Giving meaning to cancer in the era of genomics

Contract INCa (2018-2021) | Cermes3
Coordinators: Claire Beaudevin and Catherine Bourgain, Cermes3

Until recently, the genetic molecularisation of cancer has had only a limited impact on clinical management and on the organisation of care. But with the development of targeted therapies and associated genetic testing, the situation is changing.

The social sciences have taken hold of this evolution, especially by studying trials in clinical research centres. Too little attention has been given to the genomics of tumours, as a widespread and routine practice. And yet, the importance of local clinical contexts and the diffusion of standards and technologies for creating biomedicine is well-described today.

This project aims to study how the widespread introduction of genomic technologies and knowledge modifies the way professionals and patients together make sense of cancer. The arrival of genomic technologies in the field of cancer cannot be analysed as a mechanism of linear diffusion from fundamental biology to the patient, but rather as a process of negotiation between different actors (biologists, clinicians, pathologists, patients, bio-computing specialists, industrialists….). Starting from settings for negotiation – clinical genomic infrastructures, patient associations, and clinical interactions – our multi-site ethnography focuses on three molecular genetics infrastructures of the INCa (National Cancer Institute) and one recent national rapid sequencing infrastructure.

Our objective is to produce detailed qualitative data on the socio-technological, epistemic and organisational conditions that shape the integration of genomics into clinical practice in oncology, as well as on the experiences and forms of socialisation of the disease. The aim is both to highlight concrete practices from the point of view of insufficiently-studied actors and to answer the question: "Can cancer be managed as 'one genomic disease among others'"?

Collaborators: Ashveen Peerbaye (Lisis, University of Paris-Est), Marc Billaud (Centre Léon Bérard, Cnrs).