1
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Wei W, Blaha O, Esserman D, Zelterman D, Kane M, Liu R, Lin J. A Bayesian platform trial design with hybrid control based on multisource exchangeability modelling. Stat Med 2024; 43:2439-2451. [PMID: 38594809 DOI: 10.1002/sim.10077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/25/2024] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Abstract
Enrolling patients to the standard of care (SOC) arm in randomized clinical trials, especially for rare diseases, can be very challenging due to the lack of resources, restricted patient population availability, and ethical considerations. As the therapeutic effect for the SOC is often well documented in historical trials, we propose a Bayesian platform trial design with hybrid control based on the multisource exchangeability modelling (MEM) framework to harness historical control data. The MEM approach provides a computationally efficient method to formally evaluate the exchangeability of study outcomes between different data sources and allows us to make better informed data borrowing decisions based on the exchangeability between historical and concurrent data. We conduct extensive simulation studies to evaluate the proposed hybrid design. We demonstrate the proposed design leads to significant sample size reduction for the internal control arm and borrows more information compared to competing Bayesian approaches when historical and internal data are compatible.
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Affiliation(s)
- Wei Wei
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Ondrej Blaha
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Denise Esserman
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Daniel Zelterman
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Michael Kane
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Rachael Liu
- Statistical & Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Jianchang Lin
- Statistical & Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
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2
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Chen K, Zhao Y, Liu M, Lin J, Liu R. DOD-Combo: Bayesian dose finding design in combination trials with meta-analytic-predictive prior. J Biopharm Stat 2024:1-18. [PMID: 38468381 DOI: 10.1080/10543406.2024.2325142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/24/2024] [Indexed: 03/13/2024]
Abstract
Combination therapy, a treatment modality that involves multiple treatment agents, has become imperative for improving treatment effectiveness and addressing resistance in the field of oncology. However, determining the most effective dose for these combinations, particularly when dealing with intricate drug interactions and diverse toxicity patterns, presents a substantial challenge. This paper introduces a novel Bayesian dose-finding design for combination therapies with information borrowing, named the DOD-Combo design. Leveraging historical single-agent trials and the meta-analytic-predictive (MAP) power prior, our approach utilizes a copula-type model to connect individual drug priors with joint toxicity probabilities in combination treatments. The MAP power prior allows the integration of information from multiple historical trials, constructing informative priors for each agent. Extensive simulations confirm our method's superior performance compared to combination designs with no information borrowing. By adaptively incorporating historical data, our approach reduces sample sizes and enhances efficiency in selecting the maximum tolerated dose (MTD), effectively addressing the intricate challenges presented by combination trials.
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Affiliation(s)
- Kai Chen
- Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, USA
| | - Yunqi Zhao
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, USA
| | - Meizi Liu
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, USA
| | - Jianchang Lin
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, USA
| | - Rachael Liu
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, USA
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3
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Bi D, Liu M, Lin J, Liu R. BEATS: Bayesian hybrid design with flexible sample size adaptation for time-to-event endpoints. Stat Med 2023; 42:5708-5722. [PMID: 37858287 DOI: 10.1002/sim.9936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/17/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
As the roles of historical trials and real-world evidence in drug development have substantially increased, several approaches have been proposed to leverage external data and improve the design of clinical trials. While most of these approaches focus on methodology development for borrowing information during the analysis stage, there is a risk of inadequate or absent enrollment of concurrent control due to misspecification of heterogeneity from external data, which can result in unreliable estimates of treatment effect. In this study, we introduce a Bayesian hybrid design with flexible sample size adaptation (BEATS) that allows for adaptive borrowing of external data based on the level of heterogeneity to augment the control arm during both the design and interim analysis stages. Moreover, BEATS extends the Bayesian semiparametric meta-analytic predictive prior (BaSe-MAP) to incorporate time-to-event endpoints, enabling optimal borrowing performance. Initially, BEATS calibrates the expected sample size and initial randomization ratio based on heterogeneity among the external data. During the interim analysis, flexible sample size adaptation is performed to address conflicts between the concurrent and historical control, while also conducting futility analysis. At the final analysis, estimation is provided by incorporating the calibrated amount of external data. Therefore, our proposed design allows for an approximation of an ideal randomized controlled trial with an equal randomization ratio while controlling the size of the concurrent control to benefit patients and accelerate drug development. BEATS also offers optimal power and robust estimation through flexible sample size adaptation when conflicts arise between the concurrent control and external data.
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Affiliation(s)
- Dehua Bi
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Meizi Liu
- Statistical & Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Jianchang Lin
- Statistical & Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Rachael Liu
- Statistical & Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
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4
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Hatswell AJ. Incorporating Prior Beliefs Into Meta-Analyses of Health-State Utility Values Using the Bayesian Power Prior. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:1389-1397. [PMID: 37187235 DOI: 10.1016/j.jval.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/17/2023] [Accepted: 04/28/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES Health-state utility values (HSUVs) directly affect estimates of Quality-Adjusted Life-Years and thus the cost-utility estimates. In practice a single preferred value (SPV) is often selected for HSUVs, despite meta-analysis being an option when multiple (credible) HSUVs are available. Nevertheless, the SPV approach is often reasonable because meta-analysis implicitly considers all HSUVs as equally relevant. This article presents a method for the incorporation of weights to HSUV synthesis, allowing more relevant studies to have greater influence. METHODS Using 4 case studies in lung cancer, hemodialysis, compensated liver cirrhosis, and diabetic retinopathy blindness, a Bayesian Power Prior (BPP) approach is used to incorporate beliefs on study applicability, reflecting the authors' perceived suitability for UK decision making. Older studies, non-UK value sets, and vignette studies are thus downweighted (but not disregarded). BPP HSUV estimates were compared with a SPV, random effects meta-analysis, and fixed effects meta-analysis. Sensitivity analyses were conducted iteratively updating the case studies, using alternative weighting methods, and simulated data. RESULTS Across all case studies, SPVs did not accord with meta-analyzed values, and fixed effects meta-analysis produced unrealistically narrow CIs. Point estimates from random effects meta-analysis and BPP models were similar in the final models, although BPP reflected additional uncertainty as wider credible intervals, particularly when fewer studies were available. Differences in point estimates were seen in iterative updating, weighting approaches, and simulated data. CONCLUSIONS The concept of the BPP can be adapted for synthesizing HSUVs, incorporating expert opinion on relevance. Because of the downweighting of studies, the BPP reflected structural uncertainty as wider credible intervals, with all forms of synthesis showing meaningful differences compared with SPVs. These differences would have implications for both cost-utility point estimates and probabilistic analyses.
