Research Article 2026-04-21 under-review v1

Improved utility with adaptive penalties in dose-optimization trials

W
Weijia Zhang Hubei University of Automotive Technology
J
Jingyi Chen Imperial College London

Abstract

Background: The objective of Phase I/II dose-finding design is to determine the Optimal Biological Dose(OBD) that is acceptably safe and demonstrates sufficient anti-tumor activity by maximizing a pre-specified utility function that balances safety and efficacy. In oncology, treatment is typically delivered over multiple cycles, which complicates OBD identification, moreover, achieving higher anti-tumor activity requires toxicity that is under control. Method: To address this challenge, we propose and evaluate the improved utility with pre-specified weights and adaptive penalties methods to regulate toxicity according to doses. Results: This approach enables the dynamic optimal dose that could be recommended based on trade-off between safety and efficacy. Conclusions: The simulation studies demonstrate that the proposed model outperforms the simply utility method across several performance metrics.

Citation Information

@article{weijiazhang2026,
  title={Improved utility with adaptive penalties in dose-optimization trials},
  author={Weijia Zhang and Jingyi Chen},
  journal={BMC Medical Research Methodology},
  year={2026},
  doi={https://doi.org/10.21203/rs.3.rs-8852216/v1}
}
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