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Phase 1 oncology studies focus on safety of novel treatments and identifying a dose associated with acceptable toxicity level. Various model-based designs have been proposed for guiding dose escalation and estimating maximum tolerated dose in dose-finding studies. However, these methods are either excessively conservative or imprudent by allowing overly toxic doses. Transparent and easy to implement model-assisted designs have also received increasing attention but require pre-set rules including perceived dose levels. Therefore, we propose a hybrid model-based design that has a high probability to select MTD with a good balance of overdose control by disentangling in two separate models, which is flexible and easy to implement. Extensive simulations show the model to have real promise.

Hybrid continuous reassessment method with overdose control for safer dose escalation