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Dehua Bi

Publications and source records attributed to Dehua Bi.

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TWICEBEE: A Two-stage Intra-patient Curve-free Bayesian Decision-Theoretic Dose Escalation Design

We propose a novel Phase I intra-patient dose-escalation design tailored for multi-cycle immunotherapy settings, in which toxicity at a fixed dose level is clinically expected to decrease over successive treatment cycles. This design was motivated by a phase I trial of CAR T cell therapy, an emerging cellular immunotherapy with established applications in cancer and growing investigation in autoimmune disease. The design is intended for settings in which nonincreasing cycle-specific toxicity assumption is clinically justified. Specifically, we build on the extrapolation property of the modified curve-free Bayesian decision-theoretic (c-CFBD) design for two-agent trials (Xu, et al. 2025), treating treatment cycle as a second dimension. By redefining the partial order, the c-CFBD framework can accommodate the reduction in toxicity across cycles. The proposed design adopts a two-stage structure: an initial accelerated titration stage to rapidly explore dose levels, followed by a c-CFBD stage to improve safety and estimate the cycle-specific maximum tolerated dose sequence. Simulation studies across a range of scenarios demonstrate favorable operating characteristics.

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Balancing the effective sample size in prior across different doses in the curve-free Bayesian decision-theoretic design for dose-finding trials

The primary goal of dose allocation in phase I trials is to minimize patient exposure to subtherapeutic or excessively toxic doses, while accurately recommending a phase II dose that is as close as possible to the maximum tolerated dose (MTD). Fan et al. (2012) introduced a curve-free Bayesian decision-theoretic design (CFBD), which leverages the assumption of a monotonic dose-toxicity relationship without directly modeling dose-toxicity curves. This approach has also been extended to drug combinations for determining the MTD (Lee et al., 2017). Although CFBD has demonstrated improved trial efficiency by using fewer patients while maintaining high accuracy in identifying the MTD, it may artificially inflate the effective sample sizes for the updated prior distributions, particularly at the lowest and highest dose levels. This can lead to either overshooting or undershooting the target dose. In this paper, we propose a modification to CFBD's prior distribution updates that balances effective sample sizes across different doses. Simulation results show that with the modified prior specification, CFBD achieves a more focused dose allocation at the MTD and offers more precise dose recommendations with fewer patients on average. It also demonstrates robustness to other well-known dose finding designs in literature.

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BESS: A Bayesian Estimator of Sample Size

We consider a Bayesian framework for estimating the sample size of a clinical trial. The new approach, called BESS, is built upon three pillars: Sample size of the trial, Evidence from the observed data, and Confidence of the final decision in the posterior inference. It uses a simple logic of "given the evidence from data, a specific sample size can achieve a degree of confidence in trial success." The key distinction between BESS and standard sample size estimation (SSE) is that SSE, typically based on Frequentist inference, specifies the true parameters values in its calculation to achieve properties under repeated sampling while BESS assumes possible outcome from the observed data to achieve high posterior probabilities of trial success. As a result, the calibration of the sample size is directly based on the probability of making a correct decision rather than type I or type II error rates. We demonstrate that BESS leads to a more interpretable statement for investigators, and can easily accommodates prior information as well as sample size re-estimation. We explore its performance in comparison to the standard SSE and demonstrate its usage through a case study of oncology optimization trial. An R tool is available at https://ccte.uchicago.edu/BESS.

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PAM-HC: A Bayesian Nonparametric Construction of Hybrid Control for Randomized Clinical Trials Using External Data

It is highly desirable to borrow information from external data to augment a control arm in a randomized clinical trial, especially in settings where the sample size for the control arm is limited. However, a main challenge in borrowing information from external data is to accommodate potential heterogeneous subpopulations across the external and trial data. We apply a Bayesian nonparametric model called Plaid Atoms Model (PAM) to identify overlapping and unique subpopulations across datasets, with which we restrict the information borrowing to the common subpopulations. This forms a hybrid control (HC) that leads to more precise estimation of treatment effects Simulation studies demonstrate the robustness of the new method, and an application to an Atopic Dermatitis dataset shows improved treatment effect estimation.

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A Class of Dependent Random Distributions Based on Atom Skipping

We propose the Plaid Atoms Model (PAM), a novel Bayesian nonparametric model for grouped data. Founded on an idea of `atom skipping', PAM is part of a well-established category of models that generate dependent random distributions and clusters across multiple groups. Atom skipping referrs to stochastically assigning 0 weights to atoms in an infinite mixture. Deploying atom skipping across groups, PAM produces a dependent clustering pattern with overlapping and non-overlapping clusters across groups. As a result, interpretable posterior inference is possible such as reporting the posterior probability of a cluster being exclusive to a single group or shared among a subset of groups. We discuss the theoretical properties of the proposed and related models. Minor extensions of the proposed model for multivariate or count data are presented. Simulation studies and applications using real-world datasets illustrate the performance of the new models with comparison to existing models.

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