Abstract
Background: The efficacy-toxicity trade-off based design is a practical Bayesian phase I-II dose-finding methodology. Because the design's performance is very sensitive to prior hyperparameters and the shape of the target trade-off contour, specifying these two design elements properly is essential.
Purpose: The goals are to provide a method that uses elicited mean outcome probabilities to derive a prior that is neither overly informative nor overly disperse, and practical guidelines for specifying the target trade-off contour.
Methods: A general algorithm is presented that determines prior hyperparameters using least squares penalized by effective sample size. Guidelines for specifying the trade-off contour are provided. These methods are illustrated by a clinical trial in advanced prostate cancer. A new version of the efficacy-toxicity program is provided for implementation.
Results: Together, the algorithm and guidelines provide substantive improvements in the design's operating characteristics.
Limitations: The method requires a substantial number of elicited values and design parameters, and computer simulations are required to obtain an acceptable design.
Conclusion: The two key improvements greatly enhance the efficacy-toxicity design's practical usefulness and are straightforward to implement using the updated computer program. The algorithm for determining prior hyperparameters to ensure a specified level of informativeness is general, and may be applied to models other than that underlying the efficacy-toxicity method.
Original language | English (US) |
---|---|
Pages (from-to) | 657-666 |
Number of pages | 10 |
Journal | Clinical Trials |
Volume | 11 |
Issue number | 6 |
DOIs | |
State | Published - Dec 20 2014 |
Keywords
- Adaptive design
- Bayesian design
- Clinical trial
- Dose-finding
- Phase I/II trial
ASJC Scopus subject areas
- Pharmacology
MD Anderson CCSG core facilities
- Biostatistics Resource Group