3.8 Article

Maximum tolerated dose estimations using various stopping rules in phase I clinical trial

期刊

KOREAN JOURNAL OF APPLIED STATISTICS
卷 35, 期 2, 页码 251-263

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KOREAN STATISTICAL SOC
DOI: 10.5351/KJAS.2022.35.2.251

关键词

maximum tolerated dose; phase I clinical trial; stopping rule

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Phase I clinical trial is the first step in experimenting on humans with new drugs. This paper discusses methods for determining the maximum tolerated dose and compares the SM3, NM, Rim, J3, and BSM methods. The results show that the BSM method estimates the MTD closest to the target toxicity probability, and the J3 method requires the least number of subjects.
Phase I clinical trial is called 'Dose finding study'. It is first step of experimenting on humans with new drugs developed through animal experiments or vitro experiments. The important area of interest in designing Phase I clinical trial is determining the dose that acceptable level to the patients and provides the greatest efficacy. In this paper, we explain about methods to determine the maximum tolerated dose using various stopping rules. The SM3, NM, Rim, J3, BSM methods are compared through simulation. And we consider how the methods might be reformed. As a result of the simulation, BSM estimated the MTD closest to the target toxicity probability. J3 method required the least number of subjects. These results are due to the feature of the stopping rules of both methods. The BSM adds 2 or 1 subject at the same dose level when there is a toxic reaction. In addition, the J3 method has a smaller number of subjects than the other methods. If the methods are improved by combining these features, MTD can be estimated more efficiently. If the total number of subjects can be reduced while using the stopping rule of the BSM, accurate estimation is possible for a small number of subjects.

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