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Her-2: The Making of Herceptin, a Revolutionary Treatment for Breast Cancer

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Two years after she underwent a mastectomy and chemotherapy, Barbara Bradfield's aggressive breast cancer had recurred and spread to her lungs. The outlook was grim. Then she took part in Genentech's clinical trials for a new drug. Five years later she remains cancer-free.

        Her-2 is the biography of Herceptin, the drug that provoked dramatic responses in Barbara Bradfield and other women in the trials and that offers promise for hundreds of thousands of breast cancer patients. Unlike chemotherapy or radiation, Herceptin has no disabling side effects. It works by inactivating Her-2/neu--a protein that makes cancer cells grow especially quickly-- produced by a gene found in 25 to 30 percent of all breast tumors. Herceptin caused some patients' cancers to disappear completely; in others, it slowed the progression of the disease and gave the women months or years they wouldn't otherwise have had. Herceptin is the first treatment targeted at a gene defect that gives rise to cancer. It marks the beginning of a new era of treatment for all kinds of cancers.

        Robert Bazell presents a riveting account of how Herceptin was born. Her-2 is a story of dramatic discoveries and strong personalities, showing the combination of scientific investigation, money, politics, ego, corporate decisions, patient activism, and luck involved in moving this groundbreaking drug from the lab to a patient's bedside. Bazell's deft portraits introduce us to the remarkable people instrumental in Herceptin's history, including Dr. Dennis Slamon, the driven UCLA oncologist who played the primary role in developing the treatment; Lily Tartikoff, wife of television executive Brandon Tartikoff, who tapped into Hollywood money and glamour to help fund Slamon's research; and Marti Nelson, who inspired the activists who lobbied for a "compassionate use" program that would allow women outside the clinical trials to have access to the limited supplies of Herceptin prior to FDA approval of the drug. And throughout there are the stories of the heroic women with advanced breast cancer who volunteered for the trials, risking what time they had left on an unproven treatment. Meticulously researched, written with clarity and compassion, Her-2 is masterly reporting on cutting-edge science.

214 pages, Hardcover

First published August 25, 1998

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Robert Bazell

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Displaying 1 - 30 of 35 reviews
6 reviews
August 19, 2018
This drug saved my life, and it was interesting reading about the process it went through to get FDA approval. An eye opening account of the frustrations and trials of many scientists and women. The author mixes a lot of science and and personal stories throughout the book, and while at times I felt sad and frustrated reading this book, it ultimately left me feeling grateful. *If I were the author, I would print a 2nd edition which updates the lives of the women, as well as advances in the drug.
Profile Image for Irene.
476 reviews
October 17, 2019
I first read about the dramatic story behind Herceptin in The Emperor of All Maladies: A Biography of Cancer , a sweeping biography of cancer that includes Herceptin as one of many major developments in cancer research. When I learned of a book that dives in deep and provides all the fascinating details of Herceptin's own biography, I jumped to read it.

This story has all the players you might expect, and more. There are academic researchers, oncologists, and biotechnology executives; insurance companies, government agencies, Hollywood philanthropists, and activists. There are missed opportunities, serendipitous encounters, and determined individuals with unrelenting perseverence.

The author, Robert Bazell, interweaves the story of Herceptin with stories of women with breast cancer who helped make the drug available by participating in clinical trials or by advocating for compassionate access before it was FDA-approved. Bazell provides important facts about cancer and cancer research alongside candid accounts of the reality of cancer treatment and recurrence. There is poignancy and meaning in each woman's story.

For me, this book is personal, so maybe my rating is inflated. I was diagnosed with a HER2-positive breast cancer and am currently receiving targeted therapy with Herceptin. I am keenly aware that if I had been diagnosed 25 years earlier, my prognosis would very likely have been much more grim. I am deeply indebted to every individual who believed that Herceptin would save lives, and who persisted despite obstacles and set-backs. I feel sincere gratitude towards each woman whose participation in a clinical trial helped bring the drug to market.

