Adaptive seamless clinical trials using early outcomes for treatment or subgroup selection : Methods, simulation model and their implementation in R

© 2020 The Authors. Biometrical Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim..

Adaptive seamless designs combine confirmatory testing, a domain of phase III trials, with features such as treatment or subgroup selection, typically associated with phase II trials. They promise to increase the efficiency of development programmes of new drugs, for example, in terms of sample size and/or development time. It is well acknowledged that adaptive designs are more involved from a logistical perspective and require more upfront planning, often in the form of extensive simulation studies, than conventional approaches. Here, we present a framework for adaptive treatment and subgroup selection using the same notation, which links the somewhat disparate literature on treatment selection on one side and on subgroup selection on the other. Furthermore, we introduce a flexible and efficient simulation model that serves both designs. As primary endpoints often take a long time to observe, interim analyses are frequently informed by early outcomes. Therefore, all methods presented accommodate interim analyses informed by either the primary outcome or an early outcome. The R package asd, previously developed to simulate designs with treatment selection, was extended to include subgroup selection (so-called adaptive enrichment designs). Here, we describe the functionality of the R package asd and use it to present some worked-up examples motivated by clinical trials in chronic obstructive pulmonary disease and oncology. The examples both illustrate various features of the R package and provide insights into the operating characteristics of adaptive seamless studies.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:62

Enthalten in:

Biometrical journal. Biometrische Zeitschrift - 62(2020), 5 vom: 04. Sept., Seite 1264-1283

Sprache:

Englisch

Beteiligte Personen:

Friede, Tim [VerfasserIn]
Stallard, Nigel [VerfasserIn]
Parsons, Nicholas [VerfasserIn]

Links:

Volltext

Themen:

Adaptive design
Clinical trials
Closed test procedure
Combination test
Dunnett test
Journal Article
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 08.09.2021

Date Revised 01.12.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1002/bimj.201900020

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM307104354