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This style of initial accompanied by long penwork extensions in red and blue I designs and with small spirals, circles, flourishes.
Simulations indicate that this approach performs substantially better than the commonly used method and it compares favorably with other phase I designs.
We have conducted simulation studies to compare its operating characteristics using selected derived versions of EWOC because EWOC itself has already been extensively compared with common Phase I designs [3].
In almost all current Phase I designs, toxicity response is treated coarsely as a binary indicator of dose limiting toxicity (DLT) and a lot of useful toxicity information is discarded.
For phase I designs, the traditional assumption that increasing dose will always lead to increasing efficacy, appropriate for cytotoxic agents, is not applicable to novel therapeutics such as in colorectal carcinoma.
After discussion of the main inconsistencies of current phase I designs, we propose a new strategy to facilitate the inclusion of molecularly selected patients, in order to accelerate and mitigate risks in drug development as well as to increase the chance of benefit among trial participants.
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