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Affiliation(s)
- Anthony J Hatswell
- Delta Hat Limited, Nottingham, England, UK; Department of Statistical Science, University College London, London, England, UK.
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5
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Peng L, Jin J, Chambonneau L, Zhao X, Zhang J. Bayesian borrowing from historical control data in a vaccine efficacy trial. Pharm Stat 2023; 22:815-835. [PMID: 37226586 DOI: 10.1002/pst.2313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 02/27/2023] [Accepted: 05/03/2023] [Indexed: 05/26/2023]
Abstract
In the context of vaccine efficacy trial where the incidence rate is very low and a very large sample size is usually expected, incorporating historical data into a new trial is extremely attractive to reduce sample size and increase estimation precision. Nevertheless, for some infectious diseases, seasonal change in incidence rates poses a huge challenge in borrowing historical data and a critical question is how to properly take advantage of historical data borrowing with acceptable tolerance to between-trials heterogeneity commonly from seasonal disease transmission. In this article, we extend a probability-based power prior which determines the amount of information to be borrowed based on the agreement between the historical and current data, to make it applicable for either a single or multiple historical trials available, with constraint on the amount of historical information to be borrowed. Simulations are conducted to compare the performance of the proposed method with other methods including modified power prior (MPP), meta-analytic-predictive (MAP) prior and the commensurate prior methods. Furthermore, we illustrate the application of the proposed method for trial design in a practical setting.
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Affiliation(s)
- Lin Peng
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jing Jin
- Biostatistical Sciences Sanofi, Beijing, China
| | | | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Juying Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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6
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Bofill Roig M, Burgwinkel C, Garczarek U, Koenig F, Posch M, Nguyen Q, Hees K. On the use of non-concurrent controls in platform trials: a scoping review. Trials 2023; 24:408. [PMID: 37322532 DOI: 10.1186/s13063-023-07398-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/19/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Platform trials gained popularity during the last few years as they increase flexibility compared to multi-arm trials by allowing new experimental arms entering when the trial already started. Using a shared control group in platform trials increases the trial efficiency compared to separate trials. Because of the later entry of some of the experimental treatment arms, the shared control group includes concurrent and non-concurrent control data. For a given experimental arm, non-concurrent controls refer to patients allocated to the control arm before the arm enters the trial, while concurrent controls refer to control patients that are randomised concurrently to the experimental arm. Using non-concurrent controls can result in bias in the estimate in case of time trends if the appropriate methodology is not used and the assumptions are not met. METHODS We conducted two reviews on the use of non-concurrent controls in platform trials: one on statistical methodology and one on regulatory guidance. We broadened our searches to the use of external and historical control data. We conducted our review on the statistical methodology in 43 articles identified through a systematic search in PubMed and performed a review on regulatory guidance on the use of non-concurrent controls in 37 guidelines published on the EMA and FDA websites. RESULTS Only 7/43 of the methodological articles and 4/37 guidelines focused on platform trials. With respect to the statistical methodology, in 28/43 articles, a Bayesian approach was used to incorporate external/non-concurrent controls while 7/43 used a frequentist approach and 8/43 considered both. The majority of the articles considered a method that downweights the non-concurrent control in favour of concurrent control data (34/43), using for instance meta-analytic or propensity score approaches, and 11/43 considered a modelling-based approach, using regression models to incorporate non-concurrent control data. In regulatory guidelines, the use of non-concurrent control data was considered critical but was deemed acceptable for rare diseases in 12/37 guidelines or was accepted in specific indications (12/37). Non-comparability (30/37) and bias (16/37) were raised most often as the general concerns with non-concurrent controls. Indication specific guidelines were found to be most instructive. CONCLUSIONS Statistical methods for incorporating non-concurrent controls are available in the literature, either by means of methods originally proposed for the incorporation of external controls or non-concurrent controls in platform trials. Methods mainly differ with respect to how the concurrent and non-concurrent data are combined and temporary changes handled. Regulatory guidance for non-concurrent controls in platform trials are currently still limited.
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Affiliation(s)
- Marta Bofill Roig
- Center for Medical Data Science, Medical University of Vienna, Vienna, Austria.
| | - Cora Burgwinkel
- Center for Medical Data Science, Medical University of Vienna, Vienna, Austria
- Department of Biostatistics, Paul-Ehrlich Institut, Langen, Germany
| | | | - Franz Koenig
- Center for Medical Data Science, Medical University of Vienna, Vienna, Austria
| | - Martin Posch
- Center for Medical Data Science, Medical University of Vienna, Vienna, Austria
| | - Quynh Nguyen
- Department of Biostatistics, Paul-Ehrlich Institut, Langen, Germany
| | - Katharina Hees
- Department of Biostatistics, Paul-Ehrlich Institut, Langen, Germany.
