The Story of Taxol: Nature and Politics in the Pursuit of an Anti-cancer Drug (review)

Jordan Goodman and Vivien Walsh. The Story of Taxol. Nature and Politics in the Pursuit of an Anti-cancer Drug. New York, Cambridge University Press, 2001. 296 pp. $27.95.

This book is the tale of taxol, the anticancer drug discovered by publicly funded scientists in the bark of the Pacific yew, and of how private industry captured the drug, deserted the tree, and rewrote its history. The story begins with pieces of bark, stem, and needles of the Pacific yew that were collected in 1962 as part of a program organized by the National Cancer Institute’s (NCI) Cancer Chemotherapy National Service Center (CCNSC) to screen plant extracts for anticancer properties. The crude extract from these woody samples was found to have cytotoxic activity in 1964, and the active compound was isolated two years later and named taxol in 1967. It seemed a promising substance, but not that promising. Many thousands of compounds passed through the NCI’s drug development program, and some appeared to have better prospects than taxol. Taxol did not perform well in the assays for antileukemic activity that dominated the NCI’s testing program in the 1960s, and its promise only brightened with the introduction in the 1970s of new assays for activity against solid tumors. The compound turned out to be particularly active against one type of melanoma in mice, but its future remained uncertain. First, this activity was limited to only one route of administration, and the compound might still have been discarded had not the NCI changed its drug screening program in the early 1970s to include human tumor xenografts in nude mice. Second, although taxol did especially well against a particular mammary xenograft and entered clinical trials, some patients experienced severe adverse reactions, and the death of one patient resulted in the temporary cessation and review of all trials of the drug. For such reasons, and because of problems of solubility and supply, taxol’s development was painfully slow. At many stages in the program, it was quite unclear that taxol had a future as an anticancer drug, and the book nicely captures such uncertainties.

If this book is about the uncertainties of drug development, it is also about the different meanings of taxol to the various groups that encountered it. This is a tale of U.S. Department of Agriculture collectors, cell biologists, and chemists. To each of these groups taxol meant something very different, and Goodman and Walsh ably set out these different meanings. They also examine how, as clinical trials got underway in the mid-1980s, a shortage of supply brought others into conflict. To the NCI, the shortage not only meant that it was difficult to obtain enough of the drug for current trials, it also raised real uncertainties about the possibility of satisfying future demand should taxol prove useful against cancer. To conservationists, the growing demand for taxol meant the further destruction of old-growth forests where the slow-growing Pacific yew flourished: collecting meant stripping the bark of thousands of trees and so killing them, and conservationists attempted (and failed) to have the Pacific yew classified as a threatened species in 1990. In contrast, to many bark collectors the new demand raised hopes that a new industry might emerge around taxol to replace jobs lost because of the decline of logging. As it turned out, Bristol-Myers Squibb (which in 1991 acquired rights from the NCI to develop taxol) was not content to remain dependent on the bark, and eventually developed and patented a semi-synthesis from a precursor found in the needles of another species of yew, a renewable resource. It was no longer necessary to kill a tree to save a patient, conservationists no longer found themselves pitted against those with cancer, and bark collectors found...