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Genomic medicine enters the clinic: translational research, actionable mutations, clinical utility, and the reframing of oncology

Alberto Cambrosio

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Canadian Institutes of Health Research (CIHR)
The nature and scope of genomic initiatives in the cancer domain has expanded dramatically in recent years. A shift from the initial focus on diagnosis to the development of targeted therapies has given renewed meaning to notions such as personalized or precision medicine. The validation and testing of these therapies in clinical trials, their approval by regulators, and the necessary articulation of novel approaches with established clinical practices raise, however, a number of major organizational, regulatory, and sociotechnical issues, which in turn call for innovative solutions. These often-controversial solutions include the redesign of clinical trials and their organizational infrastructure, the mobilization of novel analytical platforms, and, in the end, a major reshaping of clinical and translational research. The purpose of our comparative (North America - Europe) project is to provide an analytical understanding of this complex dynamics, based on a detailed empirical investigation of the aforementioned initiatives, complemented by the use of network-analysis tools to closely follow and map developments and trends in the biomedical literature. In particular, we seek to analyze how fundamental changes in the social, organizational and conceptual configuration of biomedical practices are accompanied by the emergence of new collective modes of practice and interaction in the biomedical domain.

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