From screening to clinical research: the cure of leukemia and the early development of the cooperative oncology groups, 1955-1966.

Recent work in the history and sociology of biomedicine has emphasized the novelty of the biomedical enterprise as a distinctive institutional, material, and epistemological configuration. Since World War II, biology and medicine have become such tightly intertwined research enterprises that those working in biomedicine cannot predict whether a particular research project, clinical investigation, or even clinical intervention will result in biological or medical facts. In this paper, we examine part of the process of the emergence of biomedicine by focusing on the development of clinical cancer trials in the United States in the years 1955-66, a period during which the clinical trials program run by the National Cancer Institute became autonomous from the Institute's screening program for anticancer compounds. We examine in particular the work carried out by the cooperative groups and the Acute Leukemia Task Force to which they belonged, analyzing the evolution of the relations between screening, chemotherapy, clinical trials, and clinical research.