The End of the Beginning: Cancer, Immunity, and the Future of a Cure

by Michael Kinch

Overview

A fascinating history of our understanding and the treatment of cancer by one of the leading figures in the field—who is also a pioneer on the cusp of a breakthrough.

For the first time since a 5th century Greek physician gave the name “cancer” (karkinos, in Greek) to a deadly disease first described in Egyptian Papyri, the medical world is near a breakthrough that could allow even the most conservative doctors and pragmatic patients to use the other “c word” – cure – in the same sentence as cancer. A remarkable series of events has brought us to this point, thanks in large part to a new ability to more efficiently harness the extraordinary power of the human immune system.

The End of the Beginning is a remarkable history of cancer treatment and the evolution of our understanding of its dynamic interplay with the immune system. Through Michael Kinch’s personal experience as a cancer researcher and the head of the oncology program at a leading biotechnology company, we witness the incredible accumulation of breakthrough science and its rapid translation into life-saving technologies that have begun to dramatically increase the quality and quantity of life for cancer patients.

In clear and accessible prose, Kinch details the remarkable history of people, science, technology and disease and presents thrilling next-generation technologies that hold the promise to eliminate cancer for some, and perhaps ultimately, for all.

Product Details

ISBN-13:	9781643130255
Publisher:	Pegasus Books
Publication date:	04/02/2019
Pages:	328
Product dimensions:	6.00(w) x 9.10(h) x 1.40(d)

About the Author

Michael Kinch is a professor at Washington University in St. Louis. He is the author of Between Hope and Fear (Pegasus Books), The End of the Beginning (Pegasus Books) and A Prescription for Change (UNC Press). Beyond his current work documenting the sources of innovation responsible for new medicines, he has led cancer research activities at the biotechnology company MedImmune and the development of medicines to prevent pandemic virus outbreaks at Functional Genetics, Inc. He led drug discovery at Yale University before moving to St Louis.

Table of Contents

Introduction ix

1 A Growing Concern 1

2 Surveillance State 31

3 That Which Doesn't Kill You … 55

4 Deadly Sins 86

5 An Old Story 122

6 Smart Bombs and Payloads 146

7 Designer Drugs 176

8 Checkmate! 204

9 The End of the Beginning 234

Epilogue 259

Acknowledgments 263

Endnotes 265

Index 285

Editorial Reviews

02/18/2019

Kinch (Between Hope and Fear), a radiation oncology professor at Washington University School of Medicine, approaches cancer philosophically in this well-grounded, if not groundbreaking, history of the search for a cure. Asking what is meant by the “deceiving” word “cancer,” he provides a nuanced answer that debunks misconceptions, such as cancer being a disease of accelerated cell growth, and painstakingly describes the immunization-based targeting of the disease. He sometimes indulges in elaborate asides, such as about how John D. Rockefeller’s family background motivated his founding the Rockefeller Institute, but generally remains focused, discussing many unusual cases—for example, actor Alec Guinness and his wife, Merula Silvia Salaman, dying in the same year of a rare carcinoma. Kinch also describes and explains the pioneering research linking cancer and viruses conducted worldwide during the last century. His own experiences in the 1980s bio-technology boom only come into play toward the end, where he describes the “ugly imbroglio of finger-pointing and greed” that blocked cutting-edge research. Readers may wish Kinch had given more time to this story but they will still gain from his thoughtful book an improved understanding of the “promises and perils” involved in finding a cure for cancer. Agent: Don Fehr, Trident Media Group. (Apr.)

Publishers Weekly

"Kinch builds on the narrative he began with Between Hope and Fear. He now changes focus to review cancer biology and the promise of immune-mediated treatments.  He can speak with authority [and] his narrative is lavishly ornamented. This immunologist explains it all."

New York Times

"Kinch writes with passion and authority. He deftly describes how each immune system is unique, shaped in part by individual histories of infection. The End of the Beginning is a timely reminder of the bright future in cancer treatment that seems to lie ahead."

Nature

★ 2019-01-15

A cancer researcher chronicles the history of the disease and the prospects in the search for a cure.

A cure for cancer has been just around the corner for nearly a century but is drawing near, according to this richly detailed, expert description of the history of cancer, its treatment, and research that is now producing quantum-leap breakthrough therapy. Kinch (Between Hope and Fear: A History of Vaccines and Human Immunity, 2018), oncology researcher and professor at Washington University, begins before 1900 with the brilliant but mostly obscure researchers who gradually revealed the nature of cancer. Investigations of bacteria, a 19th-century obsession, were a dead end, but studies after 1900 found that tiny, nearly invisible particles, later revealed as viruses, were one cause. Knowledge of immunity also grew, but few associated this with cancer until after World War II, when scientists discovered that antibodies and white blood cells normally destroy tissues that become malignant but sometimes fail. Since the discovery of monoclonal antibodies and cell-based immunity in the 1970s and '80s, pharmaceutical companies have been creating treatments that program the patient's own immune system to attack cancer cells alone. This is a vast improvement over traditional chemotherapy, which poisons normal cells almost as badly as malignant ones. There have also been miracle cures in which massive tumors melt away, although they remain a minority. More commonly, the cancer shrinks for a time and then resumes growing. The best of today's cutting-edge therapies fail half the time, and serious toxicities are also turning up. Finally, these "biologicals" consist of complex molecules, hundreds of times larger than the old ones. Requiring enormous time and labor, they are wildly expensive—approaching $1 million per course.

As the title suggests, scientists have reached only the end of the beginning, but the beginning of the end of cancer is on the horizon, and Kinch's intensely researched, definitely not dumbed down and lucid account makes this superbly clear.

Kirkus Reviews