing the treatment approach for any individual patient.

Cancer chemotherapy by infusion. J.J. Lokich. Precept Press Inc., Chicago, 1987.

Cancer chemotherapy by continuous infusion constitu- tes a promising avenue for improving the therapeutic index of highly toxic cytostatics. Such an improvement usually results from an enhanced host tolerance for these drugs as a result of avoiding high drug levels in the bloodstream. Moreover, continuous tumor cell exposure to cytostatics may also increase their probabi- lity of being killed. The author is one of the pioneers in the development of such a therapeutic strategy whose merits have already been demonstrated in the treatment of cancers of the head and neck, breast and gastrointestinal tract as well as hematologic malignan- cies.

This book first presents the rationale for such a therapeutic strategy : concept, experimental back- ground and clinical pharmacology of drugs (chapters I-III). Experimental data mostly include in vim examples, which support or contraindicate a conti- nuous, usually short-term, exposure of tumor cells from various lines. Accounts of in viva experiments with animal tumor models are less common. Nonetheless, the drug-by-drug presentation is clear, and allows ready access to information. However, the short chapter on the clinical pharmacology of infusional chemotherapy is too thcorctical, and no clinical observations have been provided.

General technical aspects are then described (chapters IV-VII). The chapter on drug administration systems presents some of the external and implantable systems in use. A critical appraisal of the pros and cons of each device is given, and the technical characteristics are summarized in a highly informative table. However, many new devices have appeared since 1987 when this book was edited, and these have not been listed. TWO chapters summarize the main techniques, incidence of complications and nursing management regarding

venous or arterial access and constitute a valuable and practical source of information.

Chapter VII, which deals with the stability and compatibility of drugs used in continuous infusion, is among the best. It presents exhaustive data for each drug according to diluent, concentration, container and temperature. It certainly needs to be read by those who are using or will use continuous infusions with drugs used alone or as admixtures. A second section sum- marizes the various uses of continuous infusion for different drug categories (e.g., fluoropyrimidines, me- thotrexate, etc.). There is a special chapter on pro- tracted continuous infusions, which summarizes the challenging results obtained to date by such treatment modalities.

Section III presents results of continuous infusion chemotherapy according to tumor category. Conti- nuous administration of fluoropyrimidines appears to markedly improve the response rate of head and neck and colorectal cancer as compared to standard bolus

5-FU. This section provides a comprehensive summary of the literature on this topic and lists treatment modalities for various diseases, which drug(s) should be utilized, and how they should be administered.

A fourth section is concerned with regional infusion - arterial, into the portal vein, intravesical infusion, and so on... The advantages of combining continuous 5-FU with irradiation are also documented both expe- rimentally and clinically.

In summary, this 747 page-long book constitutes a must for any physician, pharmacist or scientist involved in the use of continuous chemotherapy of cancers. All aspects of this topic are described. Its presentation is extremely clear and allows the reader easy access to the information that interests him. However, recent infor- mation is lacking, including the development of new drug administration systems - programmable in time - and the influence of biological rhythms which may have to be taken into account for optimizing continuous infusion of drugs.