A nonparametric Bayesian continual reassessment method in single-agent dose-finding studies

Abstract Background The main purpose of dose-finding studies in Phase I trial is to estimate maximum tolerated dose (MTD), which is the maximum test dose that can be assigned with an acceptable level of toxicity. Existing methods developed for single-agent dose-finding assume that the dose-toxicity relationship follows a specific parametric potency curve. This assumption may lead to bias and unsafe dose escalations due to the misspecification of parametric curve. Methods This paper relaxes the parametric assumption of dose-toxicity relationship by imposing a Dirichlet process prior on unknown dose-toxicity curve. A hybrid algorithm combining the Gibbs sampler and adaptive rejection Metropolis sampling (ARMS) algorithm is developed to estimate the dose-toxicity curve, and a two-stage Bayesian nonparametric adaptive design is presented to estimate MTD. Results For comparison, we consider two classical continual reassessment methods (CRMs) (i.e., logistic and power models). Numerical results show the flexibility of the proposed method for single-agent dose-finding trials, and the proposed method behaves better than two classical CRMs under our considered scenarios. Conclusions The proposed dose-finding procedure is model-free and robust, and behaves satisfactorily even in small sample cases.