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How to design a dose-finding study on combined agents: Choice of design and development of R functions


Autoři: Monia Ezzalfani aff001
Působiště autorů: Institut Curie, PSL Research University, Biometry Unit, Paris, France aff001
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0224940

Souhrn

Background

In oncology, the aim of dose-finding phase I studies is to find the maximum tolerated dose for further studies. The use of combinations of two or more agents is increasing. Several dose-finding designs have been proposed for this situation. Numerous publications have however pointed out the complexity of evaluating therapies in combination due to difficulties in choosing between different designs for an actual trial, as well as complications related to their implementation and application in practice.

Methods

In this work, we propose R functions for Wang and Ivanova’s approach. These functions compute the dose for the next patients enrolled and provide a simulation study in order to calibrate the design before it is applied and to assess the performance of the design in different scenarios of dose-toxicity relationships. This choice of the method was supported by a simulation study which the aim was to compare two designs in the context of an actual phase I trial: i) in 2005, Wang and Ivanova developed an empirical three-parameter model-based method in Bayesian inference, ii) in 2008, Yuan and Yin proposed a simple, adaptive two-dimensional dose-finding design. In particular, they converted the two-dimensional dose-finding trial to a series of one-dimensional dose-finding sub-trials by setting the dose of one drug at a fixed level. The performance assessment of Wang’s design was then compared with those of designs presented in the paper by Hirakawa et al. (2015) in their simulation context.

Results and conclusion

It is recommended to assess the performances of the designs in the context of the clinical trial before beginning the trial. The two-dimensional dose-finding design proposed by Wang and Ivanova is a comprehensive approach that yields good performances. The two R functions that we propose can facilitate the use of this design in practice.

Klíčová slova:

Agent-based modeling – Algorithms – Probability density – Probability distribution – Simulation and modeling – Toxic agents – Toxicity – Phase I clinical investigation


Zdroje

1. O’Quigley J. and Pepe M. and Fisher L. Continual reassessment method: a practical design for phase 1 clinical trials in cancer. Biometrics. 1990 Mar;46(1):33–48. doi: 10.2307/2531628 2350571

2. Wang K. and Ivanova A. Two-dimensional dose finding in discrete dose space. Biometrics. 2005 Mar; 61 (1):217–222. doi: 10.1111/j.0006-341X.2005.030540.x 15737096

3. Yuan Y. and Yin G. Sequential continual reassessment method for two-dimensional dose finding. Stat Med. 2008 Nov; 27 (27):5664–5678. doi: 10.1002/sim.3372 18618901

4. Ivanova A. and Wang K. A non-parametric approach to the design and analysis of two-dimensional dose-finding trials. Stat Med. 2004 Jun; 23 (12):1861–1870. doi: 10.1002/sim.1796 15195320

5. Mandrekar S. J. and Cui Y. and Sargent D. J. An adaptive phase I design for identifying a biologically optimal dose for dual agent drug combinations. Stat Med. 2007 May; 26 (11):2317–2330. doi: 10.1002/sim.2707 17016867

6. Mandrekar S. J. and Qin R. and Sargent D. J. Model-based phase I designs incorporating toxicity and efficacy for single and dual agent drug combinations: methods and challenges. Stat Med. 2010 May; 29(10):1077–1083. doi: 10.1002/sim.3706 20419760

7. Wages N. A. and Conaway M. R. and O’Quigley J. Continual reassessment method for partial ordering. Biometrics. 2011 Dec; 67(4):1555–1563. doi: 10.1111/j.1541-0420.2011.01560.x 21361888

8. Riviere M-K and Dubois F and Zohar S. Competing designs for drug combination in phase I dose-finding clinical trials. Statistics in medicine. 2015; 34(1):1–12. doi: 10.1002/sim.6094 24464821

9. Ivanova A. and Kim S. H. Dose finding for continuous and ordinal outcomes with a monotone objective function: a unified approach. Biometrics. 2009 Mar; 65(1):307–315. doi: 10.1111/j.1541-0420.2008.01045.x 18479486

10. Yin Guosheng and Yuan Ying. Bayesian dose finding in oncology for drug combinations by copula regression. Journal of the Royal Statistical Society: Series C (Applied Statistics). 2009; 58(2):211–224. doi: 10.1111/j.1467-9876.2009.00649.x

11. Iasonos A. and Wilton A. S. and Riedel E. R. and Seshan V. E. and Spriggs D. R. A comprehensive comparison of the continual reassessment method to the standard 3 + 3 dose escalation scheme in Phase I dose-finding studies. Clin Trials. 2008; 5(5):465–477. doi: 10.1177/1740774508096474 18827039

12. Hirakawa A. and Wages N. A. and Sato H. and Matsui S. A comparative study of adaptive dose-finding designs for phase I oncology trials of combination therapies. Stat Med. 2015 Oct; 34(24):3194–3213. doi: 10.1002/sim.6533 25974405

13. Braun Thomas M and Wang Shufang. A hierarchical Bayesian design for phase I trials of novel combinations of cancer therapeutic agents. Biometrics. 2010; 66(3):805–812. doi: 10.1111/j.1541-0420.2009.01363.x 19995354

14. Hirakawa A. and Hamada C. and Matsui S. A dose-finding approach based on shrunken predictive probability for combinations of two agents in phase I trials. Stat Med. 2013 Nov; 32(26):4515–4525. doi: 10.1002/sim.5843 23650098

15. Wages N. A. and Conaway M. R. and O’Quigley J. Dose-finding design for multi-drug combinations”, Clin Trials. 2011 Aug; 8(4):380–389. doi: 10.1177/1740774511408748 21652689

16. Conaway M. R. and Dunbar S. and Peddada S. D. Designs for single- or multiple-agent phase I trials”, Biometrics. 2004 Sep; 60(3):661–669. doi: 10.1111/j.0006-341X.2004.00215.x 15339288

17. Riviere M. K. and Yuan Y. and Dubois F. and Zohar S. A Bayesian dose-finding design for drug combination clinical trials based on the logistic model. Pharm Stat. 2014; 13(4):247–257. doi: 10.1002/pst.1621 24828456

18. Yin G. and Lin R. Comments on Competing designs for drug combination in phase I dose‐finding clinical trials by M‐K. Riviere, F. Dubois, and S. Zohar. Stat Med. 2015 Jan; 34(1):13–17. doi: 10.1002/sim.6338 25492615

19. Hirakawa A. and Sato H. Authors’ Reply”. Stat Med. 2016 Feb; 35(3):479–480. doi: 10.1002/sim.6751 26757958


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PLOS One


2019 Číslo 11
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