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Abstract

Late-onset toxicity is common for immunotherapies and targeted therapies. It causes major logistic difficulty in conducting phase I trials using most existing phase I designs, which require that toxicity can be observed quickly to inform the dose assignment for the next new cohort of patients. This chapter introduces three model-based designs, including the time-to-event CRM (TITE-CRM), fractional CRM (fCRM), data augmentation CRM (DA-CRM), and a model-assisted design, i.e., time-to-event BOIN (TITE-BOIN), to deal with late-onset toxicity. Trial examples and software are provided to demonstrate the implementation of designs.

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References

  • Al-Atrash, G. (2018). Nivolumab and Ipilimumab after donor stem cell transplant in treating participants with high risk refractory or relapsed acute myeloid leukemia. ClinicalTrials. gov Identifier: NCT03600155.

    Google Scholar 

  • Babb, J., Rogatko, A., & Zacks, S. (1998). Cancer phase I clinical trials: Efficient dose escalation with overdose control. Statistics in Medicine, 17(10), 1103–1120.

    Article  MATH  Google Scholar 

  • Chan, C. Y., Li, H., Wu, M. F., Liu, C. H., Lu, H. W., Lin, Z. Q., & Li, J. (2021). A dose-finding trial for hyperthermic intraperitoneal cisplatin in gynecological cancer patients receiving hyperthermic intraperitoneal chemotherapy. Frontiers in Oncology, 11, 672.

    Article  Google Scholar 

  • Cheung, Y. K., & Chappell, R. (2000). Sequential designs for phase I clinical trials with lateonset toxicities. Biometrics, 56(4), 1177–1182.

    Article  MathSciNet  MATH  Google Scholar 

  • Efron, B. (1967, January). The two sample problem with censored data. In Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability (Vol. 4, pp. 831–853). University of California Press.

    Google Scholar 

  • Furman, R. R., Martin, P., Ruan, J., Cheung, Y. K. K., Vose, J. M., LaCasce, A. S., Elstrom, R., Coleman, M., & Leonard, J. P. (2010). Phase 1 trial of bortezomib plus RCHOP in previously untreated patients with aggressive nonHodgkin lymphoma. Cancer, 116(23), 5432–5439.

    Google Scholar 

  • Guirgis, F. W., Black, L. P., DeVos, E., Henson, M., Ferreira, J., Miller, T., Rosenthal, M., Leeuwenburgh, C., Kalynych, C., Moldawer, L., & Moore, F. (2020). Lipid intensive drug therapy for sepsis pilot: A Bayesian phase I clinical trial. Journal of the American College of Emergency Physicians Open, 1(6), 1332–1340.

    Google Scholar 

  • Huang, B., & Kuan, P. F. (2014). Time-to-event continual reassessment method incorporating treatment cycle information with application to an oncology phase I trial. Biometrical Journal, 56(6), 933–946.

    Article  MathSciNet  MATH  Google Scholar 

  • Ivanova, A., Flournoy, N., & Chung, Y. (2007). Cumulative cohort design for dose-finding. Journal of Statistical Planning and Inference, 137(7), 2316–2327.

    Article  MathSciNet  MATH  Google Scholar 

  • Leonard, J. P., Abramson, J. S., & Rutherford, S. (2017). Study of Venetoclax Plus DA-EPOCH-R for the treatment of aggressive B-cell lymphomas (V+ DA-EPOCH-R). ClinicalTrials. gov Identifier: NCT03036904.

    Google Scholar 

  • Lin, R., & Yuan, Y. (2020). Time-to-event model-assisted designs for dose-finding trials with delayed toxicity. Biostatistics, 21(4), 807–824.

    Article  MathSciNet  Google Scholar 

  • Little, R. J., & Rubin, D. B. (2019). Statistical analysis with missing data (Vol. 793). John Wiley & Sons.

