Summary

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. From the Hardcover edition.

Author Biography

Robert Bazell is the chief science correspondent for NBC News. His reports, which appear on the NBC Nightly News, Today, and Dateline NBC, have won every major award in broadcasting. He has written for many publications, including The New Republic, The New York Times, and The New York Times Magazine. He lives in New York with his wife, Margot, and daughter, Stephanie. From the Hardcover edition.

Acknowledgments

Introduction

Dr. Mary-Claire King

Prologue

Discovering Cancer

(16)

A Limited Arsenal

(10)

A New Way of Doing Science

(24)

Courting the Thought Leader

(13)

A Fabulous Endowment

(11)

The First Life Saved

(11)

The Mayor of the Infusion Room

(21)

Fighting for Compassion and Access

109

(24)

Trials and Errors

133

(9)

Failure to Accrue

142

(10)

Strawberries and Champagne

152

(26)

Springtime in L.A.

178

(9)

Epilogue

187

(10)

Notes

197

(8)

Index

205

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Excerpts

Discovering Cancer One morning in the fall of 1978, Anne McNamara showered while her husband, Jeff, tended to Luke, their one-year-old son. As she soaped and scrubbed, she felt something unfamiliar in her left breast. "Uh-oh," she thought, a chill going down her spine. She had a history of fibrocystic disease. She tried to convince herself that all this could be was just another benign growth. Silently she recited the statistics: she was thirty-two; in premenopausal women, just one out of twelve tumors turns out to be cancerous. Fighting the impulse to panic, she sought comfort in the knowledge that there was no history of cancer in her family. Anne McNamara brought uncommon understanding to her discovery. Having been a biology major and a chemistry minor in college, her first job had been in a laboratory of a scientist at Yale Medical School, who was carrying out medical research. She tested the effects of radiation and chemotherapy on cancer cells. Much as she wanted to believe that this lump, like many others she had previously had, would go away as she moved through her monthly hormonal cycle, she had a feeling that this one was different. In unguarded moments over the next couple of weeks, she probed the new growth. Had it changed? Did it feel different? Once you find a lump, she says, "You check it three times a day." After more than a month had passed without any change in the lump, she went to see her gynecologist, who said he thought it was just a cyst. Nonetheless, he sent her to a surgeon for a biopsy. Just to be sure. A few days later, McNamara met with her doctor, James Finn, who offered her the choice that most women in her position then faced: he could do the biopsy and wait until McNamara came out of the anesthesia to give her the results, or they could agree ahead of time that he would remove her breast if the tumor turned out to be malignant. McNamara, typically matter-of-fact, chose the second option, the course of least emotional complication. As Jeff remembers it, "She did not fear the worst, but she prepared for the worst." Anne's delicate appearance and honeyed Georgia accent belie her toughness. Her face settles naturally into a warm smile, and when she talks in her straightforward and low-key manner, her large green eyes and her high-arched eyebrows give the listener a clear window on her emotions. She's now a youthful fifty-two years old, with auburn hair flowing to her shoulders. Jeff, a muscular man with a neatly trimmed mustache and ice-blue eyes, had just returned from a four-year stint in the Air Force and was finishing up his business degree when they met. They lived in the same apartment building in New Haven; when Anne had totaled her motorcycle, and Jeff, an inveterate tinkerer, saw it crumpled in a corner of the garage, he asked her if he could take a crack at fixing it. They've been together ever since. Anne's surgery was scheduled for the week after Thanksgiving. Jeff stayed home with the baby and awaited word from the hospital. In the operating room, the surgeon was stunned by the lump's size: five centimeters, the size of a lemon. Moments later, a pathologist confirmed that it was a tumor and it was indeed malignant. Dr. Jim (as the McNamaras called him) phoned Jeff from the operating room. "It's not good, Jeff." "How not good?" "Bad." Jeff paused to collect himself and then said, "Do what you've got to do. Take care of her the best way that you know how." McNamara remembers slowly coming out of the anesthesia. "I was still extremely groggy, and I was trying to figure out if my breast was gone or not. I knew if it was, then it meant I had cancer. But I was so groggy that I clutched at my chest and I couldn't figure it out." As the anesthesia wore off, she realized that her torso was wrapped in a bandage. "I knew what that meant." Her doctor was flabbe