Books by Alberto Cambrosio
Papers by Alberto Cambrosio
New Genetics and Society, Dec 1, 2013
sequencing technologies to generate "actionable" genomic results that can be applied to the clini... more sequencing technologies to generate "actionable" genomic results that can be applied to the clinical management of oncology patients. We argue that the term "actionable" is not merely a buzzword, but signals the emergence of a distinctive sociotechnical regime of genomic medicine in oncology. Unlike other regimes of genomic medicine that are organized around assessing and managing inherited risk for developing cancer (e.g., BRCA testing), actionable regimes aim to generate predictive relationships between genetic information and drug therapies, thereby generating new kinds of clinical actions. We explore how these genomic results are made actionable by articulating them with existing clinical routines, clinical trials, regulatory regimes, and health care systems; and in turn, how clinical sequencing programs have begun to reconfigure knowledge and practices in oncology. Actionability regimes confirm the emergence of bio-clinical decision-making in oncology, whereby the articulation of molecular hypotheses and experimental therapeutics become central to patient care.
Sociology of Health and Illness, Oct 4, 2023
Based on fieldwork carried out at the Early Drug Development Service of a world-leading cancer in... more Based 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.
Sociology of Health and Illness, Jun 28, 2008
HAL (Le Centre pour la Communication Scientifique Directe), 2014
International audienceWe presently witness a profound transformation of the configuration of biom... more International audienceWe presently witness a profound transformation of the configuration of biomedical practices, as characterized by an increasingly collective dimension, and by a growing reliance on disruptive technologies that generate large amounts of data. We also witness a proliferation of biomedical databases, often freely accessible on the Web, which can be easily analyzed thanks to network analysis software. In this position paper we discuss how science and technology studies (S&TS) may cope with these developments. In particular, we examine a number of shortcomings of the notion of networks, namely those concerning: (a) the relation between agency and structural analysis; (b) the distinction between network clusters and collectives; (c) the (ac)counting strategies that fuel the networking approach; and (d) the privileged status ascribed to textual documents. This will lead us to reframe the question of the relations between S&TS and biomedical scientists, as big data offer an interesting opportunity for developing new modes of cooperation between the social and the life sciences, while avoiding the dichotomies - between the social and the cognitive, or between texts and practices - that S&TS has successfully managed to discard
Frontiers in Pharmacology, 2013
Quantitative science studies, Sep 1, 2020
This article examines the thorny issue of the relationship (or lack thereof) between qualitative ... more This article examines the thorny issue of the relationship (or lack thereof) between qualitative and quantitative approaches in Science and Technology Studies (STS). Although quantitative methods, broadly understood, played an important role in the beginnings of STS, these two approaches subsequently strongly diverged, leaving an increasing gap that only a few scholars have tried to bridge. After providing a short overview of the origins and development of quantitative analyses of textual corpora, we critically examine the state of the art in this domain. Focusing on the availability of advanced network structure analysis tools and Natural Language Processing workflows, we interrogate the fault lines between the increasing offer of computational tools in search of possible uses and the conceptual specifications of STS scholars wishing to explore the epistemic and ontological dimensions of techno-scientific activities. Finally, we point to possible ways to overcome the tension between ethnographic descriptions and quantitative methods while continuing to avoid the dichotomies (social/cognitive, organizing/experimenting) that STS has managed to discard.
Sociology of Health and Illness, Jun 13, 2019
The recent development of cancer precision medicine is associated with the emergence of 'Molecula... more The recent development of cancer precision medicine is associated with the emergence of 'Molecular Tumour Boards' (MTBs). Attended by a heterogenous set of practitioners, MTBs link genomic platforms to clinical practices by establishing 'actionable' connections between drugs and molecular alterations. Their activities rely on a number of evidential resourcese.g. databases, clinical trial results, basic knowledge about mutations and pathways-that need to be associated with the clinical trajectory of individual patients. Experts from various domains are required to master and align diverse kinds of information. However, rather than examining MTBs as an institution interfacing different kinds of expertise embedded in individual experts, we argue that expertise is the emergent outcome of MTBs, which can be conceptualized as networks or 'agencements' of humans and devices. Based on the ethnographic analysis of the activities of four clinical trial MTBs (three in France and an international one), and of two French routine-care MTBs, the paper analyses how MTBs produce therapeutic decisions, centring on the new kind of expertise they engender. The development and activities of MTBs signal a profound transformation of the evidentiary basis and processes upon which biomedical expertise and decision-making in oncology are predicated, and, in particular, the emergence of a clinic of variants.
