A Utility Score Framework for Dose Optimization Studies with Binary Efficacy-Safety Endpoints: Sample Size Determination and Bias Characterization

Fuente: arXiv
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Main Authors: Gu, Xuemin, Xu, Cong, Xu, Lei, Yu, Ying
Format: Preprint
Published: 2026
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author Gu, Xuemin
Xu, Cong
Xu, Lei
Yu, Ying
author_facet Gu, Xuemin
Xu, Cong
Xu, Lei
Yu, Ying
contents The FDA's Project Optimus initiative emphasizes patient-centered dose selection in oncology that balances efficacy and safety. We develop a framework for randomized dose optimization studies that uses clinically interpretable utility scores to integrate binary efficacy and safety endpoints and select the optimal dose for a follow-on confirmatory trial. The framework provides: (i) a systematic method for eliciting utility scores that reflect clinical priorities; (ii) closed-form sample size formulas to achieve prespecified Probabilities of Correct Selection (PCS) under clinically relevant scenarios; and (iii) analytical expressions characterizing the propagation of selection-induced bias to confirmatory trials, including time-to-event endpoints correlated with the selection endpoint. Extensive simulations (10^6 replications per scenario) confirm that the sample size methods achieve target PCS and that the bias and Type I error formulas closely match empirical estimates. An R package DoseOptDesign and an interactive Shiny application are publicly available.
format Preprint
id arxiv_https___arxiv_org_abs_2603_15884
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle A Utility Score Framework for Dose Optimization Studies with Binary Efficacy-Safety Endpoints: Sample Size Determination and Bias Characterization
Gu, Xuemin
Xu, Cong
Xu, Lei
Yu, Ying
Applications
Methodology
The FDA's Project Optimus initiative emphasizes patient-centered dose selection in oncology that balances efficacy and safety. We develop a framework for randomized dose optimization studies that uses clinically interpretable utility scores to integrate binary efficacy and safety endpoints and select the optimal dose for a follow-on confirmatory trial. The framework provides: (i) a systematic method for eliciting utility scores that reflect clinical priorities; (ii) closed-form sample size formulas to achieve prespecified Probabilities of Correct Selection (PCS) under clinically relevant scenarios; and (iii) analytical expressions characterizing the propagation of selection-induced bias to confirmatory trials, including time-to-event endpoints correlated with the selection endpoint. Extensive simulations (10^6 replications per scenario) confirm that the sample size methods achieve target PCS and that the bias and Type I error formulas closely match empirical estimates. An R package DoseOptDesign and an interactive Shiny application are publicly available.
title A Utility Score Framework for Dose Optimization Studies with Binary Efficacy-Safety Endpoints: Sample Size Determination and Bias Characterization
topic Applications
Methodology
url https://arxiv.org/abs/2603.15884