@nickwedig It takes a long time and a lot of lists. Back in the day I was part of a three-person team tasked with anglicising 'Harold and Kumar Go To White Castle'. It took us ten minutes to get 'Harold and Kumar Get The Munchies' and two more days to not come up with anything better. But those two days were absolutely crucial to the process.
@nickwedig Alas Vegas was originally called Vague As Hell, and then it was Blackjack, and briefly Craps, then The Fields, and then something else I can't remember. Very, very occasionally the right title comes immediately. Sometimes it takes years.