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Main Authors: Kanrar, Rohit, Li, Chunlin, Ghodsi, Zara, Gamalo, Margaret
Format: Preprint
Published: 2025
Subjects:
Online Access:https://arxiv.org/abs/2507.22344
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author Kanrar, Rohit
Li, Chunlin
Ghodsi, Zara
Gamalo, Margaret
author_facet Kanrar, Rohit
Li, Chunlin
Ghodsi, Zara
Gamalo, Margaret
contents Early-phase clinical trials face the challenge of selecting optimal drug doses that balance safety and efficacy due to uncertain dose-response relationships and varied participant characteristics. Traditional randomized dose allocation often exposes participants to sub-optimal doses by not considering individual covariates, necessitating larger sample sizes and prolonging drug development. This paper introduces a risk-inclusive contextual bandit algorithm that utilizes multi-arm bandit (MAB) strategies to optimize dosing through participant-specific data integration. By combining two separate Thompson samplers, one for efficacy and one for safety, the algorithm enhances the balance between efficacy and safety in dose allocation. The effect sizes are estimated with a generalized version of asymptotic confidence sequences (AsympCS), offering a uniform coverage guarantee for sequential causal inference over time. The validity of AsympCS is also established in the MAB setup with a possibly mis-specified model. The empirical results demonstrate the strengths of this method in optimizing dose allocation compared to randomized allocations and traditional contextual bandits focused solely on efficacy. Moreover, an application on real data generated from a recent Phase IIb study aligns with actual findings.
format Preprint
id arxiv_https___arxiv_org_abs_2507_22344
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Risk-inclusive Contextual Bandits for Early Phase Clinical Trials
Kanrar, Rohit
Li, Chunlin
Ghodsi, Zara
Gamalo, Margaret
Methodology
Early-phase clinical trials face the challenge of selecting optimal drug doses that balance safety and efficacy due to uncertain dose-response relationships and varied participant characteristics. Traditional randomized dose allocation often exposes participants to sub-optimal doses by not considering individual covariates, necessitating larger sample sizes and prolonging drug development. This paper introduces a risk-inclusive contextual bandit algorithm that utilizes multi-arm bandit (MAB) strategies to optimize dosing through participant-specific data integration. By combining two separate Thompson samplers, one for efficacy and one for safety, the algorithm enhances the balance between efficacy and safety in dose allocation. The effect sizes are estimated with a generalized version of asymptotic confidence sequences (AsympCS), offering a uniform coverage guarantee for sequential causal inference over time. The validity of AsympCS is also established in the MAB setup with a possibly mis-specified model. The empirical results demonstrate the strengths of this method in optimizing dose allocation compared to randomized allocations and traditional contextual bandits focused solely on efficacy. Moreover, an application on real data generated from a recent Phase IIb study aligns with actual findings.
title Risk-inclusive Contextual Bandits for Early Phase Clinical Trials
topic Methodology
url https://arxiv.org/abs/2507.22344