ABSTRACT

Cancer treatment ordinarily involves a series of treatment decisions made over the course of a patient’s disease. Key decision points may correspond to milestones in the disease process, such as remission, progression, or recurrence; or decisions may be necessitated by, for example, occurrence of an adverse event. In practice, at each decision point, a clinician will synthesize the accrued information on the patient, which might include demographic and

Trials: Issues in Design and

genetic/genomic information as well as evolving physiologic and other clinical variables, to select a treatment from among the available options, with the goal of “personalizing” the decision to the patient to achieve the “best” clinical outcome.