RE: Combination tech bought …14 Apr 2026 14:44
CJ from AI regarding BOIN
Variable cohort sizes — Unlike 3+3 (fixed cohorts of 3, expanding to 6 only on 1 DLT), BOIN supports starting with cohort size 1 (single-patient escalation) at low doses with no/minimal toxicity. It seamlessly switches to larger cohorts (e.g., 3) only after the first DLT is observed. This is similar to an accelerated titration design but within one coherent framework.
No rigid "expand to 6" requirement — Escalation decisions can be made at any accumulated patient number (not just exactly 3 or 6), allowing quicker progression through safe lower doses.
Direct escalation on low observed toxicity — If the DLT rate stays below the escalation boundary (e.g., 0/3 or even 0/1 or 1/4 depending on boundaries), it escalates immediately without mandatory expansion
So to answer your question yes they can escalate doses based on no DLT in patient 1.