Book Review

The Molecular Basis of Cancer

N Engl J Med 1996; 334:199January 18, 1996

Article

The Molecular Basis of Cancer
By John Mendelsohn, Peter M. Howley, Mark A. Israel, and Lance A. Liotta. 574 pp., illustrated. Philadelphia, W.B. Saunders, 1995. $130. ISBN: 0-7216-6483-0

In The Molecular Basis of Cancer, the editors have undertaken the formidable task of presenting the state of the art of the rapidly changing field of molecular oncology. They have gathered an impressive array of well-known investigators and educators to contribute to this multiauthored textbook. The book is divided into four broad sections. The first, on the molecular basis of malignant transformation, focuses on the current understanding of the role of oncogene activation, signaling pathways, cell-cycle determinants, and tumor-suppressor genes in the expression of the malignant phenotype. The second section reviews the regulation of the growth and metastasis of malignant cells. The third describes the molecular abnormalities associated with specific malignant conditions. The fourth and final section surveys the molecular basis of cancer therapy, with discussions of chemotherapy, radiation, immunotherapy, the use of growth factors, and the emerging field of gene therapy.

The first nearly unavoidable problem with a textbook summarizing a rapidly changing field is that many of the actual details are already out of date by the time of publication. The best way to overcome this is to create a textbook that concentrates on general concepts and therefore presents enduring portions of the canon that will not be weakened by the addition of more information. A second problem is that although the writing of such a textbook implies the existence of a field of great breadth, there is ample opportunity for overlap, and the focus of each chapter must be narrowly defined to prevent extensive redundancy. In addition, the multiauthored nature of the book means that the editors must deal with wide variations in style and focus.

Although it contains several absolutely outstanding chapters, this work has clearly not been completely successful in overcoming these inherent pitfalls. The overall result is quite uneven, with a few chapters especially weak. The introductory chapter on cell-cycle regulation starts the book off strongly. It provides a general overview that is as current as possible and establishes a general structure for the coming chapters. The contrast with the subsequent chapter on molecular and cytogenetic analysis of hematopoietic malignant conditions is striking. Chapter 2 is totally unfocused, and almost half the references are over 10 years old. Nearly all the topics are better dealt with in other chapters. Similar contrasts can be found in other sections: in section 3, an extremely detailed and up-to-date discussion of lymphoid neoplasms with over 300 references is followed by a superficial chapter on the molecular biology of leukemia that contains only 19 references. Despite the unevenness of the presentation, the chapters on oncogenes, tumor-suppressor genes, and tumor angiogenesis are only a few of the absolutely superb presentations that make this book a worthwhile reference.

It seems appropriate to view this book in parallel with The Molecular Basis of Blood Diseases (George Stamatoyannopoulos, Arthur W. Nienhuis, Philip W. Majerus, and Harold Varmus, eds. Philadelphia: W.B. Saunders, 1994) issued by the same publisher. That textbook, now in its second edition, successfully presents current concepts of molecular hematology. It can be anticipated that the oncology textbook, like the hematology textbook, will show improvements from the first to the second edition that will make it a more consistently excellent reference for students and investigators in the field of molecular oncology.

Nancy Berliner, M.D.
Yale University School of Medicine, New Haven, CT 06570