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Bayesian Optimization for Dose Finding with Two Agents: Participant Allocation and Final Selection

Abstract

In two-agent dose-finding trials, the next cohort should help identify a combination for final selection. We studied a constrained knowledge-gradient (cKG) rule with one-cohort lookahead that updates independent Gaussian-process models of efficacy and continuous toxicity, reapplies a probability criterion for mean toxicity, and evaluates the resulting selection. We derived a deterministic calculation over a fixed set of dose combinations, holding fitted model parameters fixed during each hypothetical update. We compared cKG with constrained expected improvement (cEI) and two toxicity-only rules, targeted mean squared error (tMSE) and entropy, in four synthetic scenarios. In the primary obstructive sleep apnea (OSA)-derived scenario, averaged equally over strata and five probability cutoffs, cKG assigned fewer participants to combinations above the true mean-toxicity limit than tMSE (17.92% versus 27.08%), but selected such combinations more often at trial completion (18.80% versus 11.85%). Compared with cEI, cKG had higher mean simulated reduction in the 4%-desaturation apnea-hypopnea index (AHI4) at final selection (7.46 versus 6.72 events/hour), more above-limit final selections (18.80% versus 10.50%), and more above-limit assignments (17.92% versus 15.10%). Across scenarios, its efficacy advantage over cEI was smaller under stricter toxicity criteria. Continuous outcomes, uncalibrated toxicity limits, and a rule that still selects a combination when none meets the criterion limit clinical interpretation. Allocation and final-selection toxicity should be reported separately, alongside efficacy.

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BibTeX
@misc{wang2026bayesian,
  title = {{Bayesian Optimization for Dose Finding with Two Agents: Participant Allocation and Final Selection}},
  author = {Xinzhu Wang and Tanzy Love},
  howpublished = {arXiv},
  year = {2026},
  month = oct,
  doi = {10.48550/arxiv.2610.09245},
  eprint = {2610.09245},
  archivePrefix = {arXiv},
  url = {https://arxiv.org/abs/2610.09245},
}
RIS
TY  - UNPB
TI  - Bayesian Optimization for Dose Finding with Two Agents: Participant Allocation and Final Selection
AU  - Xinzhu Wang
AU  - Tanzy Love
PY  - 2026
DA  - 2026/10/07
PB  - arXiv
DO  - 10.48550/arxiv.2610.09245
UR  - https://arxiv.org/abs/2610.09245
AB  - In two-agent dose-finding trials, the next cohort should help identify a combination for final selection. We studied a constrained knowledge-gradient (cKG) rule with one-cohort lookahead that updates independent Gaussian-process models of efficacy and continuous toxicity, reapplies a probability criterion for mean toxicity, and evaluates the resulting selection. We derived a deterministic calculation over a fixed set of dose combinations, holding fitted model parameters fixed during each hypothetical update. We compared cKG with constrained expected improvement (cEI) and two toxicity-only rules, targeted mean squared error (tMSE) and entropy, in four synthetic scenarios. In the primary obstructive sleep apnea (OSA)-derived scenario, averaged equally over strata and five probability cutoffs, cKG assigned fewer participants to combinations above the true mean-toxicity limit than tMSE (17.92% versus 27.08%), but selected such combinations more often at trial completion (18.80% versus 11.85%). Compared with cEI, cKG had higher mean simulated reduction in the 4%-desaturation apnea-hypopnea index (AHI4) at final selection (7.46 versus 6.72 events/hour), more above-limit final selections (18.80% versus 10.50%), and more above-limit assignments (17.92% versus 15.10%). Across scenarios, its efficacy advantage over cEI was smaller under stricter toxicity criteria. Continuous outcomes, uncalibrated toxicity limits, and a rule that still selects a combination when none meets the criterion limit clinical interpretation. Allocation and final-selection toxicity should be reported separately, alongside efficacy.
ER  -