escalation

Methods for working with dose-finding clinical trials. We provide implementations of many dose-finding clinical trial designs, including the continual reassessment method (CRM) by O'Quigley et al. (1990) doi:10.2307/2531628, the toxicity probability interval (TPI) design by Ji et al. (2007) doi:10.1177/1740774507079442, the modified TPI (mTPI) design by Ji et al. (2010) doi:10.1177/1740774510382799, the Bayesian optimal interval design (BOIN) by Liu & Yuan (2015) doi:10.1111/rssc.12089, EffTox by Thall & Cook (2004) doi:10.1111/j.0006-341X.2004.00218.x; the design of Wages & Tait (2015) doi:10.1080/10543406.2014.920873, and the 3+3 described by Korn et al. (1994) doi:10.1002/sim.4780131802. All designs are implemented with a common interface. We also offer optional additional classes to tailor the behaviour of all designs, including avoiding skipping doses, stopping after n patients have been treated at the recommended dose, stopping when a toxicity condition is met, or demanding that n patients are treated before stopping is allowed. By daisy-chaining together these classes using the pipe operator from 'magrittr', it is simple to tailor the behaviour of a dose-finding design so it behaves how the trialist wants. Having provided a flexible interface for specifying designs, we then provide functions to run simulations and calculate dose-paths for future cohorts of patients.