Precision Oncology and Cancer Biomarkers

This open access book reflects on matters of social and ethical concern raised in the daily practices of those working in and around precision oncology. Each chapter addresses the experiences, concerns and issues at stake for people who work in settings where precision oncology is practiced, enacted, imagined or discussed. It subsequently discusses and analyses bioethical dilemmas, scientific challenges and economic trade-offs, the need for new policies, further technological innovation, social work, as well as phenomenological research. This volume takes a broad actor-centred perspective as, whenever cancer is present, the range of actors with issues at stake appears almost unlimited. This perspective and approach opens up the possibility for further in-depth and diverse questions, posed by the actors themselves, such as: How are cancer researchers navigating biological uncertainties? How do clinicians and policy-makers address ethical dilemmas around prioritisationof care? What are the patients' experiences with, and hopes for, precision oncology? How do policy-makers and entrepreneurs envisage precision oncology? These questions are of great interest to a broad audience, including cancer researchers, oncologists, policy-makers, medical ethicists and philosophers, social scientists, patients and health economists.

This book is open access, which means that you have free and unlimited access Brings together an interdisciplinary group of expert scholars on the timely issue of precision oncology Proposes a highly reflexive and critical perspective on precision oncology by going beyond the common perceived goodness Takes a unique actor-centred approach allowing new insights into how imagine and work with this concept

Auteur
Anne Bremer is a senior researcher at the Centre for the Study of the Sciences and the Humanities at the University of Bergen, Norway. Anne's background is broadly in Science and Technology Studies (STS), and she has been working for ten years on various projects studying how science is employed for complex and uncertain health and environmental challenges. Since 2014 her work has focussed on the ethical, legal and social aspects of cancer research, particularly precision oncology and cancer biomarkers, including what constitutes responsible research in those fields. As a researcher affiliated with the Centre for Cancer Biomarkers in Bergen, Anne is integrated within an interdisciplinary precision oncology community, and works closely with scientists - from oncologists to health economists, health philosophers and ethicists - to nurture critical reflections on the broader social context of their research. This is done in different ways, from courses to seminars, to co-authored pieces. Her experiences have been distilled in various publications, including Mapping Ethical and Social Aspects of Cancer Biomarkers (New Biotechnology; 2016), and co-editing the volume Cancer Biomarkers: Ethics, Economics and Society (Megaloceros Press; 2017).
Roger Strand is Professor at the Centre for the Study of the Sciences and Humanities and the Centre for Cancer Biomarkers (CCBIO) at the University of Bergen, Norway, and Adjunct Professor at Department of Biotechnology and Food Science, the Norwegian University of Science and Technology, Trondheim, Norway. At CCBIO, Strand is the Principal Investigator for Team 4 that researches ethical and societal aspects of cancer biomarkers and cancer research. Originally trained as a natural scientist (PhD, biochemistry 1998), Strand developed research interests in the philosophy of science and has worked on issues of scientific uncertainty and complexity, including the theory of post-normal science. This hasgradually led his research into broader strands of social research, philosophy and broader issues of policy, decision-making and governance at the science-society interface. He has coordinated two EU FP7 projects (TECHNOLIFE and EPINET), which both addressed the need for more dynamic governance of science in society. He was a member of the National Research Ethics Committee for Science and Technology in Norway (2006-2013) and Chair of the European Commission Expert Group on Indicators for Responsible Research and Innovation (2014-2015). He is one of the Directors of the European Centre for Governance in Complexity.

Contenu
Introduction (Anne Bremer and Roger Strand).- Chapter 1. Precision oncology in the news (Mille Stenmarck and Irmelin Nilsen).- Chapter 2. Cancer biomarkers from a patient's perspective (Karen Gissum).- Chapter 3. Breast cancer: reconstruction of trouble (Hanna Dillekås).- Chapter 4. HER2: an apparently 'simple' biomarkers revealing the complexities and uncertainties of precision oncology (Elisabeth Wik, Anne Bremer and Lars A. Akslen).- Chapter 5. Integrating genomic and non-genomic factors in shaping the personal fingerprint in personalised cancer treatments (Mariano Bizzari and Andrea Pensotti).- Chapter 6. Systems medicine and perspectives on precision oncology (Rune Kleppe, Inge Jonassen and Roger Strand).- Chapter 7. Precision oncology: the challenges related to publishing (Maria Lie Lotsberg).- Chapter 8. Filled with Desire, Perceive Molecules (Caroline Engen and Roger Strand).- Chapter 9. Precision health and ethical ambiguity: How much cancer can we afford to prevent? (Leonard Fleck).- Chapter 10. New cancer drugs and the public controversy: how can biomarkers contribute? (Eirik Tranvåg and Roger Strand).- Chapter 11. Assessing the cost-effectiveness of targeted therapies and checkpoint inhibitors (John Cairns).- Chapter 12. Real-world data in Health Technology Assessment of targeted cancer therapy (Jiyeon Kang).- Chapter 13. Negotiating safety and resources in a first in human cancer trial in Denmark (Line Hillersdal).- Conclusion: Precision oncology: Fact or fantasy? (Roger Strand and Anne Bremer).