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A Bayesian model-free approach to combination therapy phase Ⅰ trials using censored time-to-toxicity data

机译:使用审查的毒性时间数据的贝叶斯无模型联合疗法Ⅰ期试验方法

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摘要

The product of independent beta probabilities escalation design for dual agent phase Ⅰ dose escalation trials is a Bayesian model-free approach for identifying multiple maximum tolerated dose combinations of novel combination therapies. Despite only being published in 2015, the design has been implemented in at least two oncology trials. However, these trials require patients to have completed follow-up before clinicians can make dose escalation decisions. For trials of radiotherapy or advanced therapeutics, this may lead to impractically long trial durations due to late-onset treatment-related toxicities. We extend the product of independent probabilities escalation design to use censored time-to-event toxicity outcomes for making dose escalation decisions. We show via comprehensive simulation studies and sensitivity analyses that trial duration can be reduced by up to 35%, particularly when recruitment is faster than expected, without compromising on other operating characteristics.
机译:双剂Ⅰ期剂量递增试验的独立beta概率递增设计产品是一种贝叶斯无模型方法,用于识别多种新型联合疗法的最大耐受剂量组合。尽管该设计仅在2015年发布,但已至少在两项肿瘤学试验中实施了该设计。但是,这些试验要求患者在临床医生做出剂量递增决定之前必须完成随访。对于放射疗法或先进治疗方法的试验,由于与后期发作有关的毒性,可能导致不切实际的长试验期。我们扩展了独立概率递增设计的产品,以使用经过审查的事件发生时间的毒性结果来做出剂量递增决策。我们通过全面的仿真研究和敏感性分析表明,试验持续时间最多可缩短35%,尤其是在招募速度快于预期的情况下,而不会影响其他操作特性。

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