Cancer Clinical Trials: The Emergence and Development of a New Style of Practice

Clinical trials are the principal vector for the development of chemotherapy, and they have become such a pervasive element of clinical cancer research that modern oncologists tend to take them for granted. Yet the system of cancer clinical trials amounts to a relatively recent (post–World War II) innovation. Its development has proceeded through ad hoc adjustments, and has produced a self-vindicating, yet open-ended, style of practice. This paper examines the historical development and articulation of the components of this new style of practice (protocols, oncologists, statistics, patients, and diseases), and of the new kind of objectivity they engender, by drawing on selected examples from American and European cancer clinical trial systems.