Finally, this book reaffirmed my belief that health care and pharmaceuticals should not be for-profit industries. I am horrified to think of how many potentially life-saving drugs aren't under development because corporate executives don't see a path to profit.
Profile Image for K. Lincoln.
Author 18 books93 followers
December 31, 2013
I am a breast cancer survivor-- although not of the aggressive type that the title drug of this book was developed to fight.

My cancer was hormone positive, and treatable by the drug Tamoxifen, but this book chronicles the development from root research to submission of approval to the FDA of Herceptin.

Most breast cancers are tested for two major things: hormone receptor status and HER/neu over expression. If you get hormone positive and her negative, that's a "good diagnosis." Up until Herceptin was developed, the opposite (er-/her positive) was not so good. There was nothing for oncologists to try if your cancer proved chemo-resistant.

What was interesting to me as a breast cancer survivor in this book was the detailed analysis of the tricky, complicated path Herceptin took to get into the hands of cancer patients who most needed it to live.

It took literally an army of players over years to make Herceptin-- one of the star players of cancer treatment not because its mostly non-toxic, a targeted antibody therapy instead of "mass-destruction" chemo, and has easily demonstrable tumor-shrinking results--available to patients.

Players that not only included cell biologoists, oncologist researchers, Revlon, Breast Cancer Advocates, Genentech, and the federal government, but also a slew of breast cancer patients who would not admit defeat even when told there were no options or they weren't eligible for trials by their own doctors.

The lesson to be learned here is that ultimately, breast cancer survivors and patients do best when we are responsible for keeping up to date on developments in oncology ourselves, and also to question and push our doctors to think beyond standard treatments when those treatments fail. (Because truthfully, except for surgery, the cancer treatments standard today like radiation and chemo are mostly a crap shoot.)

The other lesson to be learned here is to be grateful for the series of coincidences and luck that lead to Herceptin not stalling out due to lack of money during primary research (thank you Revlon) or being lost to poorly designed clinical trials (thanks to Genentech for sticking with it!) or never being able to be submitted for FDA approval due to lack of enrollees in the trials (antibody based treatments were a new thing and so breast cancer patients had to be truly desperate) or any of a number of things. How many other targeted drugs get lost or never come to market because of the financial or political issues surrounding drug development?

An eye-opener for me was the information regarding how hard lobbyists and activists both in Breast CAncer and AIDS had to work in order to get a compassionate-use program (when drug companies allow desperate patients access to a drug still undergoing clinical trials) for Herceptin that paved the way for other drugs to be distributed for compassionate use. It seemed a no brainer, but was in fact much more complicated.

If you have a HER-positive cancer, this book is invaluable in understanding the science behind your own cancer, anecdotal cases of women whose HER-positive cancer was controlled by Herceptin, as well as the different combinations of chemo plus Herceptin that oncologists have tried. For anyone else like myself without the HER-positive cancer, but who experienced a life-threatening disease, its a clearly written, readable account about the science and politics of treating disease in the United States.

There does seem to be a bit of a complicated rush at the end of the book when describing key players and some of their rivalries and gripes, but this is a minor criticism on my part.

