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In recent years there has been a paradigm shift in the treatment of cancer as immunotherapy drugs have taken centre stage. The success of harnessing a patient's own immune system has led to an unprecedented expansion of treatment options for both solid and haematological malignancies. Immune checkpoint inhibitors in particular have been shown to improve outcomes in patients with a range of tumours and are in routine first line use in a number of malignancies. The development of genetically modified T cell therapy has demonstrated real advances in the treatment of haematological malignancies and, although in its infancy in the treatment of solid tumours, early successes have shown promising results.

Much excitement has centred around the observation of durable, long-term response to immunotherapy. With longer-term follow-up the suggestion of cancer cure in some patients has become a real possibility. There remain, however, challenges in the introduction of immunotherapies into standard clinical practice. While many immunotherapy drugs have been shown to be better tolerated than cytotoxic chemotherapies or targeted agents, the side effects experienced are very different from those traditionally observed with anticancer agents. Education of oncology teams and the wider medical community is paramount in ensuring early detection and correct management of side effects. Discovery of robust biomarkers to identify patients most likely to benefit from immunotherapies and those in whom side effects may occur remains elusive. The optimism created by the arrival of immunotherapy is real and justified but has also created practical problems, as patients may remain on treatment and follow-up for many years. This is a gratifying situation to be in, but one which requires increased resources for treatment units, and places an increased financial burden on healthcare systems.

This most recent book in the Association of Cancer Physicians' prize-winning Problem Solving series seeks to provide the reader with a review of the most up-to-date issues and challenges in immunotherapy treatments. Twelve chapters, written by leading authorities in the field, give an overview of the development of immunotherapy at a molecular, clinical and patient-centred level. Twenty-three individual case histories are then used to illustrate how immunotherapy has been successful across a range of tumour types, highlighting evidence-based practice and illustrating how immune-related side effects are managed in the clinic.

This is a fast-moving area of cancer treatment and we have captured the most recent findings and highlighted future developments to help healthcare professionals understand this evolving field. Our purpose has been to provide a highly readable text that is accessible and understandable for anyone interested in this exciting area of novel cancer treatment.

Ruth Board, Paul Nathan, Tom Newsom-Davis, Sophie Papa and Peter Johnson, Editors
David Cunningham, Chairman, Association of Cancer Physicians
Peter Selby, President, Association of Cancer Physicians

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