Abstract
In the last 20 years, breakthroughs in the understanding of cancer cell biology resulted in the development of MTAs that are targeted to the unique genetics of each tumor and each patient. MTAs modulate specific aberrant pathways in cancer cells while sparing normal tissues, so that some MTAs do not necessarily need to be administered at their MTD to have maximal efficacy. Therefore, dose-finding methods that take into account the bivariate-correlating outcomes of both efficacy and toxicity are required for the clinical development of MTAs. In addition, the dose–efficacy model for MTAs is necessary to capture the specific relation between efficacy and the dose level. The efficacy may increase initially with the dose level but then reaches a plateau; however, this situation may not always be the case. Several powerful methods taking into account such a dose–efficacy relationship inherent in MTAs were devised recently. In this chapter, we overview the existing dose-finding methods intended to determine the optimal dose in singe-agent trials of MTAs.
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