    Google Scholar 

  • Liu, S., Yin, G., & Yuan, Y. (2013). Bayesian data augmentation dose finding with continual reassessment method and delayed toxicity. The Annals of Applied Statistics, 7(4), 1837.

    Article  MathSciNet  MATH  Google Scholar 

  • Magenau, J., Tobai, H., Pawarode, A., Braun, T., Peres, E., Reddy, P., Kitko, C., Choi, S., Yanik, G., Frame, D., & Mineishi, S. (2011). Clofarabine and busulfan conditioning facilitates engraftment and provides significant antitumor activity in nonremission hematologic malignancies. Blood, The Journal of the American Society of Hematology, 118(15), 4258-4264.

    Google Scholar 

  • Normolle, D., & Lawrence, T. (2006). Designing dose-escalation trials with late-onset toxicities using the time-to-event continual reassessment method. Journal of Clinical Oncology, 24(27), 4426–4433.

    Article  Google Scholar 

  • Phan, J. (2017). Trial of Stereotactic HYpofractionateD RadioAblative (HYDRA) treatment of laryngeal cancer. ClinicalTrials.gov Identifier: NCT03114462.

    Google Scholar 

  • Phan, T. G., Ma, H., Lim, R., Sobey, C. G., & Wallace, E. M. (2018). Phase 1 trial of amnion cell therapy for ischemic stroke. Frontiers in Neurology, 9, 198.

    Article  Google Scholar 

  • van Werkhoven, E., Hinsley, S., Frangou, E., Holmes, J., de Haan, R., Hawkins, M., Brown, S., & Love, S. B. (2020). Practicalities in running early-phase trials using the time-to-event continual reassessment method (TiTE-CRM) for interventions with long toxicity periods using two radiotherapy oncology trials as examples. BMC Medical Research Methodology, 20(1), 1–10.

    Google Scholar 

  • Wu, C., Liu, C., Zhu, Y., Zhou, Z., Jiang, T., Liu, W., Li, H., Wu, C., & Ye, B. (2016). Early Paleozoic magmatic history of central Inner Mongolia, China: implications for the tectonic evolution of the Southeast Central Asian Orogenic Belt. International Journal of Earth Sciences, 105(5), 1307–1327.

    Google Scholar 

  • Yin, G., & Yang, Z. (2020). Fractional design: An alternative paradigm for late-onset toxicities in oncology dose-finding studies. Contemporary Clinical Trials Communications, 100650.

    Google Scholar 

  • Yuan, Y., Wu, J., & Gilbert, M. R. (2021). BOIN: A novel Bayesian design platform to accelerate early phase brain tumor clinical trials. Neuro-Oncology Practice.

    Google Scholar 

  • Yuan, Y., Lin, R., Li, D., Nie, L., & Warren, K. E. (2018). Time-to-event Bayesian optimal interval design to accelerate phase I trials. Clinical Cancer Research, 24(20), 4921–4930.

    Article  Google Scholar 

  • Zhao, Lili, Lee, Julia, Mody, Rajen, & Braun, Thomas M. (2011). The superiority of the time-to-event continual reassessment method to the rolling six design in pediatric oncology Phase I trials. Clinical Trials, 8(4), 361–369.

    Article  Google Scholar 

  • Zhou, H., Chen, C., Sun, L., & Zeng, Z. (2021). A novel framework of Bayesian optimal interval design for phase I trials with late-onset toxicities. Contemporary Clinical Trials, 105, 106404.

    Article  Google Scholar 

  • Zhou, T., Guo, W., & Ji, Y. (2020). Pod-tpi: Probability-of-decision toxicity probability interval design to accelerate phase I trials. Statistics in Biosciences, 12(2), 124–145.

    Article  Google Scholar 

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Correspondence to Haitao Pan .

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Pan, H., Yuan, Y. (2023). Phase I Designs for Late-Onset Toxicity. In: Bayesian Adaptive Design for Immunotherapy and Targeted Therapy. Springer, Singapore. https://doi.org/10.1007/978-981-19-8176-0_2

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