The New England Journal of Statistics in Data Science

The MiniPDX model is a cost-effective preclinical platform that replicates human tumor microenvironments in mice, enabling rapid drug response evaluation in precision oncology. In contrast, the patient-derived xenograft (PDX) model offers a more comprehensive but slower and costlier approach by engrafting human tumors into immunodeficient mice to evaluate efficacy in a physiologically relevant context. In this study, we present an integrated Bayesian framework that supports both separate and joint analyses of MiniPDX and PDX data. Our models borrow information across biomarker-defined subgroups and between assays, improving the efficiency and precision of drug effect estimation. Furthermore, we implement an adaptive sample size re-estimation procedure for MiniPDX experiments, allowing for more flexible designs and optimized resource utilization. Together, these methods provide a Bayesian framework that improves estimation efficiency for small-sample MiniPDX and PDX experiments and offers a principled adaptive sample-size rule, helping to identify biomarker-defined subpopulations with distinct predictive profiles for treatment response.

We consider a formal statistical design that allows simultaneous enrollment of a main cohort and a backfill cohort of patients in a dose-finding trial. The goal is to accumulate more information at various doses to facilitate dose optimization. The proposed design, called Bi3+3, combines the simple dose-escalation algorithm in the i3+3 design and a model-based inference under the framework of probability of decisions (POD), both previously published. As a result, Bi3+3 provides a simple algorithm for backfilling patients to lower doses in a dose-finding trial once these doses exhibit safety profile in patients. The POD framework allows dosing decisions to be made when some backfill patients are still being followed with incomplete toxicity outcomes, thereby potentially expediting the clinical trial. At the end of the trial, Bi3+3 uses both toxicity and efficacy outcomes to estimate an optimal biological dose (OBD). The proposed inference is based on a dose-response model that takes into account either a monotone or plateau dose-efficacy relationship, which are frequently encountered in modern oncology drug development. Simulation studies show promising operating characteristics of the Bi3+3 design in comparison to existing designs.