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7
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Han Z, Zhang Q, Wang M, Ye K, Chen MH. On efficient posterior inference in normalized power prior Bayesian analysis. Biom J 2023; 65:e2200194. [PMID: 36960489 DOI: 10.1002/bimj.202200194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/24/2022] [Accepted: 02/15/2023] [Indexed: 03/25/2023]
Abstract
The power prior has been widely used to discount the amount of information borrowed from historical data in the design and analysis of clinical trials. It is realized by raising the likelihood function of the historical data to a power parameterδ ∈ [ 0 , 1 ] $\delta \in [0, 1]$ , which quantifies the heterogeneity between the historical and the new study. In a fully Bayesian approach, a natural extension is to assign a hyperprior to δ such that the posterior of δ can reflect the degree of similarity between the historical and current data. To comply with the likelihood principle, an extra normalizing factor needs to be calculated and such prior is known as the normalized power prior. However, the normalizing factor involves an integral of a prior multiplied by a fractional likelihood and needs to be computed repeatedly over different δ during the posterior sampling. This makes its use prohibitive in practice for most elaborate models. This work provides an efficient framework to implement the normalized power prior in clinical studies. It bypasses the aforementioned efforts by sampling from the power prior withδ = 0 $\delta = 0$ andδ = 1 $\delta = 1$ only. Such a posterior sampling procedure can facilitate the use of a random δ with adaptive borrowing capability in general models. The numerical efficiency of the proposed method is illustrated via extensive simulation studies, a toxicological study, and an oncology study.
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Affiliation(s)
- Zifei Han
- School of Statistics, University of International Business and Economics, Beijing, China
| | - Qiang Zhang
- School of Statistics, University of International Business and Economics, Beijing, China
| | - Min Wang
- Department of Management Science and Statistics, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Keying Ye
- Department of Management Science and Statistics, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
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8
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Brizzi F, Steiert B, Pang H, Diack C, Lomax M, Peck R, Morgan Z, Soubret A. A model-based approach for historical borrowing, with an application to neovascular age-related macular degeneration. Stat Methods Med Res 2023; 32:1064-1081. [PMID: 37082812 DOI: 10.1177/09622802231155597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Bayesian historical borrowing has recently attracted growing interest due to the increasing availability of historical control data, as well as improved computational methodology and software. In this article, we argue that the statistical models used for borrowing may be suboptimal when they do not adjust for differing factors across historical studies such as covariates, dosing regimen, etc. We propose an alternative approach to address these shortcomings. We start by constructing a historical model based on subject-level historical data to accurately characterize the control treatment by adjusting for known between trials differences. This model is subsequently used to predict the control arm response in the current trial, enabling the derivation of a model-informed prior for the treatment effect parameter of another (potentially simpler) model used to analyze the trial efficacy (i.e. the trial model). Our approach is applied to neovascular age-related macular degeneration trials, employing a cross-sectional regression trial model, and a longitudinal non-linear mixed-effects drug-disease-trial historical model. The latter model characterizes the relationship between clinical response, drug exposure and baseline covariates so that the derived model-informed prior seamlessly adapts to the trial population and can be extrapolated to a different dosing regimen. This approach can yield a more accurate prior for borrowing, thus optimizing gains in efficiency (e.g. increasing power or reducing the sample size) in future trials.
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Affiliation(s)
- Francesco Brizzi
- Predictive Modelling and Data Analytics, Roche Pharma Research & Early Development, Roche Innovation Center Basel, Switzerland
| | - Bernhard Steiert
- Predictive Modelling and Data Analytics, Roche Pharma Research & Early Development, Roche Innovation Center Basel, Switzerland
| | - Herbert Pang
- Methods Collaboration & Outreach (MCO) Enabling Platform, Genentech Inc., South San Francisco, USA
| | - Cheikh Diack
- Predictive Modelling and Data Analytics, Roche Pharma Research & Early Development, Roche Innovation Center Basel, Switzerland
| | - Mark Lomax
- Data & Statistical Sciences, F. Hoffman-La Roche Ltd, Welwyn Garden City, UK
| | - Robbie Peck
- Data & Statistical Sciences, Hoffmann-La Roche AG, Basel, Switzerland
| | - Zoe Morgan
- Data & Statistical Sciences, Hoffmann-La Roche AG, Basel, Switzerland
| | - Antoine Soubret
- Predictive Modelling and Data Analytics, Roche Pharma Research & Early Development, Roche Innovation Center Basel, Switzerland
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9
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Li L, Jemielita T. Confounding adjustment in the analysis of augmented randomized controlled trial with hybrid control arm. Stat Med 2023. [PMID: 37186394 DOI: 10.1002/sim.9753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 03/03/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023]
Abstract
The augmented randomized controlled trial (RCT) with hybrid control arm includes a randomized treatment group (RT), a smaller randomized control group (RC), and a large synthetic control (SC) group from real-world data. This kind of trial is useful when there is logistics and ethics hurdle to conduct a fully powered RCT with equal allocation, or when it is necessary to increase the power of the RCT by incorporating real-world data. A difficulty in the analysis of augmented RCT is that the SC and RC may be systematically different in the distribution of observed and unmeasured confounding factors, causing bias when the two control groups are analyzed together as hybrid controls. We propose to use propensity score (PS) analysis to balance the observed confounders between SC and RC. The possible bias caused by unmeasured confounders can be estimated and tested by analyzing propensity score adjusted outcomes from SC and RC. We also propose a partial bias correction (PBC) procedure to reduce bias from unmeasured confounding. Extensive simulation studies show that the proposed PS + PBC procedures can improve the efficiency and statistical power by effectively incorporating the SC into the RCT data analysis, while still control the estimation bias and Type I error inflation that might arise from unmeasured confounding. We illustrate the proposed statistical procedures with data from an augmented RCT in oncology.
