Better success rates come with a price and getting more personalized is complex and expensive, but in the long run I believe it will pay because trials success rates will rise, and trials will be more targeted and less expensive to conduct, and medicine will become much more effective. My thinking of personalized medicine is for example adoptive immunotherapy (using autologous T cells genetically engineered to express a receptor against an antigen specific for a certain tumor), which looks quite real nowadays. Since it's nearly the weekend here's an 18 min TEDMED talk describing a fascinating different approach, that still seems like science fiction but I can certainly see this happen because this guy is not only very talented, he is also a doer:
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