Presses Universitaires de France eBooks, 2007
History and Philosophy of The Life Sciences, May 18, 2017
This paper builds on previous work that investigated anticancer drugs as 'informed materials', i.... more This paper builds on previous work that investigated anticancer drugs as 'informed materials', i.e., substances that undergo an informational enrichment that situates them in a dense relational web of qualifications and measurements generated by clinical experiments and clinical trials. The paper analyzes the recent transformation of anticancer drugs from 'informed' to 'informing material'. Briefly put: in the post-genomic era, anti-cancer drugs have become instruments for the production of new biological, pathological, and therapeutic insights into the underlying etiology and evolution of cancer. Genomic platforms characterize individual patients' tumors based on their mutational landscapes. As part of this new approach, drugs targeting specific mutations transcend informational enrichment to become tools for informing (and destabilizing) their targets, while also problematizing the very notion of a 'target'. In other words, they have become tools for the exploration of cancer pathways and mechanisms. While several studies in the philosophy and history of biomedicine have called attention to the heuristic relevance and experimental use of drugs, few have investigated concrete instances of this role of drugs in clinical research.
HAL (Le Centre pour la Communication Scientifique Directe), 2012
This paper examines the emergence and development of one of the key components of genomics, namel... more This paper examines the emergence and development of one of the key components of genomics, namely gene expression profiling. It does so by resorting to computer-based methods to analyze and visualize networks of scientific publications. Our results show the central role played by oncology in this domain, insofar as the initial proof-of-principle articles based on a plant model organism have quickly led to the demonstration of the value of these techniques in blood cancers and to applications in the field of solid tumors, and in particular breast cancer. The article also outlines the essential role played by novel bioinformatics and biostatistical tools in the development of the domain. These computational disciplines thus qualify as one of the three corners (in addition to the laboratory and the clinic) of the translational research triangle.
Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences, Oct 1, 2016
The paper examines the debate about the nature and status of "Triple-negative breast cancer", a c... more The paper examines the debate about the nature and status of "Triple-negative breast cancer", a controversial biomedical entity whose existence illustrates a number of features of postgenomic translational research. The emergence of TNBC is intimately linked to the rise of molecular oncology, and, more generally, to the changing configuration of the life sciences at the turn of the new century. An unprecedented degree of integration of biological and clinical practices has led to the proliferation of bio-clinical entities emerging from translational research. These translations take place between platforms rather than between clinical and laboratory settings. The complexity and heterogeneity of TNBC, its epistemic and technical, biological and clinical dualities, result from its multiple instantiations via different platforms, and from the uneven distribution of biological materials, techniques, and objects across clinical research settings. The fact that TNBC comes in multiple forms, some of which seem to be incompatible or, at least, only partially overlapping, appears to be less a threat to the whole endeavor, than an aspect of an ongoing translational research project. Discussions of translational research that rest on a distinction between basic research and its applications fail to capture the dynamics of this new domain of activity, insofar as application is built-in from the very beginning in the bio-clinical entities that emerge from the translational research domain.
arXiv (Cornell University), Dec 31, 2019
This paper presents a contribution to the study of bibliographic corpora in the context of scienc... more This paper presents a contribution to the study of bibliographic corpora in the context of science mapping. Starting from a graph representation of documents and their textual dimension, we observe that stochastic block models (SBMs) can provide a simultaneous clustering of documents and words that we call a domain-topic model. Previous work by (Gerlach et al., 2018) investigated the resulting topics, or word clusters, while ours focuses on the study of the document clusters, which we call domains. To enable the synthetic description and interactive navigation of domains, we introduce measures and interfaces relating both types of clusters, which reflect the structure of the graph and the model. We then present a procedure that, starting from the document clusters, extends the block model to also cluster arbitrary metadata attributes of the documents. We call this procedure a domain-chained model, and our previous measures and interfaces can be directly transposed to read the metadata clusters. We provide an example application to a corpus that is relevant to current STS research, and an interesting case for our approach: the 1995-2017 collection of abstracts presented at ASCO, the main annual oncology research conference. Through a sequence of domain-topic and domain-chained models, we identify and describe a particular group of domains in ASCO that have notably grown through the last decades, and which we relate to the establishment of "oncopolicy" as a major concern in oncology.
Minerva, May 29, 2017
International Conference "Towards personalized medicine? Biomarkers between health care practices... more International Conference "Towards personalized medicine? Biomarkers between health care practices and imagined futures" at University of Vienna (June 28-29, 2012). We would like to thank the organizers, Ingrid Metzler and the late Herbert Gottweis, for their kind invitation. We would also like to thank the clinicians and researchers who kindly accepted to be interviewed, Patrick Castel who single-handedly introduced us to the sociology of organizations, and Étienne Vignola-Gagné for his thoughtful comments on the present version
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Books by Alberto Cambrosio
Papers by Alberto Cambrosio