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Affiliation(s)
- Liang Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Thomas Jemielita
- Early Oncology Statistics, Merck & Co., Inc., Rahway, New Jersey, USA
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10
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Akalu Banbeta, Lesaffre E, Martina R, van Rosmalen J. Bayesian Borrowing Methods for Count Data: Analysis of Incontinence Episodes in Patients with Overactive Bladder. Stat Biopharm Res 2023. [DOI: 10.1080/19466315.2023.2190933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Affiliation(s)
- Akalu Banbeta
- I-Biostat, UHasselt, Hasselt, Belgium
- Department of Statistics, Jimma University, Jimma, Ethiopia
| | | | - Reynaldo Martina
- Faculty of Science, Technology, Engineering and Mathematics, Open University, Milton Keynes, UK
| | - Joost van Rosmalen
- Department of Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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11
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Li J, Du Y, Liu H, Yi Y. An Improved Matching Practice for Augmenting a Randomized Clinical Trial with External Control. Ther Innov Regul Sci 2023; 57:611-618. [PMID: 36809484 DOI: 10.1007/s43441-023-00497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/10/2023] [Indexed: 02/23/2023]
Abstract
The use of information from real world to assess the effectiveness of medical products is becoming increasingly popular and more acceptable by regulatory agencies. According to a strategic real-world evidence framework published by U.S. Food and Drug Administration, a hybrid randomized controlled trial that augments internal control arm with real-world data is a pragmatic approach worth more attention. In this paper, we aim to improve on existing matching designs for such a hybrid randomized controlled trial. In particular, we propose to match the entire concurrent randomized clinical trial (RCT) such that (1) the matched external control subjects used to augment the internal control arm are as comparable as possible to the RCT population, (2) every active treatment arm in an RCT with multiple treatments is compared with the same control group, and (3) matching can be conducted and the matched set locked before treatment unblinding to better maintain the data integrity and increase the credibility of the analysis. Besides a weighted estimator, we also introduce a bootstrap method to obtain its variance estimation. The finite sample performance of the proposed method is evaluated by simulations based on data from a real clinical trial.
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Affiliation(s)
- Jianghao Li
- Department of Biometrics, Eli Lilly and Company, Indianapolis, IN, USA
| | - Yu Du
- Department of Biometrics, Eli Lilly and Company, Indianapolis, IN, USA
| | - Huayu Liu
- Department of Biometrics, Eli Lilly and Company, Indianapolis, IN, USA
| | - Yanyao Yi
- Department of Biometrics, Eli Lilly and Company, Indianapolis, IN, USA.
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12
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Alt EM, Nifong B, Chen X, Psioda MA, Ibrahim JG. The scale transformed power prior for use with historical data from a different outcome model. Stat Med 2023; 42:1-14. [PMID: 36318875 PMCID: PMC9789178 DOI: 10.1002/sim.9598] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 08/26/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022]
Abstract
We develop the scale transformed power prior for settings where historical and current data involve different data types, such as binary and continuous data. This situation arises often in clinical trials, for example, when historical data involve binary responses and the current data involve some other type of continuous or discrete outcome. The power prior, proposed by Ibrahim and Chen, does not address the issue of different data types. Herein, we develop a new type of power prior, which we call the scale transformed power prior (straPP). The straPP is constructed by transforming the power prior for the historical data by rescaling the parameter using a function of the Fisher information matrices for the historical and current data models, thereby shifting the scale of the parameter vector from that of the historical to that of the current data. Examples are presented to motivate the need for such a transformation, and simulation studies are presented to illustrate the performance advantages of the straPP over the power prior and other informative and noninformative priors. A real dataset from a clinical trial undertaken to study a novel transitional care model for stroke survivors is used to illustrate the methodology.
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Affiliation(s)
- Ethan M Alt
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brady Nifong
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Xinxin Chen
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Matthew A Psioda
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joseph G Ibrahim
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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13
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Zhao Y, Liu R, Takeda K. Incorporating historical information to improve dose optimization design with toxicity and efficacy endpoints: iBOIN-ET. Pharm Stat 2022; 22:440-460. [PMID: 36514849 DOI: 10.1002/pst.2281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/13/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022]
Abstract
In modern oncology drug development, adaptive designs have been proposed to identify the recommended phase 2 dose. The conventional dose finding designs focus on the identification of maximum tolerated dose (MTD). However, designs ignoring efficacy could put patients under risk by pushing to the MTD. Especially in immuno-oncology and cell therapy, the complex dose-toxicity and dose-efficacy relationships make such MTD driven designs more questionable. Additionally, it is not uncommon to have data available from other studies that target on similar mechanism of action and patient population. Due to the high variability from phase I trial, it is beneficial to borrow historical study information into the design when available. This will help to increase the model efficiency and accuracy and provide dose specific recommendation rules to avoid toxic dose level and increase the chance of patient allocation at potential efficacious dose levels. In this paper, we propose iBOIN-ET design that uses prior distribution extracted from historical studies to minimize the probability of decision error. The proposed design utilizes the concept of skeleton from both toxicity and efficacy data, coupled with prior effective sample size to control the amount of historical information to be incorporated. Extensive simulation studies across a variety of realistic settings are reported including a comparison of iBOIN-ET design to other model based and assisted approaches. The proposed novel design demonstrates the superior performances in percentage of selecting the correct optimal dose (OD), average number of patients allocated to the correct OD, and overdosing control during dose escalation process.
