Between Bench and Bedside

In 1985 the media announced a new therapy for cancer. It was expensive, labor-intensive, and toxic--but, they said, it worked. How it worked is the story Ilana Lwy tells in Between Bench and Bedside, a compelling account of the clinical trials of interleukin-2 at a major French cancer hospital. Her book offers a remarkable insider's view of the culture of clinical experimentation in oncology--and of how this culture affects the development of new treatments for cancer. Lwy, a historian of science who trained as an immunologist, makes the life of the laboratory and the hospital comprehensible and immediate. Before immersing us in the clinical drama, she fills in the history behind the action--a background of chemotherapy and radiation, controlled clinical trials, and the long line of immunological approaches that finally led to interleukin-2. The story then shifts to the introduction of interleukin-2 in a cancer ward. Lwy conveys the clinical investigation as a complex, multilayered phenomenon that defies the stereotypes of modern biomedicine. In this picture, the miracle-makers and arrogant, self-centered professionals of myth give way to moving images of real people negotiating the tensions between institutional and professional constraints, the search for a scientific breakthrough, and the obligation to alleviate the suffering of a patient. The result is a rare firsthand look at the multiple factors that shape real-life clinical experiments and the institutional tangle and emotional muddle that surround such trials--an invaluable view at a time when medicine is undergoing such great and confusing changes.