Histology agnosticism: Infra-molecularizing disease?

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.