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Affiliation(s)
- Yunqi Zhao
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Rachael Liu
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Kentaro Takeda
- Data Science, Astellas Pharma Global Development, Inc., Northbrook, Illinois, USA
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14
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Chao YC, Braun TM, Tamura RN, Kidwell KM. Power prior models for estimating response rates in a small n, sequential, multiple assignment, randomized trial. Stat Methods Med Res 2022; 31:2297-2309. [PMID: 36082955 DOI: 10.1177/09622802221122795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A small n, sequential, multiple assignment, randomized trial (snSMART) is a small sample, two-stage design where participants receive up to two treatments sequentially, but the second treatment depends on response to the first treatment. The parameters of interest in an snSMART are the first-stage response rates of the treatments, but outcomes from both stages can be used to obtain more information from a small sample. A novel way to incorporate the outcomes from both stages uses power prior models, in which first stage outcomes from an snSMART are regarded as the primary (internal) data and second stage outcomes are regarded as supplemental data (co-data). We apply existing power prior models to snSMART data, and we also develop new extensions of power prior models. All methods are compared to each other and to the Bayesian joint stage model (BJSM) via simulation studies. By comparing the biases and the efficiency of the response rate estimates among all proposed power prior methods, we suggest application of Fisher's Exact Test or the Bhattacharyya's overlap measure to an snSMART to estimate the response rates in an snSMART, which both have performance mostly as good or better than the BJSM. We describe the situations where each of these suggested approaches is preferred.
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Affiliation(s)
- Yan-Cheng Chao
- Department of Biostatistics, 51329School of Public Health, University of Michigan, Ann Arbor, MI USA
| | - Thomas M Braun
- Department of Biostatistics, 51329School of Public Health, University of Michigan, Ann Arbor, MI USA
| | - Roy N Tamura
- Health Informatics Institute, 7831University of South Florida, Tampa, FL USA
| | - Kelley M Kidwell
- Department of Biostatistics, 51329School of Public Health, University of Michigan, Ann Arbor, MI USA
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15
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Ohigashi T, Maruo K, Sozu T, Gosho M. Using horseshoe prior for incorporating multiple historical control data in randomized controlled trials. Stat Methods Med Res 2022; 31:1392-1404. [PMID: 35379046 DOI: 10.1177/09622802221090752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Meta-analytic approaches and power priors are often used to incorporate historical controls into the analysis of a current randomized controlled trial. In this study, we propose a method for incorporating multiple historical controls based on a horseshoe prior, which is a type of global-local shrinkage prior. The method assumes that historical controls follow the same distribution as the current control. In the case in which only a few historical controls are heterogeneous, we consider them to follow a potentially biased distribution from the distribution of the current control. We analyze two clinical trial examples with binary and time-to-event endpoints and conduct simulation studies to compare the performance of the proposed and existing methods. In the analysis of the clinical trial example, the posterior standard deviation of the treatment effect is decreased by the proposed method by considering the bias between the current control and heterogeneous historical control. In the scenarios in which the current and historical controls follow the same distribution, the statistical power using the proposed method is higher than that using existing methods. The proposed method is advantageous when few or no heterogeneous historical controls are expected.
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Affiliation(s)
- Tomohiro Ohigashi
- Graduate School of Comprehensive Human Sciences, 13121University of Tsukuba, Tsukuba, Japan.,Department of Biostatistics, Tsukuba Clinical Research & Development Organization, 13121University of Tsukuba, Tsukuba, Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, 13121University of Tsukuba, Tsukuba, Japan
| | - Takashi Sozu
- Department of Information and Computer Technology, Faculty of Engineering, 26413Tokyo University of Science, Tokyo, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, 13121University of Tsukuba, Tsukuba, Japan
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16
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Affiliation(s)
- Zifei Han
- School of Statistics, University of International Business and Economics
| | - Keying Ye
- Department of Management Science and Statistics, The University of Texas at San Antonio
| | - Min Wang
- Department of Management Science and Statistics, The University of Texas at San Antonio
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17
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Qi H, Rizopoulos D, Lesaffre E, van Rosmalen J. Incorporating historical controls in clinical trials with longitudinal outcomes using the modified power prior. Pharm Stat 2022; 21:818-834. [PMID: 35128780 PMCID: PMC9356117 DOI: 10.1002/pst.2195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/12/2022] [Accepted: 01/22/2022] [Indexed: 11/16/2022]
Abstract
Several dynamic borrowing methods, such as the modified power prior (MPP), the commensurate prior, have been proposed to increase statistical power and reduce the required sample size in clinical trials where comparable historical controls are available. Most methods have focused on cross‐sectional endpoints, and appropriate methodology for longitudinal outcomes is lacking. In this study, we extend the MPP to the linear mixed model (LMM). An important question is whether the MPP should use the conditional version of the LMM (given the random effects) or the marginal version (averaged over the distribution of the random effects), which we refer to as the conditional MPP and the marginal MPP, respectively. We evaluated the MPP for one historical control arm via a simulation study and an analysis of the data of Alzheimer's Disease Cooperative Study (ADCS) with the commensurate prior as the comparator. The conditional MPP led to inflated type I error rate when there existed moderate or high between‐study heterogeneity. The marginal MPP and the commensurate prior yielded a power gain (3.6%–10.4% vs. 0.6%–4.6%) with the type I error rates close to 5% (5.2%–6.2% vs. 3.8%–6.2%) when the between‐study heterogeneity is not excessively high. For the ADCS data, all the borrowing methods improved the precision of estimates and provided the same clinical conclusions. The marginal MPP and the commensurate prior are useful for borrowing historical controls in longitudinal data analysis, while the conditional MPP is not recommended due to inflated type I error rates.
