Optimal, minimax, and Bayesian two-stage designs in two-dose phase II clinical trials

Background: For most cytotoxic and biologic anti-cancer agents, the response rate of the drug is commonly assumed to be non-decreasing with an increasing dose. However, an increasing dose does not always result in an appreciable increase in the response rate. This may especially be true at high doses for a biologic agent. Therefore, in a phase II trial the investigators may be interested in testing the anti-tumor activity of a drug at more than one (often two) doses, instead of only at the maximum tolerated dose (MTD). This way, when the lower dose appears equally effective, this dose can be recommended for further confirmatory testing in a phase III trial under potential long-term toxicity and cost considerations. A common approach to designing such a phase II trial has been to use an independent (e.g., Simon's two-stage) design at each dose ignoring the prior knowledge about the ordering of the response probabilities at the different doses. However, failure to account for this ordering constraint in estimating the response probabilities may result in an inefficient design. In this dissertation, we developed extensions of Simon's optimal and minimax two-stage designs, including both frequentist and Bayesian methods, for two doses that assume ordered response rates between doses. ^ Methods: Optimal and minimax two-stage designs are proposed for phase II clinical trials in settings where the true response rates at two dose levels are ordered. We borrow strength between doses using isotonic regression and control the joint and/or marginal error probabilities. Bayesian two-stage designs are also proposed under a stochastic ordering constraint. ^ Results: Compared to Simon's designs, when controlling the power and type I error at the same levels, the proposed frequentist and Bayesian designs reduce the maximum and expected sample sizes. Most of the proposed designs also increase the probability of early termination when the true response rates are poor. ^ Conclusion: Proposed frequentist and Bayesian designs are superior to Simon's designs in terms of operating characteristics (expected sample size and probability of early termination, when the response rates are poor) Thus, the proposed designs lead to more cost-efficient and ethical trials, and may consequently improve and expedite the drug discovery process. The proposed designs may be extended to designs of multiple group trials and drug combination trials.^

Two-dimensional infrared spectroscopy of peptides by phase-controlled femtosecond vibrational photon echoes

Two-dimensional infrared spectra of peptides are introduced that are the direct analogues of two- and three-pulse multiple quantum NMR. Phase matching and heterodyning are used to isolate the phase and amplitudes of the electric fields of vibrational photon echoes as a function of multiple pulse delays. Structural information is made available on the time scale of a few picoseconds. Line narrowed spectra of acyl-proline-NH2 and cross peaks implying the coupling between its amide-I modes are obtained, as are the phases of the various contributions to the signals. Solvent-sensitive structural differences are seen for the dipeptide. The methods show great promise to measure structure changes in biology on a wide range of time scales.

Assessment of the benefits of two-way center left turn lanes. Phase I: report (revised).

Michigan Department of Transportation, Lansing

Experimental safety vehicle (phase two) developed by General Motors. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Passing lanes and other operational improvements on two-lane highway. Phase I - technical report.

Federal Highway Administration, Office of Safety and Traffic Operations Research and Development, Washington, D.C.

Estimating the effects of the crash-phase FMVSS on driver fatality risk in two-car collisions. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Phase two : study of the effects of crude oil constituents on the reduction and precipitation of uranium /

"Project No. 550837."

Draft phase two report : "peer review and technical assistance of nine facilities, a move to improve" : technical assistance and staff training for intermediate care facilities for the developmentally disabled (ICFDD) and for those ICFDD for fifteen or fewer persons.

"August, 1988."

Illinois rail system plan : phase two, September 1975 /

Mode of access: Internet.

Phase diagram of the three-band half-filled Cu-O two-leg ladder

We determine the phase diagram of the half-filled two-leg ladder both at weak and strong coupling, taking into account the Cu d(x)(2)-y(2) and the O p(x) and p(y) orbitals. At weak coupling, renormalization group flows are interpreted with the use of bosonization. Two different models with and without outer oxygen orbitals are examined. For physical parameters, and in the absence of the outer oxygen orbitals, the D-Mott phase arises; a dimerized phase appears when the outer oxygen atoms are included. We show that the circulating current phase that preserves translational symmetry does not appear at weak coupling. In the opposite strong-coupling atomic limit the model is purely electrostatic and the ground states may be found by simple energy minimization. The phase diagram so obtained is compared to the weak-coupling one.

