3.8 Article

A system for determining maximum tolerated dose in clinical trial

Journal

STATISTICAL THEORY AND RELATED FIELDS
Volume 5, Issue 4, Pages 288-302

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/24754269.2021.1871708

Keywords

Bayesian methods; continual reassessment method (CRM); drug dose finding; Markov chain Monte Carlo (MCMC) method; maximum tolerated dose (MTD); phase I clinical trial; toxicity responses

Funding

  1. Keying Ye and Min Wang

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This study proposes an overall MTD framework that includes different toxicity levels classifications for a single toxicity outcome, investigates the mechanism of determining MTD and conducts simulation studies, while also applying the concepts of CRM and Bayesian analysis.
Toxicity study, especially in determining the maximum tolerated dose (MTD) in phase I clinical trial, is an important step in developing new life-saving drugs. In practice, toxicity levels may be categorised as binary grades, multiple grades, or in a more generalised case, continuous grades. In this study, we propose an overall MTD framework that includes all the aforementioned cases for a single toxicity outcome (response). The mechanism of determining MTD involves a function that is predetermined by user. Analytic properties of such a system are investigated and simulation studies are performed for various scenarios. The concept of the continual reassessment method (CRM) is also implied in the framework and Bayesian analysis, including Markov chain Monte Carlo (MCMC) methods are used in estimating the model parameters.

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