Genomic expertise in action

Molecular Tumour Boards and Decision-Making in Precision Oncology

Datos Bibliográficos

ID2249606
AutoresPascale Bourret (0000-0001-7294-7461, Aix‐Marseille Univ INSERM IRD SESSTIM Institut Paoli‐Calmettes Marseille France, autor de correspondencia), Alberto Cambrosio (0000-0001-5922-0137, Department of Social Studies of Medicine McGill University Montreal QC Canada)
Año2019
Volumen41
Número8
Páginas1568-1584
Fecha de publicación2019-11-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSociology of Health & Illness (JOURNAL)
Identificadores de la revistaISSN: 0141-9889 • E-ISSN: 1467-9566
EditorialWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12970
PMID31197873
OpenAlexW2950979161
IdiomaEN
Citas recibidas22
Referencias citadas37

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 resources - for example 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 conceptualised 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

Action (physics · Bioinformatics · Biology · Clinical trial · Computational biology · Data science · Gene · Genomic information · Interfacing · Molecular diagnostics · Pathology · Precision medicine · Precision oncology · Set (abstract data type · Cancer Genomics and Diagnostics · Computer Science · Genetic factors in colorectal cancer · Genetics · Genomics and Rare Diseases · Internal Medicine · Medicine