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Printable Handouts
Navigable Slide Index
- Introduction
- Outline
- Phase I clinical trials
- Single-agent dose finding
- Drug combination
- Motivations for drug combination
- Challenges of drug combination trials (1)
- Challenges of drug combination trials (2)
- Challenges of drug combination trials (3)
- MTD contour
- Challenges of drug combination trials: summary
- Design combination trials
- Part I: drug-combination designs for single MTD
- Finding a single MTD
- Linearization approach: zig-zag path
- Linearization approach: linear path
- Linearization approach
- BOIN design (1)
- BOIN design (2)
- Finding MTD directly
- BOIN drug-combination design (1)
- BOIN drug-combination design (2)
- Dose escalation
- Dose de-escalation
- BOIN drug-combination design (3)
- BOIN drug-combination design (4)
- Part II: drug-combination designs for MTD contour
- Finding the MTD contour (1)
- Finding MTD contour is more challenging
- Robustness is an issue
- Finding the MTD contour (2)
- Divide and conquer
- Waterfall design (1)
- Waterfall design (2)
- Waterfall design (3)
- Transition between subtrials (1)
- Transition between subtrials (2)
- Selection of the MTD contour
Topics Covered
- Challenges of drug combination trials
- Phase I combination trial designs for finding a single MTD
- Linearization approach
- BOIN design
- Phase I combination trial design for finding the MTD contour
- Waterfall design
Talk Citation
Yuan, Y. (2017, May 29). Design early phase drug combination trials: methods [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 23, 2024, from https://doi.org/10.69645/NUBM3070.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Ying Yuan has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Design early phase drug combination trials: methods
Published on May 29, 2017
29 min
Other Talks in the Series: Adaptive Clinical Trial Design
Transcript
Please wait while the transcript is being prepared...
0:00
Hello. My name is Ying Yuan.
I'm a professor in Biostatistics
at MD Anderson Cancer Center.
Today I'm going to talk about
how to design early phase drug combination trial.
0:11
So here is outline of the talk.
First, I will talk about the challenges
for designing drug combination trials
then I will talk about some specific designs
for drug combination trial,
specifically, I will talk about
how to design a trial to find a single MTD,
and how to design a trial
to find its MTD contour.
Then I will introduce some software
to implement those designs,
and I will finish the talk
with a summary statement.
0:38
As we know, the primary objective
of phase I trial
is to find its maximum tolerated dose,
which is defined as a dose
with a specific targeted toxicity rate
like 30%.
So for single-agent trials,
the standard assumption is that
toxicity monotonically increases with the dose.
So in this case, we only find a dose
with a specific target toxicity rate.
1:01
And in this monotonic assumption means,
for the single-agent trial
the toxicity order is known.
And this greatly simplifies
the dose escalation and de-escalation.
For example, if we know the current dose
is below the MTD,
we only need to escalate the dose.
If we know the current dose
is above the MTD,
we only needed to de-escalate the dose.
1:24
In recent years, there is a lot of
interest in drug combination trial.
So if you look at the medical journal,
most of the published phase I trial
are drug combination trials.
And why people are interested
in drug combination trials
is it because they are looking for
synergistic treatment effect.