Attacking multiple hallmarks at the same time requires that we do complex clinical trials of a new kind. We can randomly combine a variety of drugs to try to attack multiple hallmarks simultaneously, but the analysis of such studies would be a statistical nightmare. The new studies need to be planned using the wiring diagram of the cancer cell in question as the blueprint. And they must be conducted in a radically different way from conventional studies.These studies hold extraordinary promise, but they are virtually impossible to achieve under the government’s current regulations. Normally, when we test a new treatment, we establish a protocol and hold that constant during the trial to isolate the effect of the treatment. But in these new multi-hallmark trials, we will need to monitor the effects and adjust the approach on the fly – during the trial – to fully use all the information at our disposal. Current regulations make it difficult to get that kind of study approved.