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Personalized Cancer Vaccines 81<br />

early and informed decision-making through prospectively defined ‘go’ or ‘no go’<br />

decision points, use of biologic end points, adjusted clinical end points, early use<br />

of randomized trials, and adaptive design components, where applicable.” However,<br />

there remain challenges with being able to effectively apply some of these<br />

concepts in the better-prognosis patient setting. The ability to glean reliable<br />

information regarding potential efficacy at time points early in a clinical trial<br />

remains a challenge and a barrier to accelerated decision making.<br />

Continued innovation and dialogue in the regulatory process for cancer<br />

vaccine development will be critical for the sustained investment of time, effort,<br />

and funds—without which progress in this novel and important area may never<br />

be achieved.<br />

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14. Powles T, Thirlwell C, Nelson M, et al. Immune reconstitution inflammatory syndrome<br />

mimicking relapse of AIDS related lymphoma in patients with HIV 1<br />

infection. Leuk Lymphoma 2003; 44(8):1417–1419.<br />

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J Natl Cancer Inst 2002; 94(20):1523–1526.

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