Evidence map›Paper›PMID 31743629›Full record

ArticleEthics & human research2019

Reprioritizing Risk and Benefit: The Future of Study Design in Early-Phase Cancer Research.

Bryan Anthony Sisk, James Dubois, Brian P Hobbs, Eric Kodish

Abstract read
In one paragraph

Article in Ethics & human research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Analysis of Phase I Clinical Trial Design of Anti-Cancer Agents.Therapeutic innovation & regulatory science · 2025
    Article
  3. Article
  4. Article
  5. Ethical challenges for a new generation of early-phase pediatric gene therapy trials.Genetics in medicine : official journal of the American College of Medical Genetics · 2021
    Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Bryan Anthony SiskClinical fellow in pediatric hematology/oncology in the Department of Pediatrics at Washington University School of Medicine.
James DuboisProfessor in the Department of Medicine at Washington University School of Medicine.
Brian P HobbsAssociate staff member in the Department of Quantitative Health Sciences in the Lerner Research Institute at the Cleveland Clinic.
Eric KodishProfessor of pediatrics, oncology, and bioethics at Case Western Reserve and Cleveland Clinic Lerner College of Medicine.

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
NCATS NIH HHS UL1 TR002345
6 · The paper itself

Abstract

The scientific purpose of phase I trials is to determine the maximum tolerated dose and/or optimal biological dose of experimental agents. Yet most participants in phase I oncology trials enroll hoping for direct medical benefit. The most common phase I trial designs use low starting doses and escalate cautiously in a "risk-escalation" model focused on minimizing risk for each participant. This approach ensures that a proportion of subjects will likely not receive any benefit, even if the intervention proves to be successful at appropriate doses. In this article, we propose that trial designs should employ dosing strategies that increase chances of providing benefit if the investigational agent should prove to be successful while limiting risk to reasonable levels. We then describe how adaptive trial designs can facilitate refined dose optimization based on both therapeutic benefit and toxicity, which can simultaneously decrease the risk of harm while increasing the chances of benefit.

Indexed as

Dose-Response Relationship, DrugMaximum Tolerated DoseNeoplasmsResearch DesignAdaptive Clinical Trials as TopicClinical Trials, Phase I as TopicHumansMedical OncologyRisk Assessmenthuman subjects researchphase 1 oncology trialsresearch benefitsresearch risks

Identifiers

PMID31743629
PMCPMC7418216

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.