Peter Keating

Signs, markers, profiles, and signatures: clinical haematology meets the new genetics (1980-2000)

We propose that a fruitful way to understand the extension of molecular biology into clinical practice is through the notion of biomedical platform. In this article, we analyze the development of the new genetics in clinical haematology since the mid‐1980s, focusing on two recent instantiations of the molecular biology platform: RT‐PCR and DNA microarrays. We show how clinical research is more closely entwined with “fundamental” biology than is often imagined and simultaneously caution that the use of techniques in clinical research does not automatically entail their use in routine clinical practice. The article calls attention to the work of articulation and regulation as constitutive aspects of a platform that enters standard clinical use.

What’s in a Pill? On the Informational Enrichment of Anti-Cancer Drugs

The May 28, 2001, cover of Time splashed the following headline: “There Is New Ammunition in the War Against Cancer: These Are the Bullets.”* Color-coded in orange, the words ammunition, cancer, and these pointed to a tiny pile of orange pills identified in a smaller headline: “Revolutionary new pills like GLEEVEC combat cancer by targeting only the diseased cells. Is this the breakthrough we’ve been waiting for?” Two years later, Daniel Vasella, Chairman and CEO of Novartis, the maker of Gleevec, reiterated both the color theme and the war metaphor in the title of his book Magic Cancer Bullet: How a Tiny Orange Pill Is Rewriting Medical History (Vasella, 2003).1

Cancer Research and Protocol Patients: From Clinical Material to Committee Advisors

As discussed by social scientists in relation to AIDS,1 neuromuscular diseases,2 and, more generally, internet discussion groups3 and biomedical research,’ patient activism has been on the rise in recent years.5 Cancer is no exception. Presently, in the US, more than 850 cancer advocacy organisations and associations — most founded within the last 15 years — sometimes cooperate and sometimes compete in an extremely partisan (and increasingly controversial)6 environment. The most important of the cancer patient advocate groups, the National Breast Cancer Coalition, formed in 1991, now comprises over 600 member organisations and over 70,000 members.’ In 1993, eight different patient groups established the Cancer Leadership Council in an attempt to reach a consensus on health care reform; the Council now federates 33 groups. By the mid-1990s other associations began to put together their own strategies and increase their political visibility. In 1996, prostate cancer activists met to form the National Prostate Cancer Coalition (NPCC), and a coalition of advocacy groups came together under the name of the Intercultural Cancer Council in early 1995, calling for, among other things, greater participation of minority physicians and patients in clinical trials.8 Similar trends can be seen in Europe, where groups such as Europa Donna9 (breast cancer) and its counterpart Europa Uomo (prostate cancer), established respectively in 1993 and 2002, came together in 2003 with close to 200 other organisations under the umbrella of the European Cancer Patient Coalition (ECPC).10