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    Rights statement: 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.

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

Research output: Contribution to journalJournal article

E-pub ahead of print
<mark>Journal publication date</mark>15/06/2018
<mark>Journal</mark>Journal of the Royal Statistical Society: Series C (Applied Statistics)
Issue number2
Volume68
Number of pages21
Pages (from-to)347-367
Publication statusE-pub ahead of print
Early online date15/06/18
Original languageEnglish

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.

Bibliographic note

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.