GUIP1: a R package for dose escalation strategies in phase I cancer clinical trials
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(2020) 20:134
SOFTWARE
Open Access
GUIP1: a R package for dose escalation strategies in phase I cancer clinical trials D. Dinart1†, J. Fraisse2†, D. Tosi2, A. Mauguen3, C. Touraine2, S. Gourgou2, M. C. Le Deley4,5, C. Bellera1 and C. Mollevi2,6*
Abstract Background: The main objective of phase I cancer clinical trials is to identify the maximum tolerated dose, usually defined as the highest dose associated with an acceptable level of severe toxicity during the first cycle of treatment. Several dose-escalation designs based on mathematical modeling of the dose-toxicity relationship have been developed. The main ones are: the continual reassessment method (CRM), the escalation with overdose control (EWOC) method and, for late-onset and cumulative toxicities, the time-to-event continual reassessment method (TITE-CRM) and the time-to-event escalation with overdose control (TITE-EWOC) methods. The objective of this work was to perform a user-friendly R package that combines the latter model-guided adaptive designs. Results: GUIP1 is an R Graphical User Interface for dose escalation strategies in Phase 1 cancer clinical trials. It implements the CRM (based on Bayesian or maximum likelihood estimation), EWOC and TITE-CRM methods using the dfcrm and bcrm R packages, while the TITE-EWOC method has been specifically developed. The program is built using the TCL/TK programming language, which can be compiled via R software libraries (tcltk, tkrplot, tcltk2). GUIP1 offers the possibility of simulating and/or conducting and managing phase I clinical trials in real-time using file management options with automatic backup of study and/or simulation results. Conclusions: GUIP1 is implemented using the software R, which is widely used by statisticians in oncology. This package simplifies the use of the main model-based dose escalation methods and is designed to be fairly simple for beginners in R. Furthermore, it offers multiple possibilities such as a full traceability of the study. By including multiple innovative adaptive methods in a free and user-friendly program, we hope that GUIP1 will promote and facilitate their use in designing future phase I cancer clinical trials. Keywords: Phase 1 clinical trial, Graphical user interface, Dose escalation design
Background The development of cancer drugs in a clinical setting requires a well-codified procedure. Phase I studies of a new treatment are usually the first to involve human subjects, and their aim is to select doses according to * Correspondence: [email protected] † D. Dinart and J. Fraisse contributed equally to this work. 2 Institut du Cancer Montpellier (ICM), Université de Montpellier, Montpellier, France 6 Institut de Recherche en Cancérologie de Montpellier INSERM U1194, Université de Montpellier, Montpellier, France Full list of author information is available at the end of the article
acceptable toxicity. The drug efficacy is then preliminarily tested in a phase II trial. Finally, a phase III trial compares the safety and efficacy of the new treat
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