Frangou, E;
              
      
            
                Holmes, J;
              
      
            
                Love, S;
              
      
            
                McGregor, N;
              
      
            
                Hawkins, M;
              
      
        
        
  
(2017)
  Challenges in implementing model-based phase I designs in a grant-funded clinical trials unit.
Trials
, 18
       (1)
    
    
    
    , Article 620.     10.1186/s13063-017-2389-2.
  
  
       
    
  
| Preview | Text s13063-017-2389-2.pdf - Published Version Download (713kB) | Preview | 
Abstract
BACKGROUND: For a clinical trials unit to run its first model-based, phase I trial, the statistician, chief investigator, and trial manager must all acquire a new set of skills. These trials also require a different approach to funding and data collection. CHALLENGES AND DISCUSSION: From the statisticians' viewpoint, we highlight what is needed to move from running rule-based, early-phase trials to running a model-based phase I study as we experienced it in our trials unit located in the United Kingdom. Our example is CHARIOT, a dose-finding trial using the time-to-event continual reassessment method. It consists of three stages and aims to discover the maximum tolerated dose of the combination of radiotherapy, chemotherapy, and the ataxia telangiectasia mutated Rad3-related inhibitor M6620 (previously known as VX-970) in patients with oesophageal cancer. We present the challenges we faced in designing this trial and how we overcame them as a way of demystifying the conduct of a model-based trial in a grant-funded clinical trials unit. CONCLUSIONS: Although we appreciate that undertaking model-based trials requires additional time and effort, they are feasible to implement and, once suitable tools such as guiding publications and document templates become available, the design and set-up process will be easier and more efficient.
| Type: | Article | 
|---|---|
| Title: | Challenges in implementing model-based phase I designs in a grant-funded clinical trials unit | 
| Location: | England | 
| Open access status: | An open access version is available from UCL Discovery | 
| DOI: | 10.1186/s13063-017-2389-2 | 
| Publisher version: | https://doi.org/10.1186/s13063-017-2389-2 | 
| Language: | English | 
| Additional information: | Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | 
| Keywords: | CRM, Continual reassessment method, Design, Dose-finding, Model-based, Phase I | 
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng | 
| URI: | https://discovery.ucl.ac.uk/id/eprint/10061641 | 
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