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Affiliation(s)
- Hongchao Qi
- Department of BiostatisticsErasmus University Medical CenterRotterdamThe Netherlands
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Dimitris Rizopoulos
- Department of BiostatisticsErasmus University Medical CenterRotterdamThe Netherlands
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
| | | | - Joost van Rosmalen
- Department of BiostatisticsErasmus University Medical CenterRotterdamThe Netherlands
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
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18
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Faya P, Novick S, Seaman JW, Peterson JJ, Pourmohamad T, Banton D, Zheng Y. Continuous method validation: beyond one-time studies to characterize analytical methods. Stat Biopharm Res 2022. [DOI: 10.1080/19466315.2022.2036637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Paul Faya
- Statistics – Discovery/Development, Eli Lilly and Company, Indianapolis, IN, USA
| | - Steven Novick
- Department of Data Sciences & Quantitative Biology, Discovery Sciences, R&D, AstraZeneca, Gaithersburg, MD, USA
| | - John W. Seaman
- Department of Statistical Science, Baylor University, Waco, TX, USA
| | | | | | - Dwaine Banton
- Translational Medicine and Early Development Statistics, Janssen, Raritan, NJ, USA
| | - Yanbing Zheng
- Data and Statistical Sciences, AbbVie Inc., North Chicago, IL, USA
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19
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20
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Wang X, Suttner L, Jemielita T, Li X. Propensity score-integrated Bayesian prior approaches for augmented control designs: a simulation study. J Biopharm Stat 2021; 32:170-190. [PMID: 34939894 DOI: 10.1080/10543406.2021.2011743] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Drug development can be costly, and the availability of clinical trial participants may be limited either due to the disease setting (rare or pediatric diseases) or due to many sponsors evaluating multiple drugs or combinations in the same patient population. To maximize resource utilization, sponsors may leverage patient-level control data from historical trials. However, in a study with no control arm, it is impossible to evaluate if the historical controls are an appropriate comparator for the current study. Here, instead of conducting a single-arm trial and relying solely on historical controls, we evaluate the situation where a minimal number of patients are enrolled into a control arm, which is augmented by borrowing historical control data. Propensity score (PS) methods are commonly used to minimize bias for non-randomized data. In addition, Bayesian information borrowing with PS adjustments has been proposed when it may not be reasonable to include all available historical data. This paper proposes using PS adjustment integrated with Bayesian commensurate priors to adaptively borrow information. We then evaluate the performance of different PS adjustment methods and different Bayesian priors for augmented control using simulation studies to help inform the design of future trials. In general, we find that propensity weighting or matching combined with the commensurate prior yield reasonable statistical properties across a range of scenarios. Finally, our proposed methods are applied to a real trial with a binary outcome.Abbreviations: PS: propensity score; IPTW: inverse probability of treatment weighting; ATT: average treatment effect on those who received treatment; RCT: randomized controlled trial; CDD: covariate distribution difference; ESS: effective sample size.
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Affiliation(s)
- Xi Wang
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
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21
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Banbeta A, Lesaffre E, van Rosmalen J. The power prior with multiple historical controls for the linear regression model. Pharm Stat 2021; 21:418-438. [PMID: 34851549 DOI: 10.1002/pst.2178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 11/06/2022]
Abstract
Combining historical control data with current control data may reduce the necessary study size of a clinical trial. However, this only applies when the historical control data are similar enough to the current control data. Several Bayesian approaches for incorporating historical data in a dynamic way have been proposed, such as the meta-analytic-predictive (MAP) prior and the modified power prior (MPP). Here we discuss the generalization of the MPP approach for multiple historical control groups for the linear regression model. This approach is useful when the controls differ more than in a random way, but become again (approximately) exchangeable conditional on covariates. The proposed approach builds on the approach previously developed for binary outcomes by some of the current authors. Two MPP approaches have been developed with multiple controls. The first approach assumes independent powers, while in the second approach the powers have a hierarchical structure. We conducted several simulation studies to investigate the frequentist characteristics of borrowing methods and analyze a real-life data set. When there is between-study variation in the slopes of the model or in the covariate distributions, the MPP approach achieves approximately nominal type I error rates and greater power than the MAP prior, provided that the covariates are included in the model. When the intercepts vary, the MPP yields a slightly inflated type I error rate, whereas the MAP does not. We conclude that our approach is a worthy competitor to the MAP approach for the linear regression case.
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Affiliation(s)
- Akalu Banbeta
- I-Biostat, UHasselt, Hasselt, Belgium.,Department of Statistics, Jimma University, Jimma, Ethiopia
| | | | - Joost van Rosmalen
- Department of Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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22
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Jin H, Yin G. Unit information prior for adaptive information borrowing from multiple historical datasets. Stat Med 2021; 40:5657-5672. [PMID: 34302378 DOI: 10.1002/sim.9146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 11/06/2022]
Abstract
In clinical trials, there often exist multiple historical studies for the same or related treatment investigated in the current trial. Incorporating historical data in the analysis of the current study is of great importance, as it can help to gain more information, improve efficiency, and provide a more comprehensive evaluation of treatment. Enlightened by the unit information prior (UIP) concept in the reference Bayesian test, we propose a new informative prior called UIP from an information perspective that can adaptively borrow information from multiple historical datasets. We consider both binary and continuous data and also extend the new UIP to linear regression settings. Extensive simulation studies demonstrate that our method is comparable to other commonly used informative priors, while the interpretation of UIP is intuitive and its implementation is relatively easy. One distinctive feature of UIP is that its construction only requires summary statistics commonly reported in the literature rather than the patient-level data. By applying our UIP to phase III clinical trials for investigating the efficacy of memantine in Alzheimer's disease, we illustrate its ability to adaptively borrow information from multiple historical datasets. The Python codes for simulation studies and the real data application are available at https://github.com/JINhuaqing/UIP.
