Between Bench and Bedside: Science, Healing, and Interleukin-2 in a Cancer Ward

About the Book

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 Löwy 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.

Löwy, 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. Löwy 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.

About the Author :
Ilana Löwy is Senior Researcher, INSERM (U158), Hôpital Necker-Enfants Malades, Paris.

Review :
[F]uture historians of medicine will...have to rely on reports from emissaries to the cancer wards of the 1990s. Between Bench and Bedside is an important contribution to that literature...[Löwy's] account includes a clear description of the underlying science--which, being immunological, is very complicated. But she is mainly concerned with the way doctors, scientists and patients coped with the gradual realization that interleukin-2 is not all they had hoped it to be. [Illana Löwy] is an excellent writer. In Between Bench and Bedside, she provides a rich analytic and descriptive study of the interplay between the worlds of basic biomedical and clinical research in the 'war' against cancer. Between Bench and Bedside provides the reader with a remarkable view of the culture of clinical experimentation in oncology, in particular, a view of the interactions between the biology laboratory and the oncology ward. In this book, a clinical trial of interleukin-2 (IL-2) begun in 1986 at the Cancer Foundation, a major French cancer treatment center, is critically examined in an attempt to answer the question 'What can be learned from the study of a semiroutine clinical experiment in a cancer treatment center?'...By using perspectives borrowed from the histories of science and medicine, the sociology of scientific knowledge, the ethnography of the laboratory and the sociology of medicine, she creates a very realistic picture of this and other clinical trails...Between Bench and Bedside makes for excellent reading and can be highly recommended to immunologists and those among scientists and the public who seek to know more about the challenges involved in developing effective treatments for human malignancies. Between Bench and Bedside is a fascinating journey across many boundaries: between the worlds of the laboratory and the clinic, between the disciplines of history and ethnography, and between medical research communities on both sides of the Atlantic. Löwy's compelling account of the development of an innovative anti-cancer therapy gives us an important lesson in how biomedicine is able to simultaneously achieve generality while cultivating its local dimensions.