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Testing devices or experimental systems? Cancer clinical trials take the genomic turn
Nicole C Nelson1, Peter Keating2, Alberto Cambrosio3
1Department of the History of Science, University of Wisconsin-Madison, 1225 Linden Drive, Madison, WI 53706, USA.
Social Science & Medicine (1982)
|April 29, 2014
Summary
Contemporary oncology clinical trials are evolving beyond simple drug testing. They are increasingly used as experimental systems to explore complex biological questions and generate novel insights, especially with biomarker-driven approaches.
Area of Science:
- Oncology
- Clinical Research
- Biomedical Science
Background:
- Clinical trials are traditionally viewed as systematic processes for evaluating drug safety and efficacy within industrial drug development.
- This perspective often reduces trials to 'testing machines' focused on predefined outcomes.
Purpose of the Study:
- To challenge the reductionist view of clinical trials in oncology.
- To introduce a conceptual framework contrasting 'testing machines' with 'clinical experimental systems'.
- To highlight the growing use of trials for open-ended scientific inquiry.
Main Methods:
- Ethnographic fieldwork and interviews with oncology researchers (2010-2013).
- Conceptual analysis contrasting two models of clinical trials.
- Examination of trends like biomarker-driven trials and networked research.
Main Results:
- Oncology clinical trials are increasingly functioning as experimental systems, not just testing machines.
- Practitioners utilize trial heterogeneity to uncover novel biological and clinical insights.
- Biomarker-driven trials exemplify a shift towards more experimental and open-ended research.
Conclusions:
- Clinical trials in oncology are becoming more experimental, moving beyond simple drug evaluation.
- The structure of clinical research is adapting to support flexible, networked, and patient-as-model systems.
- Trials serve dual roles: generating specific data and facilitating broader scientific exploration.
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