Dose-finding designs for trials of molecularly targeted agents and immunotherapies.

TitleDose-finding designs for trials of molecularly targeted agents and immunotherapies.
Publication TypeJournal Article
Year of Publication2017
AuthorsChiuzan, Cody, Jonathan Shtaynberger, Gulam A. Manji, Jimmy K. Duong, Gary K. Schwartz, Anastasia Ivanova, and Shing M. Lee
JournalJ Biopharm Stat
Volume27
Issue3
Pagination477-494
Date Published2017
ISSN1520-5711
KeywordsAntineoplastic Agents, Clinical Trials, Phase I as Topic, Dose-Response Relationship, Drug, Humans, Immunotherapy, Maximum Tolerated Dose, Medical Oncology, Molecular Targeted Therapy, Neoplasms
Abstract

Recently, there has been a surge of early phase trials of molecularly targeted agents (MTAs) and immunotherapies. These new therapies have different toxicity profiles compared to cytotoxic therapies. MTAs can benefit from new trial designs that allow inclusion of low-grade toxicities, late-onset toxicities, addition of an efficacy endpoint, and flexibility in the specification of a target toxicity probability. To study the degree of adoption of these methods, we conducted a Web of Science search of articles published between 2008 and 2014 that describe phase 1 oncology trials. Trials were categorized based on the dose-finding design used and the type of drug studied. Out of 1,712 dose-finding trials that met our criteria, 1,591 (92.9%) utilized a rule-based design, and 92 (5.4%; range 2.3% in 2009 to 9.7% in 2014) utilized a model-based or novel design. Over half of the trials tested an MTA or immunotherapy. Among the MTA and immunotherapy trials, 5.8% used model-based methods, compared to 3.9% and 8.3% of the chemotherapy or radiotherapy trials, respectively. While the percentage of trials using novel dose-finding designs has tripled since 2007, the adoption of these designs continues to remain low.

DOI10.1080/10543406.2017.1289952
Alternate JournalJ Biopharm Stat
Original PublicationDose-finding designs for trials of molecularly targeted agents and immunotherapies.
PubMed ID28166468
PubMed Central IDPMC5383533
Grant ListP01 CA142538 / CA / NCI NIH HHS / United States
P30 CA016086 / CA / NCI NIH HHS / United States