After 2 decades of minimal progress, there have been important advances in the treatment of brain tumors with chemotherapy. A trial conducted by the European Organization for Research and Treatment of Cancer (EORTC) and the National Cancer Institute of Canada (NCIC) recently demonstrated the benefit of radiation therapy with concomitant and adjuvant temozolomide (Temodar) chemotherapy for glioblastomas. There is also increasing evidence that chemotherapy may be beneficial for anaplastic and low-grade gliomas, as well as a variety of less common tumors.
The Handbook of Brain Tumor Chemotherapy, edited by Dr. Herbert Newton, is a timely comprehensive reference that summarizes the current state of chemotherapy for brain tumors. Although the title suggests a focus on chemotherapy, there is also significant emphasis on more novel forms of drug therapy such as targeted molecular agents and intratumoral chemotherapy. The book is written by experts in the field, primarily from the United States, and succeeds admirably in its goal.
The book contains over 500 pages and 36 chapters divided into four sections. The first section, entitled Pharmacology and Clinical Applications, includes chapters providing an overview of brain tumor epidemiology and histopathology, clinical pharmacology of chemotherapy, interactions with antiepileptic drugs, brain tumor models, microarray and proteomics, chemotherapy resistance and clinical trial designs.
The second section, Molecular Biology and Basic Science, provides an overview of the molecular genetics of brain tumors, regulation of the cell cycle, apoptosis, growth factor signaling pathways and receptor tyrosine kinases, Ras pathways and farnesyl transferase inhibitors, PI3kinase/Akt/mTor pathways, tumor invasion, angiogenesis, and the blood-brain barrier.
The third section, entitled Innovative Approaches To Chemotherapy Delivery, includes chapters on intra-arterial chemotherapy, blood-brain barrier disruption, interstitial chemotherapy, intratumoral administration and convection-enhanced delivery, marrow ablative chemotherapy with stem cell rescue, chemotherapy-activating gene therapy, as well as a chapter on cerebrospinal fluid spread of tumors and their treatment.
The fourth section contains 13 chapters reviewing specific chemotherapy treatments for individual tumors, including one on pediatric brain tumors.
The book is directed primarily at clinicians but will also be useful for those conducting research in this field. The chapters are generally well-written and extensively referenced. Most of them provide excellent overviews of their topics, especially the ones dealing with the interaction of chemotherapy with antiepileptic drugs, signaling pathways, and invasion. The chapters discussing targeted molecular agents, tumor invasion, and the cell cycle are accompanied by beautiful color illustrations.