155 reviews
October 12, 2021
Having worked in pharma, the story of herceptin discovery, development, and registration are familiar. Well written. It goes behind the scene with academics, patients, scientists, and activists.
Profile Image for Olivia Fox.
11 reviews
September 21, 2023
I got this book from a family friend who is alive because of the drug developed in this book, so that gave me a meaningful reason to start this book. Beyond that, I was amazed by how entertained and engaged I was throughout the whole book. Lots of scientific terminology mixed in with patient/doctor/researcher testimony which made for a nice balance of pathos and logos. I wish I could have followed the different patient throughout their journeys better, but overall good vibes learning about something new.
Profile Image for Karen.
68 reviews1 follower
January 10, 2016
Very interesting addition to my extensive reading about cancer and treatments. This is a very detailed look at the development of a new kind of treatment for breast cancer. I have a family member affected, and I am a physician, so it is good to know as much as possible, though I do not treat breast cancer as a primary care physician. This covers the various treatments and therapies, why this drug is so different, and how we got to this point. The lives saved and sadly those lost. This was also interesting because you get the behind the scenes details of research. The egos of the researchers, and their sometime zeal to grab the glory for themselves, versus those whose passion is curing patients. Reminds me a bit of the great book "And The Band Played On" by Randy Shilts about the research and treatments surrounding the AIDS/HIV disease. Patient activism really started in earnest with that battle, and breast cancer activism borrowed much from that battle! Herceptin is a remarkable medication, a different kind of therapy, and I am so pleased it is among the arsenal for breast cancer treatments! This is a bit dated, so there are even newer medications available, but this history is valuable and Mr. Bazell does a great job in telling the stories. Kudos for ending with updates on many of the patients at the end of the book.
Profile Image for Meghan.
3 reviews
September 29, 2019
I picked this up based on the recommendation of a friend currently receiving Herceptin infusions. I am also a survivor, but my cancer was Her2 negative. It also struck home that my mother, who died of metastatic breast cancer in 1994, could very well have been a part of the early trials of Herceptin. The book is gripping and has fascinating insights into the worlds of science, biotech, health advocacy, medicine and pharmaceuticals. It took an army of people, years of dedication, many sacrifices, and a lot of luck to develop Herceptin, the most significant breakthrough in breast cancer treatment in the past 30 years. I recommend it highly and would like to read a postscript as the book is over 20 years old.
Profile Image for Iris Levine Accettola.
113 reviews1 follower
January 20, 2020
Having been an oncology nurse for the last 19 years of my 39 year career, 8 of them in the outpatient chemo setting, having administered Herceptin as well as the other mentioned chemotherapies, I found this history to be fascinating. I also recently saw the made-for-tv movie about Dr. Slamon and his fight to get Herceptin manufactured. There was so much more that the movie depicted. I recommend this book highly to all nurses and patients receiving chemo to understand the struggles and egos that go into helping the ailing.
1 review
February 4, 2022
Discovery of Herceptin

A book about one of the greatest discovery in oncology,Trastuzumab ,commercial name Herceptin, wich saved since then so many her2 positive women.It opened the way for more treatments but this one was revolutionary.
The book is not complicated with scientific terms,it's more like a captivating fiction.
Easy to read and helpful for those who have this desease.
296 reviews
October 1, 2015
I found this to be such an eye-opening book that clearly highlighted the numerous factors involved with the design, funding, evaluation, and roll-out of such a groundbreaking therapy. I found the mix of facts and personal vignettes to be well balanced. I wish I could retain all of the details and lessons shared. This book was a fantastic history, told in a captivating way - it is pretty amazing.
Profile Image for Robin Larson.
83 reviews
January 15, 2017
I didn't realize this book was 19 years old until I finished it!

Still, it was great to learn about the history of Herceptin and how it came to be on the market.
Profile Image for Sara.
145 reviews
August 18, 2023
Of course, Herceptin saved my life in 2018, having had a "complete response" to the drug in combo with Perjeta (FDA 2016) and 2 chemos - taxotere and carboplatin. My tumor was the size of a lime with 1 lymph node involvement. After my neo-adjuvant treatment for 6 months, I then had surgery to find that the cancer was gone. I continued Herceptin for the next 6 months (the protocol in 2018) and then passed my 3 years and now 5 year marks. Still cancer free.

So, naturally, to read about how Slamon/ UCLA/Revlon/Genentech/MSKCI, etc. salvaged this drug again and again in 1998 was really fascinating. I would be dead without it, as was the unfortunate journey for so many women before me. To read about the 19 initial patients getting dosed, sitting in the chemo ward together, bonding, living/dying, depending on ??? back then they really didn't know why some were responding and others were not. Today, we have more science to better understand.

