A critical component of decision making is determining when to commit to a choice. This involves stopping rules that specify the requirements for decision commitment. Flexibility of decision stopping rules provides an important means of control over decision-making processes. In many situations, these stopping rules establish a balance between premature decisions and late decisions. In this study we use a novel change detection paradigm to examine how subjects control this balance when invoking different decision stopping rules. The task design allows us to estimate the temporal weighting of sensory information for the decisions, and we find that different stopping rules did not result in systematic differences in that weighting. We also find bidirectional post-error alterations of decision strategy that depend on the type of error and effectively reduce the probability of making consecutive mistakes of the same type. This is a generalization to change detection tasks of the widespread observation of unidirectional post-error slowing in forced-choice tasks. On the basis of these results, we suggest change detection tasks as a promising paradigm to study the neural mechanisms that support flexible control of decision rules. Flexible decision stopping rules confer control over decision processes. Using an auditory change detection task, we found that alterations of decision stopping rules did not result in systematic changes in the temporal weighting of sensory information. We also found that post-error alterations of decision stopping rules depended on the type of mistake subjects make. These results provide guidance for understanding the neural mechanisms that control decision stopping rules, one of the critical components of decision making and behavioral flexibility.

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Traditional chemotherapeutic agents non-selectively eliminate cancer cells at the expense of normal tissue; in an attempt to minimize such effects, a new class of targeted agents, immunotherapy, was introduced in the late 1950s with the discovery of interferons and the development of the first cancer vaccine. Ever since, immunotherapy evolved, exploiting different cellular mechanisms including dendritic cell therapy, monoclonal antibodies, and cytokines. Immune checkpoint inhibitors (ICPI) are the most recent subclass of this family and we herein review the basis of exploiting this new subclass of immunotherapy with radiotherapy in the context of studies evaluating their effects on human subjects and focusing on the synergism between the molecular pathways operating in the background. PubMed was searched for studies evaluating the combined use of ICPI and radiotherapy among human subjects. The majority of studies noted an increased response rate in patients receiving combined therapy with no significant increase in toxicity. Outcomes varied among the different ICPI, and treatment with combined anti-PD-1 and anti-CTLA-4 had a higher response rate compared to either modality alone. Synergistic use of ICPI and radiotherapy has the potential to improve survival, however the specifics regarding treatment plan is dependent on a myriad of factors including the genetic and molecular makeup of the tumor as well as the patient.