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Affiliation(s)
- Huaqing Jin
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong SAR, China
| | - Guosheng Yin
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong SAR, China
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23
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Thompson L, Chu J, Xu J, Li X, Nair R, Tiwari R. Dynamic borrowing from a single prior data source using the conditional power prior. J Biopharm Stat 2021; 31:403-424. [PMID: 34520325 DOI: 10.1080/10543406.2021.1895190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The conditional power prior is a popular method to borrow information from a single prior data source. The amount of borrowing is controlled by the power parameter which is fixed before running the new study. However, fixing this parameter before running a new study is often difficult and may be unwise because if the outcomes in the current study are much different from the prior data outcomes, the power parameter cannot be changed to reflect a more appropriate degree of borrowing. On the other hand, treating the power parameter as a random variable to be updated via Bayes theorem may relinquish control over how much to borrow in cases where regulatory oversight recommends a conservative approach.Previous authors have determined the power parameter at the end of the current study based on "stochastic" similarity in the outcomes between the current study and the prior data. In this paper, we introduce some modifications to those methods. First, we determine the power parameter based on similarity between a percentage of the current study outcome data available at an interim look and the prior outcome data. This may limit potential for operational bias resulting from the determination of the power parameter after the current study is complete. Next, we introduce a new measure of similarity between the current (interim) and prior data that limits similarity by a pre-specified clinical margin. The proposed clinical similarity region may be readily understood by clinicians who need to assess when such borrowing is clinically appropriate. Through simulations, we show that our approach has low bias and good power, while reducing type I error rate in areas outside of the "similarity region". An example of a hypothetical medical device study illustrates its potential use in practice.
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Affiliation(s)
- Laura Thompson
- Division of Biostatistics, Center for Biologics and Evaluation Research, U.S. Food and Drug Administration, Silver Spring, Maryland, United States
| | - Jianxiong Chu
- Division of Biostatistics, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, United States
| | - Jianjin Xu
- Division of Biostatistics, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, United States
| | - Xuefeng Li
- Division of Biostatistics, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, United States
| | - Rajesh Nair
- Division of Biostatistics, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, United States
| | - Ram Tiwari
- Division of Biostatistics, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, United States
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24
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Liu M, Bunn V, Hupf B, Lin J, Lin J. Propensity-score-based meta-analytic predictive prior for incorporating real-world and historical data. Stat Med 2021; 40:4794-4808. [PMID: 34126656 DOI: 10.1002/sim.9095] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/07/2021] [Accepted: 05/27/2021] [Indexed: 01/20/2023]
Abstract
As the availability of real-world data sources (eg, EHRs, claims data, registries) and historical data has rapidly surged in recent years, there is an increasing interest and need from investigators and health authorities to leverage all available information to reduce patient burden and accelerate both drug development and regulatory decision making. Bayesian meta-analytic approaches are a popular historical borrowing method that has been developed to leverage such data using robust hierarchical models. The model structure accounts for various degrees of between-trial heterogeneity, resulting in adaptively discounting the external information in the case of data conflict. In this article, we propose to integrate the propensity score method and Bayesian meta-analytic-predictive (MAP) prior to leverage external real-world and historical data. The propensity score methodology is applied to select a subset of patients from external data that are similar to those in the current study with regards to key baseline covariates and to stratify the selected patients together with those in the current study into more homogeneous strata. The MAP prior approach is used to obtain stratum-specific MAP prior and derive the overall propensity score integrated meta-analytic predictive (PS-MAP) prior. Additionally, we allow for tuning the prior effective sample size for the proposed PS-MAP prior, which quantifies the amount of information borrowed from external data. We evaluate the performance of the proposed PS-MAP prior by comparing it to the existing propensity score-integrated power prior approach in a simulation study and illustrate its implementation with an example of a single-arm phase II trial.
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Affiliation(s)
- Meizi Liu
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Veronica Bunn
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Bradley Hupf
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Junjing Lin
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Jianchang Lin
- Statistical and Quantitative Sciences, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
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25
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Hupf B, Bunn V, Lin J, Dong C. Bayesian semiparametric meta-analytic-predictive prior for historical control borrowing in clinical trials. Stat Med 2021; 40:3385-3399. [PMID: 33851441 DOI: 10.1002/sim.8970] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 12/22/2022]
Abstract
When designing a clinical trial, borrowing historical control information can provide a more efficient approach by reducing the necessary control arm sample size while still yielding increased power. Several Bayesian methods for incorporating historical information via a prior distribution have been proposed, for example, (modified) power prior, (robust) meta-analytic predictive prior. When utilizing historical control borrowing, the prior parameter(s) must be specified to determine the magnitude of borrowing before the current data are observed. Thus, a flexible prior is needed in case of heterogeneity between historic trials or prior data conflict with the current trial. To incorporate the ability to selectively borrow historic information, we propose a Bayesian semiparametric meta-analytic-predictive prior. Using a Dirichlet process mixture prior allows for relaxation of parametric assumptions, and lets the model adaptively learn the relationship between the historic and current control data. Additionally, we generalize a method for estimating the prior effective sample size (ESS) for the proposed prior. This gives an intuitive quantification of the amount of information borrowed from historical trials, and aids in tuning the prior to the specific task at hand. We illustrate the effectiveness of the proposed methodology by comparing performance between existing methods in an extensive simulation study and a phase II proof-of-concept trial in ankylosing spondylitis. In summary, our proposed robustification of the meta-analytic-predictive prior alleviates the need for prespecifying the amount of borrowing, providing a more flexible and robust method to integrate historical data from multiple study sources in the design and analysis of clinical trials.
