Book Review

Cellular Cancer Markers

N Engl J Med 1995; 333:674September 7, 1995

Article

Cellular Cancer Markers
(Contemporary Biomedicine.) Edited by Carleton T. Garrett and Stewart Sell. 484 pp. Totowa, N.J., Humana Press, 1995. $125. ISBN: 0-89603-210-8

The field of tumor markers is fast-moving and littered with hopefuls and might-have-beens. Only a handful of markers have passed successfully from study in the basic laboratory to common clinical use. Earlier studies dealt predominantly with protein markers, but new genetic markers are now emerging because of large recent gains in understanding the genetic progression of many common neoplasms. There is a great need to identify new markers that will be useful for early detection and estimation of prognosis.

In this book the editors have tried to develop a comprehensive catalogue of tumor markers in many types of cancers. This may be an impossible goal, because so many areas of research are yielding genetic and protein markers. Furthermore, many attempts to translate bench research into clinical applications are not complete and are thus difficult to assess.

The chapters in this book are diverse and often independent of each other. The lack of organization makes “coverage” of common tumor types (e.g., those of the bladder and brain) difficult. Several sections overlap substantially, especially because some single genes (considered important enough in their own right) are covered in their own chapters. The authors emphasize genetic changes in some cancers but stress immunophenotypic markers in others. Often the chapters contain much functional information, structural data, and other interesting but superfluous facts about various markers. Although this approach is of benefit for basic scientists, it seems too broad for clinicians.

Because the chapters stand alone, each must be considered on its own merits. Used for quick reference, most chapters will give the reader background information on a specific gene or tumor type. However, many chapters are really just catalogues of published information. The authors seldom offer important criticism of poor work or studies that disagree with the mainstream. Readers unfamiliar with the subject will have to fend for themselves in trying to sort the wheat from the chaff.

With respect to the book's value as a reference, some chapters provide convenient tables of all the important genetic changes in a given tumor type. Others, such as the chapter on gynecologic cancers, stress differences in techniques and methods of quantitation, allowing the reader a quick analysis of current data. Still others, such as the chapter on non-Hodgkin's lymphoma, offer clinical vignettes that present useful scenarios for the use of specific markers. As is common in cutting-edge textbooks of this type, some subjects of late-breaking news (e.g., BRCA1 and mismatch-repair genes) are thoughtfully included, whereas others (e.g., p16 and chromosome 9p) are left out. Some authors have not checked their references thoroughly, but this will annoy only readers familiar with the literature.

The editors should be commended for attempting an extensive compilation of information on cancer markers. The exceptionally well done final chapter (contributed by the editors) provides important concepts about the identification of good tumor markers. Clinicians and students could use it in evaluating a trial or a particularly promising new marker. However, the next edition needs additional chapters and a better effort to exclude redundant and superfluous information. This work is not a definitive resource for scientists in the field, but it may be useful for those in other areas seeking a “quick look.” Many clinicians will doubtless await a more definitive and critical work in this rapidly growing, promising field.

David Sidransky, M.D.
Johns Hopkins University, Baltimore, MD 21205-2196