Innovative design for a phase 1 trial with intra-patient dose escalation: The Crotoxin study

INTRODUCTION: Crotoxin has a broad antitumor activity but has shown frequent neurotoxic toxicity. To induce tolerance and limit this toxicity, we propose a new design with intra-patient dose escalation. METHODS: A new Dose Limiting Toxicity definition was used. The concept of Target Ceiling Dose was introduced. RESULTS: Dose Limiting Toxicity was the inability to dose escalate twice. Target Ceiling Dose was the highest planned dose to be administered to a patient and could change for patients along time. Recommended Dose was defined similarly as in a (3 + 3) conventional design. CONCLUSION: This innovant design was used and the clinical trial is now closed for inclusions. Results will be presented later.