Accelerated Titration Designs

A decade ago, investigators in oncology had a clear interest in modifications to the standard phase 1 design to make it more efficient, to treat fewer patients at non-toxic dose levels (which may be less efficacious), and to increase the precision of phase 2 dose recommendations. This was the conclusion of the 1996 joint meeting of the U.S. National Cancer Institute and the European Organization for the Research and Treatment of Cancer (Arbuck, 1996 [1], and Eisenhauer, 2000 [2]). At approximately the same time, a review of the recent phase 1 oncology literature revealed that few investigators were making use of the innovative phase 1 trial designs developed over the previous decade (Dent, 1996 [3]), meant to accomplish these very objectives.