Clinical trial design strategies for personalized treatment in myeloma. (A) Current standard approach with all patients recruited and treated as part of a clinical trial with subsequent subgroup analysis that may or may not be adequately powered to examine the effect of the novel strategy in high-risk patients. (B) Trial design for high-risk patients who are identified upfront and entered into dedicated protocols. These may be phase 2 or 3 randomized studies (as shown) or earlier-phase single-arm studies. (C) Umbrella trial design with patient molecular lesions identified upfront and entered into an arm examining a therapy appropriate to that lesion. (D) Basket trial design with patients with different cancers but with a shared molecular lesion entered into a study with an agent targeted to that lesion. Figures of men and women were downloaded from https://www.aiga.org/symbol-signs (free to use).