Cancer on Trial电子书

Cover

Copyright

Title Page

Dedication

Contents

Foreword

Acknowledgments

INTRODUCTION

CHAPTER 1. From “Nonentity” to Global Network

The Rise of a New Style of Biomedical Practice

An Early Career in Clinical Oncology

About This Book

A Capsule History of Cancer Clinical Trials

Cancer Clinical Trials as a New Style of Practice

The Protocol

Conclusion

PRELUDE. Before There Were Trials

Cancer Hospitals and Cancer Institutes

Diagnosing Cancer

Treating Cancer

Prognosticating Cancer

Testing Therapies

Conclusion

PART 1. The Emergence of Clinical Cancer Research (1955–66)

CHAPTER 2. A Landmark Clinical Trial

Curing Leukemia: The VAMP Trial

A Collective Undertaking

The Elements of Innovation

What about the Patients?

CHAPTER 3. The Collective Turn: Cooperative Groups as Epistemic Organizations

Assembling the US Cooperative System

Screening for Drugs: From Mice to Humans

Tinkering with the Cooperative Group Structure

Meanwhile in Europe …

Conclusion

FIRST INTERLUDE. Clinical Trial Statistics

What Is a Random Sample?

What Is Statistical Significance?

CHAPTER 4. Statisticians, Statistics, and Early Cooperative Clinical Trials

Statisticians at the NIH

Statisticians in Paris

Fabricating the Tools of the Trade

Controversial Methods

The Emergence of the Phase System

Conclusion

CHAPTER 5. Criticism and the Redefinition of Clinical Cancer Trials as an Autonomous Form of Research

Clinical Cancer Research under Fire

The Reorganization of Screening and Clinical Trials in the United States

Surgery and Radiotherapy in the Cooperative Groups

PART 2. An Avalanche of Numbers from the New Style of Practice (1965–89)

CHAPTER 6. A Web of Trials

Breast Cancer and Its Trials

The Lessons of the Breast Cancer Trials

The Emergence of Combination Chemotherapy

The Multiple Meanings of Breast Cancer Trials

Conclusion

CHAPTER 7. Statisticians, Data Centers, and the Organization of Large-Scale Clinical Trials

Centers of Calculation: US Statisticians and the Data Center

The Mechanics of Data Production

Meanwhile in Europe, Take Two

Back in the USA: Group Statisticians and NCI Statisticians

Insiders’ Dissent: The Randomization Debate

CHAPTER 8. A Relational Space of Substances and Regimens

The Clinical Evaluation of Substances

Screening Substances: The Animal Screen

Procuring Compounds

CHAPTER 9. Oncopolitics? Reshaping Collaborative Research

Centralization or Coordination? The European Debate

Clinical Trials as Clinical Research: The US Debate

Oncology in the Community

PART 3. Targeted Therapy, Targeted Trials (1990–2006)

SECOND INTERLUDE. Molecular Biology and Oncogenes

Introduction

The Rise of Molecular Biology

Cancer and Molecular Biology: 1960–80

The Clinical Isolation of Human Oncogenes

Oncogenes and Oncoproteins since 1982

CHAPTER 10. Magic Bullets? The Gleevec Trials

Molecular Biology and Targeted Substances

The Trials of a Targeted Therapy

Where Did Gleevec Come From?

Monitoring Data, Managing Risks

A Medical Oncologist and His Patients

Patients and Activists

Conclusion

CHAPTER 11. Targeted Therapy and Clinical Cancer Research

Introduction: Molecular Biology and Translational Research

Molecular Biology and the US Cooperative Groups

The Reorganization of the Drug Discovery Process and the Transformation of the NCI Screen

Clinical Trials in a Targeted Age

More Oncopolitics

Conclusion

CONCLUSION

CHAPTER 12. Looking Back and Looking Forward

The Observational Alternative to Clinical Cancer Trials

Comparative Effectiveness and Clinical Trials

Coda

Notes

References

Index