Affiliation:
1. Department of Social Studies of Medicine McGill University Montreal Quebec Canada
2. Early Drug Development Service and Thoracic Oncology Service Memorial Sloan Kettering Cancer Center New York City New York USA
3. Department of History Université du Québec à Montréal Montreal Quebec Canada
Abstract
AbstractBased on fieldwork carried out at the Early Drug Development Service of a world‐leading cancer institution, our study sheds lights on decision‐making processes at the stage where decisions are made about which clinical trial to pursue and thus which experimental drugs will feed the growing pipeline of molecularly guided therapies and therapeutic strategies available to treating physicians. The paper shows how such collective decision‐making practices by a translational research unit employ formal tools and ad hoc valuation strategies that interweave technical‐scientific matters of concern with patient‐oriented clinical ones, as part of the institutional assetization of biomedical knowledge production. In the process, decision‐making practices in part define the conditions of possibility for the provision of care in what is increasingly becoming a ‘clinic of variants.’ They do so by reconfiguring on an evolving basis the socio‐material ecosystem through which precision oncology is enacted as a rapidly evolving assemblage of patients, physicians, research and support staff, protocols, molecular markers, drugs and administrative components.
Funder
Canadian Institutes of Health Research
LUNGevity Foundation
Subject
Public Health, Environmental and Occupational Health,Health Policy,Health (social science)