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Affiliation(s)
- Bradley Hupf
- Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Veronica Bunn
- Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Jianchang Lin
- Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Cheng Dong
- Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
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26
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Bassi A, Berkhof J, de Jong D, van de Ven PM. Bayesian adaptive decision-theoretic designs for multi-arm multi-stage clinical trials. Stat Methods Med Res 2020; 30:717-730. [PMID: 33243087 PMCID: PMC8008394 DOI: 10.1177/0962280220973697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Multi-arm multi-stage clinical trials in which more than two drugs are simultaneously investigated provide gains over separate single- or two-arm trials. In this paper we propose a generic Bayesian adaptive decision-theoretic design for multi-arm multi-stage clinical trials with K (K≥2) arms. The basic idea is that after each stage a decision about continuation of the trial and accrual of patients for an additional stage is made on the basis of the expected reduction in loss. For this purpose, we define a loss function that incorporates the patient accrual costs as well as costs associated with an incorrect decision at the end of the trial. An attractive feature of our loss function is that its estimation is computationally undemanding, also when K > 2. We evaluate the frequentist operating characteristics for settings with a binary outcome and multiple experimental arms. We consider both the situation with and without a control arm. In a simulation study, we show that our design increases the probability of making a correct decision at the end of the trial as compared to nonadaptive designs and adaptive two-stage designs.
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Affiliation(s)
- Andrea Bassi
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Johannes Berkhof
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daphne de Jong
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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27
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Hatswell A, Freemantle N, Baio G, Lesaffre E, van Rosmalen J. Summarising salient information on historical controls: A structured assessment of validity and comparability across studies. Clin Trials 2020; 17:607-616. [PMID: 32957804 PMCID: PMC7649932 DOI: 10.1177/1740774520944855] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND While placebo-controlled randomised controlled trials remain the standard way to evaluate drugs for efficacy, historical data are used extensively across the development cycle. This ranges from supplementing contemporary data to increase the power of trials to cross-trial comparisons in estimating comparative efficacy. In many cases, these approaches are performed without in-depth review of the context of data, which may lead to bias and incorrect conclusions. METHODS We discuss the original 'Pocock' criteria for the use of historical data and how the use of historical data has evolved over time. Based on these factors and personal experience, we created a series of questions that may be asked of historical data, prior to their use. Based on the answers to these questions, various statistical approaches are recommended. The strategy is illustrated with a case study in colorectal cancer. RESULTS A number of areas need to be considered with historical data, which we split into three categories: outcome measurement, study/patient characteristics (including setting and inclusion/exclusion criteria), and disease process/intervention effects. Each of these areas may introduce issues if not appropriately handled, while some may preclude the use of historical data entirely. We present a tool (in the form of a table) for highlighting any such issues. Application of the tool to a colorectal cancer data set demonstrates under what conditions historical data could be used and what the limitations of such an analysis would be. CONCLUSION Historical data can be a powerful tool to augment or compare with contemporary trial data, though caution is required. We present some of the issues that may be considered when involving historical data and what (if any) statistical approaches may account for differences between studies. We recommend that, where historical data are to be used in analyses, potential differences between studies are addressed explicitly.
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Affiliation(s)
- Anthony Hatswell
- Department of Statistical Science, University College London, London, UK.,Delta Hat Limited, Nottingham, UK
| | - Nick Freemantle
- Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Gianluca Baio
- Department of Statistical Science, University College London, London, UK
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28
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Hall KT, Vase L, Tobias DK, Dashti HT, Vollert J, Kaptchuk TJ, Cook NR. Historical Controls in Randomized Clinical Trials: Opportunities and Challenges. Clin Pharmacol Ther 2020; 109:343-351. [PMID: 32602555 DOI: 10.1002/cpt.1970] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022]
Abstract
Randomized control trials (RCTs) with placebo are the gold standard for determining efficacy of novel pharmaceutical treatments. Since their inception, over 75 years ago, researchers have amassed a large body of underutilized data on outcomes in the placebo control arms of these trials. Although rare disease indications have used these historical placebo data as synthetic controls to reduce burden on patients and accelerate drug discovery, broad use of historical controls is in its infancy. Large-scale historical placebo data could be leveraged to benefit both drug developers and patients if warehoused and made more available to guide trial design and analysis. Here, we examine challenges in utilizing historical controls related to heterogeneity in trial design, outcome ascertainment, patient characteristics, and unmeasured pharmacogenomic effects. We then discuss the advantages and disadvantages of current approaches and propose a path forward to broader use of historical controls in RCTs.
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Affiliation(s)
- Kathryn T Hall
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Lene Vase
- Department of Psychology and Behavioral Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Deirdre K Tobias
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Hesam T Dashti
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Jan Vollert
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.,Neurophysiology, Centre for Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Ruprecht-Karls-University, Heidelberg, Germany
| | - Ted J Kaptchuk
- Harvard Medical School, Boston, Massachusetts, USA.,Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Nancy R Cook
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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