RE: Communication22 Mar 2023 10:07
Well, there's an interesting possibility for finding MTD quickly:
Dose the first patient at 240mg/m² and if the data continues to be as predicted (i.e. consistent), dose the next patient at 280mg/m² and so on. Six patients would take the dose level to 440mg/m² which would be 297mg/m² of doxorubicin, or 5 times the standard 60mg/m² dose or 4 times the standard 75mg/m² dose. Stop any time when there is a treatment-related DLT, or whatever the criterion for halting escalation is called, and do more thorough multi-patient fine-tuning dosing in a new 'cohort' just below that level, e.g. from 320mg/m² in 10mg/m² or 20mg/m² steps if the toxicity appeared at 360mg/m².
Would absolutely require authorisation from whichever regulatory authority was overseeing the trial (just MHRA if in the UK only) as no one, clinician or Avacta scientists, would risk reputationand everything that follows from that should such a scheme go wrong. No wonder he couched it as "talking hypothetically".