E Chu and VT Devita Jr
Jones and Bartlett Publishers (2003)
ISBN: 0-7637-4837-4 527 pages plus index
The short introductory chapter, 20 pages, is titled Principles of Chemotherapy and covers such diverse topics as ‘clinical endpoints in evaluating response’ to ‘chemotherapy and apoptosis, cell cycle control and resistance to chemotherapy’.
The pivotal section of this book (chapter 2) provides an alphabetical catalogue of over 100 drugs used to treat cancer. Each entry provides a chemical structure, trade and generic names, category, manufacturer, mechanism of action and resistance, pharmacokinetic data, indications, dose range, instructions on drug preparation and stability, drug interactions, special considerations when using the drug and expected toxicities. Five new agents have been added since the previous edition. This information requires 356 pages.
Chapter 3 ‘Guidelines for chemotherapy and dosing modifications’ contains 11 tables to be used to guide individualised dosing based on patient-specific parameters such as calculation of BSA in adult amputees, creatinine clearance, hepatic function and use of dialysis.
Chapter 4 contains lists of protocols for different tumour types and the final chapter is devoted to antiemetics.
The main deficiencies of this book relate to its US origin. Information on the drugs refer only to the products available in the US. Cisplatin, says the book, is available as 10mg or 50mg vials and is stable after reconstitution for 24 hours at room temperature, whereas in Australia we obtain cisplatin as a 1mg/ml solution in vial sizes up to 100ml with stability obviously far greater than 24 hours. Carboplatin is stated to be available only as a lyophilised powder that must be reconstituted and used within 8 hours whereas here, like cisplatin, it is available in solution. Cyclophosphamide tablets are available in the US as 25mg as well as 50mg, we are not so fortunate and have 50mg only. As well as these and similar entries containing misinformation, the layout is not consistent. Etoposide phosphate has an entry in its own right but Erwinia asparaginase is muddled in with E.Coli asparaginase, carmustine wafers are mentioned, briefly, under carmustine. Neither Erwinia asparaginase nor carmustine wafers appear in the index. Newer drugs that you would expect to find eg. cetuximab, bevacizumab, carboxypeptidase and ecteinascidin are not included. Even in the antiemetic chapter no mention is made of tropisetron, an antiemetic widely used in Australia or, more importantly, the novel acting aprepitant.
A further deficiency lies in the lists of protocols. It is difficult to see the usefulness of this chapter. No attempt is made to prioritise the protocols for a particular tumour type nor give any information other than drug name, dose, route of administration, cycle duration and number of cycles. No mention is made whether an IV dose is given by bolus or infusion, what, if any, fluid requirements there might be, what the order of treatment should be, how long infusions should be given or what ancillary treatments are required eg. premedications. It is obvious that the information provided from this source alone could not be used to determine patient treatment, nor to deliver a specific regimen to a patient – further information would always be required.
The back cover claims this book to be a practical up-to-date guide to all aspects of cancer chemotherapy and that it provides a comprehensive catalogue of drugs. Furthermore, it states, a section of Common Chemotherapy Regimens provides a reference to management of specific cancers. The book has a handy spiral-bound format and comes with an easy to use CD-ROM version that could be downloaded into an electronic device for easy transport/retrieval, but these positives are insufficient to overcome the deficiencies in the content.