An information-theoretic Phase I/II design for molecularly targeted agents that does not require an assumption of monotonicity

Mozgunov, Pavel and Jaki, Thomas Friedrich (2018) An information-theoretic Phase I/II design for molecularly targeted agents that does not require an assumption of monotonicity. Journal of the Royal Statistical Society: Series C (Applied Statistics), 68 (2). pp. 347-367. ISSN 0035-9254

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Abstract

For many years phase I and phase II clinical trials have been conducted separately, but there has been a recent shift to combine these phases. Although a variety of phase I–II model‐based designs for cytotoxic agents have been proposed in the literature, methods for molecularly targeted agents (TAs) are just starting to develop. The main challenge of the TA setting is the unknown dose–efficacy relationship that can have either an increasing, plateau or umbrella shape. To capture these, approaches with more parameters are needed or, alternatively, more orderings are required to account for the uncertainty in the dose–efficacy relationship. As a result, designs for more complex clinical trials, e.g. trials looking at schedules of a combination treatment involving TAs, have not been extensively studied yet. We propose a novel regimen finding design which is based on a derived efficacy–toxicity trade‐off function. Because of its special properties, an accurate regimen selection can be achieved without any parametric or monotonicity assumptions. We illustrate how this design can be applied in the context of a complex combination–schedule clinical trial. We discuss practical and ethical issues such as coherence, delayed and missing efficacy responses, safety and futility constraints.

Item Type:
Journal Article
Journal or Publication Title:
Journal of the Royal Statistical Society: Series C (Applied Statistics)
Additional Information:
This is the peer reviewed version of the following article: Mozgunov, P. and Jaki, T. (2018), An information theoretic phase I–II design for molecularly targeted agents that does not require an assumption of monotonicity. J. R. Stat. Soc. C. . doi:10.1111/rssc.12293 which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/rssc.12293 This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/1800/1804
Subjects:
ID Code:
125761
Deposited By:
Deposited On:
18 Jun 2018 10:30
Refereed?:
Yes
Published?:
Published
Last Modified:
25 Sep 2020 03:45