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Issue 303: PARP inhibitors have transformed ovarian cancer care, but many patients require dose adjustments or drug holidays due to toxicity. We integrated real-time microscopy and mathematical modeling to investigate whether adaptive therapy, which dynamically tailors treatment to the tumor dynamics, could help to reduce cumulative drug use. The image shows two of our simulations arranged as the two strands of a DNA helix, shattered by the emblematic double strand break induced by PARP inhibitors. The simulations (strands) compare two adaptive strategies: As the tumor responds and regrows under treatment (blue lines), doses are either modulated or skipped (shading and bars; with some artistic liberties). Our work suggests that dose modulation is superior to skipping due to a diminishing dose response and delayed cell kill, and demonstrates how adaptive therapy could enable de-escalating therapy in a personalized fashion. Based on the paper: To modulate or to skip: De-escalating PARP inhibitor maintenance therapy in ovarian cancer using adaptive therapy published in Cell Systems.