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Informing materials: drugs as tools for exploring cancer mechanisms and pathways

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Abstract

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.

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Fig. 1

Source: Karnofsky (1968, p. 233). Reproduced with the kind permission of John Wiley and Sons

Fig. 2

Source: Rini and Atkins (2009, p. 993). Reproduced with the kind permission of Elsevier

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  • 04 December 2017

    The original version of this article unfortunately contained a mistake. Three entries are incorrect in the reference list. The corrected references are given below.

Notes

  1. See, e.g., http://www.genomecanada.ca/en/programs/leading-edge-technologies/past-competitions/2015-disruptive-innovation-genomics-competition.

  2. Analogies with the field of evolution have become common: for a somewhat extreme example see Walther et al (2015). For a philosopher’s critical assessment of evolutionary accounts of cancer, see Germain (2012).

  3. The ensuing organizational changes for clinical research systems are far from trivial (Ramos and Bentires-Alj 2015). There has been in recent years a proliferation of proposals and initiatives for developing innovative clinical trial designs and infrastructures.

  4. http://www.cancer.gov/news-events/press-releases/2014/ExceptionalRespondersQandA.

  5. The Web of Science defined the resulting publication as both a “hot paper” (a paper published in the past two years that received enough citations to place it in the top 0.1% of papers in the academic field of Clinical Medicine), and a “highly cited paper” (as “it received enough citations to place it in the top 1% of the academic field of Clinical Medicine based on a highly cited threshold for the field and publication year”).

  6. See Greene (2007) for a somewhat similar argument concerning the role of pharmaceutical marketing.

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Acknowledgements

We thank the clinicians and researchers who kindly accepted to be interviewed and gave us permission to quote their remarks. Special thanks to the reviewers whose constructive objections, duly mentioned in the text, allowed us to expand and enrich our arguments. Research for this paper was made possible by Grants from the Canadian Institutes for Health Research (CIHR MOP-93553) and the Fonds de recherche du Québec Société et Culture (FRQSC SE-164195), and by an FRQSC postdoctoral fellowship to EVG.

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  1. Department of Social Studies of Medicine, McGill University, 3647 Peel, Montreal, QC, H3A 1X1, Canada

    Etienne Vignola-Gagné & Alberto Cambrosio

  2. Department of History, University of Quebec at Montreal, Case Postale 8888, Succursale Centre-Ville, Montreal, QC, H3C 3P8, Canada

    Peter Keating

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  1. Etienne Vignola-Gagné
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Correspondence to Etienne Vignola-Gagné.

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A correction to this article is available online at https://doi.org/10.1007/s40656-017-0170-1.

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Vignola-Gagné, E., Keating, P. & Cambrosio, A. Informing materials: drugs as tools for exploring cancer mechanisms and pathways. HPLS 39, 10 (2017). https://doi.org/10.1007/s40656-017-0135-4

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