I almost threw up a couple of times reading how close these humans were (in all fields) to cancelling this drug from the pipeline because 1) it only affected 20-30% of bc women; 2) it was too expensive; 3) they got burned in the past by their "interferon" experiences; 4) and egos, lack of flexibility. It reminded me of the human fixing the airplane on a bad day and forgets to tighten the bolt, only to find it was THE bolt which caused the crash.

I bought a copy of this book to sit on my shelf. I chose to read the story after I left San Diego (where I experienced my cancer) to center me in my new location and bring memories with me as I start another life.

The science was not too difficult to understand, and the author did a good job showing the massive work putting on clinical trials and all that the FDA expects, along with the cost. I have considered writing to Slamon, if he is still living, and thanking him for pursuing a molecule for which everyone else rolled their eyes. This was 1990, 1992, etc. No one could wrap their brains around antibody therapy for cancer - YET. For me, the story was a thriller with an ending of true hope combined with sadness for how many didn't make it; and, how many still today have to fight for their rights to live. We can't just sit back and expect the Dr. to tell us what to do. We have to be our own advocates.
334 reviews
September 17, 2021
This is a surprisingly good book about the development of Herceptin for the treatment of a very aggressive form of breast cancer. Bazell is a science journalist who clearly (and accurately) described what oncogenes and receptor sites are before diving into the story of how the scientists, oncologists, activists, and the biotech company Genentech developed and brought Herceptin to the many thousands of women battling Her-2/neu positive breast cancer. A big shoutout to Dennis Slamon and Axel Ullrich for their initial work and insight on the over-expression of Her-2 receptor sites on breast and ovarian cancer cells, and to Dr Slamon’s persistence in pushing for the development of the Her-2 monoclonal antibody. There are several patient profiles whose stories break your heart, and the section on how Bay Area breast cancer treatment activists emulated the HIV activists to fight for compassionate access to the antibody treatment before it was licensed certainly raised my blood pressure. Genentech didn’t come off looking good; while the company was founded by idealists, it was soon run by non-idealists. There were certainly many idealists still working there, especially in the research labs, but they had uphill battles causing many to quit and move on elsewhere.

The writing style is spare, but the economy of words nonetheless provides a nice overview of research, development, clinical trials, and marketing. I understand from other readers’s comments that there’s a good movie about Dennis Slamon - I’ll have to look for it.
489 reviews16 followers
August 11, 2022
I would have given this book 5 stars except for its age. Especially in early sections, Bazell mentions several “current” treatments that are no longer current as the book is now 20+ years old. But once he gets into the history, the age of the book matters much less. Just bear in mind that any reference to treatment protocols is probably no longer current and that many new treatments have been developed as well.

It was interesting to learn about how a major drug was developed and about how clinical trials actually work (though that may also be dated now - I don't know). It was interesting to learn that Revlon played a major role in the development of Herceptin. And that Herceptin is manufactured using ovary cells from hamsters. Because I receive treatment from Kaiser which has a facility just across Divisidero Street from a UCSF facility I was also interested to learn about the history between those two organizations. "[Kaiser] was so reviled that the local chapter of the American Medical Association refused membership to Kaiser doctors." Damn commies! LOL

