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Utility-based dose selection for phase II dose-finding studies

  • Aouni, Jihane
  • Bacro, Jean
  • Toulemonde, Gwladys
  • Colin, Pierre
  • Darchy, Loic
Publication Date
Feb 26, 2020
Kaleidoscope Open Archive
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Dose selection is a key feature of clinical development. Poor dose selection has been recognized as a major driver of development failure in late phase. It usually involves both efficacy and safety criteria. The objective of this paper is to develop and implement a novel fully Bayesian statistical framework to optimize the dose selection process by maximizing the expected utility in phase III. The success probability is characterized by means of a utility function with two components, one for efficacy and one for safety. Each component refers to a dose-response model. Moreover, a sequential design (with futility and efficacy rules at the interim analysis) is compared to a fixed design in order to allow one to hasten the decision to perform the late phase study. Operating characteristics of this approach are extensively assessed by simulations under a wide range of dose-response scenarios.

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