Comparison of two-dimensional speckle and tissue velocity based strain and validation with harmonic phase magnetic resonance imaging

Two-dimensional (2-D) strain (epsilon(2-D)) on the basis of speckle tracking is a new technique for strain measurement. This study sought to validate epsilon(2-D) and tissue velocity imaging (TVI)based strain (epsilon(TVI)) with tagged harmonic-phase (HARP) magnetic resonance imaging (MRI). Thirty patients (mean age. 62 +/- 11 years) with known or suspected ischemic heart disease were evaluated. Wall motion (wall motion score index 1.55 +/- 0.46) was assessed by an expert observer. Three apical images were obtained for longitudinal strain (16 segments) and 3 short-axis images for radial and circumferential strain (18 segments). Radial epsilon(TVI) was obtained in the posterior wall. HARP MRI was used to measure principal strain, expressed as maximal length change in each direction. Values for epsilon(2-D), epsilon(TVI), and HARP MRI were comparable for all 3 strain directions and were reduced in dysfunctional segments. The mean difference and correlation between longitudinal epsilon(2-D) and HARP MRI (2.1 +/- 5.5%, r = 0.51, p < 0.001) were similar to those between longitudinal epsilon(TVI), and HARP MRI (1.1 +/- 6.7%, r = 0.40, p < 0.001). The mean difference and correlation were more favorable between radial epsilon(2-D) and HARP MRI (0.4 +/- 10.2%, r = 0.60, p < 0.001) than between radial epsilon(TVI), and HARP MRI (3.4 +/- 10.5%, r = 0.47, p < 0.001). For circumferential strain, the mean difference and correlation between epsilon(2-D) and HARP MRI were 0.7 +/- 5.4% and r = 0.51 (p < 0.001), respectively. In conclusion, the modest correlations of echocardiographic and HARP MRI strain reflect the technical challenges of the 2 techniques. Nonetheless, epsilon(2-D) provides a reliable tool to quantify regional function, with radial measurements being more accurate and feasible than with TVI. Unlike epsilon(TVI), epsilon(2-D) provides circumferential measurements. (c) 2006 Elsevier Inc. All rights reserved.

Mass transfer characteristics of two-aqueous-phase liquid-liquid mixtures

Mass transfer rates were studied using the falling drop method. Cibacron Blue 3 GA dye was the transferring solute from the salt phase to the PEG phase. Measurements were undertaken for several concentrations of the dye and the phase-forming solutes and with a range of different drop sizes, e.g. 2.8, 3.0 and 3.7 mm. The dye was observed to be present in the salt phase as finely dispersed solids but a model confirmed that the mass transfer process could still be described by an equation based upon the Whitman two-film model. The overall mass transfer coefficient increased with increasing concentration of the dye. The apparent mass transfer coefficient ranged from 1 x 10-5 to 2 x 10 -4 m/s. Further experiments suggested that mass transfer was enhanced at high concentration by several mechanisms. The dye was found to change the equilibrium composition of the two phases, leading to transfer of salt between the drop and continuous phases. It also lowered the interfacial tension (i.e. from 1.43 x 10-4 N/m for 0.01% w/w dye concentration to 1.07 x 10-4 N/m for 0.2% w/w dye concentration) between the two phases, which could have caused interfacial instabilities (Marangoni effects). The largest drops were deformable, which resulted in a significant increase in the mass transfer rate. Drop size distribution and Sauter mean drop diameter were studied on-line in a 1 litre agitated vessel using a laser diffraction technique. The effects of phase concentration, dispersed phase hold-up and impeller speed were investigated for the salt-PEG system. An increase in agitation speed in the range 300 rpm to 1000 rpm caused a decrease in mean drop diameter, e.g. from 50 m to 15 m. A characteristic bimodal drop size distribution was established within a very short time. An increase in agitation rate caused a shift of the larger drop size peak to a smaller size.