剂量选择标准以根据排序的疗效-毒性结果确定最佳剂量,而不依赖临床实用程序
Sydney Porter1, Anne Eaton2, Thomas A Murray2
1Abbott Laboratories, Maple Grove, MN, USA.
Statistical methods in medical research
|April 1, 2025
概括
新的剂量可取性标准通过专注于疗效-毒性权衡,简化了癌症治疗剂量确定. 这些基于顺序的方法提高了确定最佳生物剂量的稳定性和可用性.
科学领域:
- 临床药理学 临床药理学
- 生物统计学 生物统计学
- 在瘤学瘤学.
背景情况:
- 现代癌症疗法,如向疗法和免疫疗法,需要剂量定位策略来平衡疗效和毒性.
- 现有的方法,如EffTox和基于实用性的贝叶斯最佳区间 (U-BOIN) 设计,可能对主观参数诱导敏感.
研究的目的:
- 引入新的,基于顺序的剂量可取性标准来确定剂量,以减少主观性和简化参数提取.
- 提出一个替代的共同可接受性标准,以更一致地处理疗效-毒性权衡.
主要方法:
- 开发了两种新的基于顺序的剂量可取性标准.
- 将这些标准与现有的基于实用和基于轮的方法进行了比较.
- 综合标准与EffTox和U-BOIN设计框架和概率模型.
- 提出了一个替代的联合疗效-毒性可接受性标准.
主要成果:
- 拟议的基于订单的标准简化了实施,并提高了对主观设计参数的可靠性.
- 模拟研究显示,当结果顺序等同时,其性能与已建立的EffTox和U-BOIN设计相提并论.
- 替代的联合可接受性标准比边际标准更符合疗效-毒性权衡.
结论:
- 新的剂量可取性标准提高了癌症治疗剂量查找设计的可用性和稳定性.
- 这些方法通过有效地管理疗效-毒性权衡,方便识别最佳的生物剂量.
- 转向联合疗效-毒性概况的转变提高了剂量可取性评估的一致性.
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