Complexity and integration are longstanding widely debated issues in philosophy of science and recent contributions have largely focused on biology and biomedicine. This paper specifically considers some methodological novelties in cancer research, motivated by various features of tumours as complex diseases, and shows how they encourage some rethinking of philosophical discourses on those topics. In particular, we discuss the integrative cluster approach, and analyse its potential in the epistemology of cancer. We suggest that, far from being the solution to tame cancer complexity, this approach offers a philosophically interesting new manner of considering integration, and show how it can help addressing the apparent contrast between a pluralistic and a unitary account.
KeywordsComplexity; Integration; Cancer; Precision medicine US President R. Nixon called the War on Cancer 1 . Since then, journals devoted to cancer research have published an increasingly large number of articles dealing with such molecular mechanisms, which also undoubtedly spurred many philosophers to investigate their nature and role.Together with most scholars in the field, Weinberg claimed that the reductionist approach resulted in remarkable steps forward in our knowledge of the details of what happens locally in certain cell compartments or in certain infracellular signalling lines. Notwithstanding its oversimplifications, the approach led to significant progress concerning the role of certain viruses in cancerogenesis, the function of oncogenes and oncosuppressors, the impact of genome and epigenome mutations, and many others. Unfortunately, however, the huge efforts of small and large laboratories over the world did not lead to victory in the cancer war, nor did they reach global knowledge of what cancer is, how it develops and how it can be defeated.It is also worth recalling that a silent change occurred in the main cancer research centres about 15 years ago: the number of bioinformaticians drastically increased, especially because the new sequencing biotechnologies started producing enormous quantities of data at an unprecedented pace, with the immediate need to govern them and understand their meaning 2 .Further major changes gradually took place. New biotechnologies and the 'omics' involved opened the road to an acknowledgement that cancerogenesis and metastatic processes were not easily understandable and that a purely reductionist approach, despite all its positive aspects, could not lead to a genuine comprehension of their nature and behaviour. Greater awareness of the limits and gaps in scientific knowledge on the topic had a major impact on attitudes and expectations concerning treatments and their efficacy. It was soon realized that cancer is an extremely spatially, temporally and hierarchically complex disease, and that a new approach was needed: an approach that could not disregard the enormous databases made available by the deluge of data produced by laboratories.Analysing this scenario, Weinberg's paper reaches a concl...