Making Sense
Markets from Stories in New Breast Cancer Therapeutics
Sophie Mützel


Contents and Abstracts
chapter abstract

The book traces the evolution of “innovative breast cancer therapeutics,” beginning from the late 1980s until 2010, to better understand how market emergence and transformation occur in dynamic conditions of innovation. At the center of drug discovery, it shows, lie complex innovation processes in which scientists, biotechnology companies, and their funders and investors need to make sense of ambiguous findings and grapple with numerous and unpredictable interdependencies over many years of product development. To do so, they use stories, especially public stories of the future. This chapter introduces the book’s key arguments, findings, and contributions. It sketches how innovation in the field of biotechnology has been analyzed in the past and points to temporal, relational, and cognitive complexity in innovation processes. It then introduces the larger theoretical perspective of the book, before it lays out the organization of the book.

1 Markets and Stories
chapter abstract

Chapter 1 fleshes out the perspective of markets as networks of sociocognitive and sociomaterial actors, in which actors tells stories. First, it discusses different perspectives on how markets are constituted and how actions are coordinated. While these perspectives highlight pertinent structural, cultural, relational, cognitive, material, and evaluative elements, their focus is typically on already existing markets. The chapter then links a structural approach on the emergence of newness to one that takes reflexive cognition, interpretation, and evaluation practices into account. These elements of cultural processes taking place in markets lead toward the second section of the chapter. This section turns to the role of stories as the central mechanism for the emergence of markets. It examines several approaches on the study of communication of economic and organizational actors. A third section discusses how stories of a projective future shape market-making processes. This chapter purposefully serves as a framework for discussions both on markets and on stories to stress their interconnectedness, which ultimately comes together in the model on markets from stories that guides the rest of this book.

2 Breast Cancer Therapies and Innovation
chapter abstract

Chapter 2 presents the empirical context of the study of market emergence of breast cancer therapeutic treatment. After an accessible introduction to the case of breast cancer as a disease, the chapter presents a brief history of the medical understanding and treatment of breast cancer, including crucial developments in oncological and molecular research, up until the late 1980s. The second section presents developments in the field of biotechnology up until the late 1980s. Chapter 2 shows how particular ideas in medicine and the pharmaceutical industry, for example, the quest for a “magic bullet” leading to a financial “blockbuster,” have guided biomedical developments, and points to alternatives. The chapter thus leads up to developments that will be analyzed in the following empirical chapters.

3 A Market of Expectations
chapter abstract

Based on a qualitative text analysis, Chapter 3 traces how actors in the field of “innovative breast cancer therapeutics” are trying to make sense of what they are about and with whom they are competing by examining their stories. In addition to reports and press releases of biotech companies themselves, the analysis examines biotech’s financial and industry analysts, the scientific community, and other market participants in their reactions to biotech’s stories. The analysis highlights ambiguities about newly developed molecules as well as biotechs’ research strategies. When in 1998 the first molecular product is approved for breast cancer, the “market of expectations without a product,” the analysis shows, becomes “a market with a product to compare against” as even more investors and companies join in with their expectations and their stories about a possible, better future. The chapter shows how the involved actors are cognitively interrelated and come to collaboratively construct a market of expectations, which, at least temporarily, turns out to be a profitable strategy.

4 Making Sense of a Market
chapter abstract

Chapter 4 shows how different socioeconomic actors come to make sense of the market once a first therapeutic product is approved. The inquiry focuses on market research analysts’ stories, their framing of the future, and how to evaluate new products. It delineates categorization processes. The analysis highlights the evaluative and interpretive struggles to come to terms with a new therapeutic category. After some disputes, the category targeted therapies is established as that which the market of this new type of therapeutics is about. This category is collaboratively constructed across multiple network domains of science, finance, and business. Following the establishment of a narratively based market of expectations, this chapter indicates the role of categorization processes for the emergence of a new market.

5 Patterns in Meaning-Making: Categories over Time
chapter abstract

The empirical analyses of Chapter 5 then take a macroscopic view of the global market over twenty-one years. It is based on large-scale textual corpora from scientific discussions, newspapers, and press release data. Using computational methods to analyze large textual corpora, this chapter shows how the category targeted therapies comes to be institutionalized in all four fields of inquiry, thus promoting the institutionalization of a new market of targeted cancer therapeutics. Topic modeling analyses highlight different field-specific trajectories. Semantic network analyses show the shifts and drifts of research strategies and of targeted therapies in oncological research over time. From a global perspective this chapter shows the construction of the new scientific and then also economically viable category targeted therapies as formative for the new market for breast cancer therapeutics.

Conclusion: Markets from Stories
chapter abstract

Through the empirical study of innovative breast cancer therapeutics, this book has challenged the view of markets as already existing forums of exchange of goods. It asked how actions are coordinated before a market exists, that is, in situations when it is unclear who participates, who will profit, and which product may be valuable. The perspective offered suggests understanding markets as networks of sociocognitive and sociomaterial actors that are based on stories. Examining textual data using qualitative and computational methods, the book has presented a cultural analysis of the emergence of a new social formation: the market for targeted breast cancer therapeutics. The last chapter highlights findings of the empirical inquiry and relates them to my analytic model and explanatory theory. It indicates its contributions to ongoing discussion in the field of sociology and suggests how the approach that stories are the central mechanism for the emergence of markets applies more generally to the study of emerging social formations and points to areas of future research. The chapter concludes with a look at developments in the field of cancer research, which continue to stir high hopes for millions of patients.