UCSF

In the development of new cancer treatment, an essential step is to determine the maximum tolerated dose in a phase I clinical trial. In general, phase I trial designs can be classified as either model-based or algorithm-based approaches. Model-based phase I designs are typically more efficient by using all observed data, while there is a potential risk of model misspecification that may lead to unreliable dose assignment and incorrect maximum tolerated dose identification. In contrast, most of the algorithm-based designs are less efficient in using cumulative information, because they tend to focus on the observed data in the neighborhood of the current dose level for dose movement. To use the data more efficiently yet without any model assumption, we propose a novel approximate Bayesian computation approach to phase I trial design. Not only is the approximate Bayesian computation design free of any dose-toxicity curve assumption, but it can also aggregate all the available information accrued in the trial for dose assignment. Extensive simulation studies demonstrate its robustness and efficiency compared with other phase I trial designs. We apply the approximate Bayesian computation design to the MEK inhibitor selumetinib trial to demonstrate its satisfactory performance. The proposed design can be a useful addition to the family of phase I clinical trial designs due to its simplicity, efficiency and robustness.