I will always wonder how many wonderful women died because this treatment wasn't available to them in time. I am so grateful for all of the women it has saved and for the doors this research opened into other treatments.
Profile Image for Laura Steinert.
1,287 reviews72 followers
May 25, 2024
It is time to stop pretending that you, your wife, your mother, or your daughters can all escape cancer. It is also time to stop pretending that big pharma cares about curing diseases that won't increase their stock prices. And if you still believe doctors are all caring, patient-centered, and altruistic all-knowing providers, it is time you stopped. Learn why you have to be proactive even after 20+ years past the miracle of Herceptin. During the delays (bad managment, poor study and trial designs, etc.) more than the number of women who could fill a football stadium died from lack of access to Herceptin.
Profile Image for Chris Rands.
60 reviews1 follower
February 24, 2023
Books I read about biotech tend to be about scandals (e.g. theranos, oxycontin), so it was enjoyable to follow a positive story relating to the industry. Nicely documenting the collaboration, yet also tensions, between patients, clinicians, academics and pharma. Only disappointment was the lack of scientific detail on Her-2/Herceptin, but I am in the sector, so probably not a typical reader in that respect
Profile Image for Megan .
203 reviews2 followers
May 16, 2021
Really thorough history of a life saving treatment for HER-2/neu positive breast cancer patients. As someone who is benefitting from Herceptin, the book made me sad (for the women who died) and incredibly thankful for myself and the other women this has helped.
Profile Image for Gabriele.
89 reviews
July 14, 2021
This story of the drug Herceptin was an important read for me. I went through the treatment for Her2Neu Breast Cancer and learning about the genesis of the drug made the treatment so much more understandable.
Profile Image for Katy.
293 reviews8 followers
June 28, 2023
I wanted to know more about the science of how Herceptin works. This was more about marketing a drug. I am not a fan of anecdotes of random people inserted into the narrative. There is too much of that for me.
651 reviews
July 3, 2024
I used to work clinical oncology. This brought a lot of memories back. I worked with one of the MDs named. I cared for patients on high dose chemo/ stem cell as well as Her patients . Good review of how we got where are today
Profile Image for Hana.
19 reviews17 followers
April 15, 2020
Interesting story, mediocre writing. Grateful for the emphasis on women’s stories battling the disease.
45 reviews
January 3, 2021
Really helped me understand the complicated process of getting one drug to market
34 reviews1 follower
February 26, 2021
Heavy on technical descriptions in the beginning, but the narrative is interesting and it really highlights the struggle to get a new drug approved, even one that shows a lot of promise early on.
This entire review has been hidden because of spoilers.
92 reviews
February 28, 2024
Origin story of Herceptin (trastuzumab), which succumbed to biosimilar competition five years ago. This book is still a classic.
163 reviews1 follower
November 3, 2016
Amazing Miracle, Thank you Dr Slamon!

Reading this book, and yes I saw the movie...again pointed out, How Very BLESSED I am to be alive! If Dr Slamon had given up on his fight to bring Herceptin to fruition...I and a very large number of women would have been dead years ago! I was able to really experience all the problems and difficulties he and many others faced. Reading about those who fought hard for its inception increases my respect and admiration. If not for those who worked so diligently to bring these developments to life many would be dead. In 1999 I was diagnosed with this aggressive form of Cancer. I truly appreciate all those women who went before me. After 8 years on Herceptin, with an OK from Dr Slamon, My weekly Herceptin was discontinued. I have been Blessed now with 16 years of life, when I had originally been given a few months.
Profile Image for Viraj.
129 reviews74 followers
November 7, 2008
A very good book mainly about the development of Her-2/Neu drug, taking it to the marketplace, what women go through when hit with breast cancer, how people try to jump to share / take credit and sometimes how the deserving guy misses out on the credits...
An important thing to learn is: it is not a good idea to trust the doctor 100%, something that most folks tend to do. You are the one who is most responsible for your own health. The doctor might be good, but might take the safest approach etc. If you want to get well, do your own homework!
174 reviews1 follower
December 30, 2013
This was recommended to me by a friend who survived breast cancer. If you read this be prepared to deal with some technical medical terms and a lot of clinical trial information. While well written, it was a little tough for me as a lay person. Some of the information was much less technical and some was way out of my comfort zone.
4 reviews
October 29, 2014
I was diagnosed with breast cancer that is HER2 neu positive. I'm not sure about anyone else but where I hoped this book would leave me feeling good, instead it left me feeling like crap. I had to keep telling myself a lot has changed since this book has been written. I would not recommend it to a sensitive patient going through the same.
7 reviews
May 27, 2008
I'm reading it now. The first chapters are amazing...
Displaying 1 - 30 of 35 reviews

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