You're absolutely right that this is the mentality that future treatments need to take.

Yeah, and I'm sure our regulatory infrastructure will catch up sometime in the Obama administration. That is, the Malia Obama administration...

If this time frame were possible this would be ideal, however, unfortunately each of these steps (if they are possible) takes significantly longer than an evening, and typically far longer than a patient has.

Then speed them up! You might have heard the story of Steve and Gorilla Glass:

http://en.wikipedia.org/wiki/Gorilla_Glass

You're not going to tell me the actual chemical reactions are slow. It's all human labor. The speed of any organization is limited by the schedule on which results are demanded - compare the Manhattan Project to the new Bay Bridge.

This is a risky game. How do I (the scientist) know which drugs were effective? How do I know how they'll react with one another? If my focus is Steve, then do I really want to risk killing him through an unexpected cross reaction of my 30-40 untested drugs?

Yes, because Steve knows he's at risk of dying anyway. Being an intelligent person, Steve compares the risk of dying from neglect, versus dying from treatment, as apples to apples. Do you?

There are (apparently) 1210 billionairs in the world. So say they all get cancer and get this team of doctors - if any of the patients survive then some aspect of the treatment worked. If they don't some aspect failed. It would be impossible to determine which is which.

It would be impossible to determine which is which by the present statistical standards. Ie, it would be impossible to absolutely absolutely 10^7 know which was which. It might be possible for an intelligent person to make a good guess, however.

This is how technique advances in any technical field that can't be reduced to pure mathematics. If you're limited to advancing on the basis of perfect truth that absolutely * 10^7 knows it's right (even if when tested in practice, it's 90% irreproducible), you can barely advance at all. Guess what - we're barely advancing at all.

A combined focus of translational and basic research is essential, with a frequent and effective dialogue between the two.

The best way to have a frequent and effective dialogue is to make basic researchers part of the teams treating patients. The distinction is imaginary, anyway.

This was I believe the case for Steve, but not even for Steve could they do personalized drug development as described. They couldn't even try drug candidates which other developers and/or researchers had abandoned along the way - an enormous library of molecules, if properly collated.

Ultimately, your argument assumes the rate of discovery will be constant. You need to consider the research in the broader picture. Cancer is a genetic disease (in terms of pathological origin, not necessarily in hereditary terms). It cost the (publicly funded) human genome project $3bn to sequence a human genome in about 12 years. Now it costs $5000 in a week or so, and both the cost and the time is coming down.

It's a separate discussion, but you're actually making the argument against investing in basic cancer biology. Rather, all the investment should be in sequencers, etc.

Reason: consider the studies you did with the tools of 10 years ago. What was difficult then is trivial now. So in what way did it contribute to what you know now? In no way, which makes it useless - if you hadn't done the work then, expensively, you could do it now, trivially. Now, consider the studies you'll do with the tools of 10 years from now...

Of course, the practical effect of funding cancer biology is to fund tools development. But it's a somewhat indirect way to accomplish the objective...