Continual reassessment method with regularization in phase I clinical trials

J Biopharm Stat. 2020 Nov 1;30(6):964-978. doi: 10.1080/10543406.2020.1818251. Epub 2020 Sep 14.

Abstract

Many Phase I trial designs have been developed to improve upon the standard 3+3 design. These designs can be classified as long-memory designs, for example, the continual reassessment method (CRM), and short-memory designs such as the modified toxicity probability interval (mTPI) design. Long-term memory designs use all data but their performance can be negatively affected by the model misspecification. Short-term memory designs only use data at the current dose and might lose efficiency as a result. To overcome these issues, we propose a regularized CRM (rCRM). The rCRM offers a trade-off between long-term memory and short-term memory methods. The rCRM gives more weight to data obtained at the doses with the estimated probability of toxicity closer to the target toxicity rate. The addition of a regularization term has an effect of shrinking the dimension of the model and leads to improved performance of the 2-parameter CRM. The rCRM is a good design choice to guide assignments in an expansion cohort phase of a dose-finding trial since dose assignments do not seem to change as often as in corresponding CRMs.

Keywords: Continual reassessment method; dose-expansion; dose-finding; regularization.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Clinical Trials, Phase I as Topic*
  • Computer Simulation
  • Dose-Response Relationship, Drug
  • Humans
  • Maximum Tolerated Dose
  • Probability
  • Research Design*