As we’ve discussed elsewhere, therapeutic intent is controversial in phase 1 studies and for good reason. I think it’s important to inform patients that dose finding studies are only a first step in clinical research. Participants can benefit but historically the probability of benefiting is low because of the unknowns:
if the target is relevant,
if the side effects offset the activity of the study drug against the disease.
If activity even translates into living longer or better.
if the active dose is a safe dose
What appeals to me about titration is that the participants have a better chance of receiving a dose with meaningful activity against the disease. Because this is why (from impression and from personal experience) many persons with terminal disease take part, phase I studies should more routinely adopt titration and avoid 3+3.