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Decision-making as discovery: Vetting clinical research in a leading precision oncology service

Alberto Cambrosio1, Jonah Campbell1, Alexander E Drilon2

  • 1Department of Social Studies of Medicine, McGill University, Montreal, Quebec, Canada.

Sociology of Health & Illness
|October 5, 2023
PubMed

Insights

This study examines how decisions are made on experimental cancer drugs for clinical trials. It reveals how these choices shape precision oncology by integrating scientific data with patient care needs.

Area of Science:

  • Oncology
  • Translational Research
  • Health Systems Science

Background:

  • Early drug development services are crucial for advancing cancer therapies.
  • The selection of clinical trials dictates the future pipeline of precision oncology treatments.
  • Understanding decision-making in this context is vital for optimizing drug development and patient care.

Purpose of the Study:

  • To analyze the decision-making processes for selecting experimental drugs in early drug development.
  • To explore how scientific and clinical factors are integrated in these decisions.
  • To understand the role of these decisions in shaping the landscape of precision oncology.

Main Methods:

  • Fieldwork conducted at an Early Drug Development Service.
  • Analysis of collective decision-making practices within a translational research unit.
  • Examination of formal tools and ad hoc valuation strategies used in decision-making.

Main Results:

  • Decision-making involves a blend of technical-scientific and patient-oriented clinical considerations.
  • These practices contribute to the institutional 'assetization' of biomedical knowledge.
  • The process reconfigures the socio-material ecosystem of precision oncology.

Conclusions:

  • Decision-making in early drug development significantly influences the availability of molecularly guided therapies.
  • These practices are central to the evolving 'clinic of variants' and precision oncology.
  • The study highlights the dynamic interplay of various components in enacting precision oncology.
Keywords:
biomedical innovationclinical trialsdecision-makingprecision oncologytranslational research

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