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Histology agnosticism: Infra-molecularizing disease?

Jonah Campbell1, Alberto Cambrosio1, Mark Basik2

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

Studies in History and Philosophy of Science
|February 20, 2024
PubMed
Summary

The infra-molecular concept refines "molecularization" in cancer care. Histology agnosticism in oncology research reconfigures drug development and treatment, showing histology

Keywords:
GenomicsMolecularizationPrecision oncologyTargeted therapiesTissue agnosticism

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Area of Science:

  • Science and Technology Studies
  • Oncology
  • Genomics

Background:

  • The concept of "molecularization" describes the shift from anatomical to submicroscopic views of the body.
  • Health and illness are increasingly defined by an individual's genetic makeup.
  • This shift is particularly relevant in (post)genomic oncology.

Purpose of the Study:

  • To introduce and explore the concept of the "infra-molecular" in (post)genomic oncology.
  • To analyze how infra-molecularity is practiced within the "histology-agnostic" approach in cancer research and care.
  • To examine the implications of this approach for drug development, clinical trials, therapeutic decision-making, and regulation.

Main Methods:

  • Drawing on fieldwork conducted in North American oncology settings.
  • Analysis of how "histology agnosticism" reconfigures knowledge and practice in cancer research and clinical care.
  • Examining the practical enactment of the infra-molecular gaze.

Main Results:

  • Histology agnosticism in oncology research partially reconfigures knowledge and practice across drug development, clinical trials, and therapeutic decision-making.
  • The infra-molecular gaze involves a "return" of histology as a modulator for histology-agnostic drugs.
  • Histology provides a background for interpreting the complexity of mutations.

Conclusions:

  • The infra-molecular concept offers a nuanced extension of molecularization in (post)genomic oncology.
  • Histology agnosticism, while seemingly reducing the role of histology, practically reintroduces it for interpreting complex genomic data and guiding treatment.
  • This ongoing revision impacts the understanding of cancer's biopathology and temporality.