Special issue

Cancer and Genomics

Scientific coordinators:
Sylvain Besle
(Centre Léon Bérard, Université Claude Bernard Lyon 1)
Pascal Ragouet
(Centre Émile Durkheim, Université de Bordeaux)

With nearly 450,000 new cases and 150,000 deaths annually, cancer continues to be a major social scourge in France, and the main focus of a large national medical and scientific community. The history of the battle against cancer is punctuated with innovations that have shaped the way treatment is organized (surgery, radiotherapy, chemotherapy), notably with the creation of specialized cancer centers (in France, the Centre de Lutte Contre le Cancer). In the last twenty years, genomics has renewed the search for treatments. Genomic sequencing technologies, used to identify and map cellular DNA, constitute a prevention, diagnosis, and treatment tool all in one and are now considered a potentially major instrument in future treatment of the disease. Genomics technologies and the treatments that accompany them have therefore come with weighty promises from health professionals, public authorities, and patient representatives. Similarly to other international initiatives (e.g., Genomics England), France has designed a program for developing genomic medicine: Plan France Médecine Génomique 2025. Cancer is prominent in the plan, the objective being to provide national access to sequencing.

In light of these observations, this special issue will explore the empirical and theoretical issues involved in developing and using genomic medicine in the field of oncology. The term “genomic medicine” does not designate a clearly delimited technology but rather a wide range of continuously evolving tools: different types of sequencing, bioinformatic analysis methods, genetic engineering, and others. This swarm of techniques and applications implies varied and in some cases unprecedented relations between science, industry, public authorities, and medicine, relations that need to be documented with detailed empirical studies. From a theoretical perspective, genomics raises crucial epistemological questions about how the processes by which cancer first develops (oncogenesis) are understood and about the social and ethics issues associated with those processes; specifically, procreation management, environmental and life habit impacts, medicalization before and after cancer onset, and family issues such as hereditary risk. But the development of genomic techniques also raises the question of relations between sociology of health and sociology of science because the large-scale deployment of sequencing scheduled by the Plan France Médecine Génomique 2025—officially presented as a clinical plan—will impact the way the judicial, ethical, organizational and professional boundaries between biomedical research and clinical practices are configured. For this reason, it seems important to us to be particularly attentive to the tensions in scale that appear when research activities and treatment activities get pulled closer together. Treatment activities are, by definition, located: in the body of the patient, in the doctor-patient relationship, in a hospital context, and in national public health policies. Research, by contrast —and particularly biomedical research—is increasingly conducted at the international scale: English-language publications, international competition for research grants, the systematic implementation of research experiments in countries outside France, the importance of international actors (pharmaceutical corporations, scientific societies). In this context, it seems to us essential to study the conditions in which genomic medicine is developing from a perspective that encompasses both clinical and research issues.

Though the following four lines of investigation are not restrictive, they seems to us to deserve particular attention:

1) Paradigm shifts and changes in research approaches in oncology. The aim is to explore the changes in theory and technique that have occurred in fundamental or clinical research in oncology. There are many explanations for the onset of cancer. The genomic approach appears prevalent today, but there are other lines of attack, including metabolism, tumor microenvironment, and approaches that focus on the new frame of the exposome. Particular attention should be paid to the role of instruments (DNA sequencers and editing tools) in these transformation processes. Science-society reconfigurations may also be investigated, notably the ways in which patients and their families appropriate genomics information and knowledge.

2) Relations between the sciences, health, and industry. Genomics has profoundly transformed the organization of medicinal drug production, which previously centered on large international pharmaceutical corporations specialized in chemistry, and of instrument design (sequencing, microfluidics, and imaging techniques). This has resulted in a myriad of enterprises (biotechnologies, artificial intelligence), some of which emerged directly out of the academic world. But new forms of collaboration are being developed as well, e.g., university-sponsored genomic clinical trials designed to test targeted pharmaceutical industry drugs. Meanwhile, patient and patient family advocacy groups may play the roles of intermediary and negotiator between these different spheres, as shown in the field of pediatric oncology (e.g., clinical trial funding/fundraising for clinical trials, and the organizing of “hybrid forums” that bring together actors from heterogeneous groups).

3) The role of data. The importance of data of various types (social, quality-of-life, health, omics) in research and treatment can no longer be doubted. And yet data collection, storage, and analysis, as well as the legal framework for all this information, raise many questions. This is a particularly important issue in genomics, where the amount of data produced can be massive (several gigabytes per patient). Although major programs for harmonizing national practices do exist (France’s Health Data Hub, for example,) policy timespans are not always aligned with daily treatment and research practices, meaning those practices have to adapt to locally available resources. This in turn gives rise to diverse techniques that are themselves worthy of study. Patient re-appropriation of data also raises numerous questions, not only because genomic data closely identify individuals but also for medical reasons that may exceed the individual framework; for example, family genetic risk detection. Another point is the strategic value these data have for other actors in either the private or public sector (insurance companies; public hospitals); this raises a large number of issues that need to be documented.

4) Access to innovations and socially rooted health inequalities. The role of clinical research in treatment no longer seems limited to a kind of “palliative care that still has some therapeutic power” (Baszanger 2002). Including patients in clinical trials, as is done for rare types of cancer, could become the norm. But this in turn impacts health inequalities due to the limited number of trial slots and trial locations. In this area, genomics could potentially amplify access issues, not only because it greatly increases the number of therapeutic strategies (over 1,600 molecules are currently being tested in oncology) but also because it is a means of subdividing existing types of cancer (for example, the distinction between “triple-negative” and “BRCA gene mutation” breast cancer). The issues of identifying and selecting patients are thus central to the implementation of genomic medicine. And while political and institutional will exists at the French and even European Union levels to circulate patients in order to provide wider access to innovative treatments, organizing such a project is difficult. Contributors to this special issue may also wish to focus on new healthcare experiences that biomedical innovations give rise to, and the treatment or biographical disruptions those innovations may cause.

5) Proposals for a critical review of a few recent and important books pertaining directly to the special issue topic are also welcome.

Contribution proposals must be between 500 and 1,500 words and written in either French or English. They must specify or include the following: 1) the specific research topic and review of the relevant literature; 2) material and methods; 3) expected results; 4) a short bibliography (no more than 5 references). Proposals that do not comply with this format will be automatically rejected.

should be sent by November 30, 2021 to Christelle Germain, assistant editor of the Revue Française de Sociologie ( and the two scientific coordinators of this special issue, Sylvain Besle ( and to Pascal Ragouet (

Contribution proposals will be examined jointly by the scientific coordinators. Acceptance letters will be sent out by January 15, 2022, at the latest.

Authors of accepted proposals must submit their full texts by May 1, 2022, at the latest. Articles may not exceed 75,000 characters (including spaces, references, and tables). Each article will be evaluated anonymously by the editorial committee of the Revue.


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Beaudevin, Claire, Ashveen Peerbaye, Catherine Bourgain. 2019. “‘It Has to Become True Genetics’: Tumor Genetics and the Division of Diagnostic Labour in the Clinic.” Sociology of Health & Illness 41 (4): 643-57.
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Tempini, Niccolò, Sabina Leonelli. 2021. “Actionable Data for Precision Oncology: Framing Trustworthy Evidence for Exploratory Research and Clinical Diagnostics.” Social Science & Medicine 272:

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