TABLE 1.

Oncology Care and Clinical Trials in the Eras of Population Oncology, Transition, and Personalized Oncology

	Population Oncology	Transitional Era	Personalized Oncology
Screening	population-wide risk reduction	population-wide approaches modified for at-risk sub-populations	individualized risk estimation & programs adapted to individual risk
Diagnosis	organ-of-origin/histology-based	organ-of-origin, histology, & some molecular markers	primarily molecular marker-based
Staging	anatomic extent of disease	anatomic extent with some molecular risk profiling	primarily molecular-risk based
Treatment Determination	typically organ-of-origin & stage-based	organ-of-origin & stage-based with some implementation of molecular markers	primarily molecular marker-based
Assessment Intervals	based on clinical evaluation/exam findings	based on routine interval imaging	early, frequent serial assessments by imaging, circulating tumor cells and other marker assessments
Early Phase Clinical Trials	oriented to maximum tolerated dose	oriented to “optimum biologic dose”	determine range of tolerable & active doses
Mid-Phase Clinical Trials	histology & prior treatment based eligibility; typically single arm non-comparator trials	histology & prior treatment based eligibility; some marker-based screening; some randomized, controlled trials	some trials histology & prior treatment based eligibility with rapid, serial assessments; many with eligibility restricted to tumor marker subsets