1
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Mueller S, Kline C, Franson A, van der Lugt J, Prados M, Waszak SM, Plasschaert SLA, Molinaro AM, Koschmann C, Nazarian J. Rational combination platform trial design for children and young adults with diffuse midline glioma: A report from PNOC. Neuro Oncol 2024; 26:S125-S135. [PMID: 38124481 PMCID: PMC11066905 DOI: 10.1093/neuonc/noad181] [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: 05/23/2023] [Indexed: 12/23/2023] Open
Abstract
Background Diffuse midline glioma (DMG) is a devastating pediatric brain tumor unresponsive to hundreds of clinical trials. Approximately 80% of DMGs harbor H3K27M oncohistones, which reprogram the epigenome to increase the metabolic profile of the tumor cells. Methods We have previously shown preclinical efficacy of targeting both oxidative phosphorylation and glycolysis through treatment with ONC201, which activates the mitochondrial protease ClpP, and paxalisib, which inhibits PI3K/mTOR, respectively. Results ONC201 and paxalisib combination treatment aimed at inducing metabolic distress led to the design of the first DMG-specific platform trial PNOC022 (NCT05009992). Conclusions Here, we expand on the PNOC022 rationale and discuss various considerations, including liquid biome, microbiome, and genomic biomarkers, quality-of-life endpoints, and novel imaging modalities, such that we offer direction on future clinical trials in DMG.
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Affiliation(s)
- Sabine Mueller
- Department of Neurology, Neurosurgery and Pediatrics, University of California, San Francisco, California, USA
| | - Cassie Kline
- Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Andrea Franson
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Michael Prados
- Department of Neurosurgery and Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Sebastian M Waszak
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
- Laboratory of Computational Neuro-Oncology, Swiss Institute for Experimental Cancer Research, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | | | - Annette M Molinaro
- Division of Biomedical Statistics and Informatics, Department of Neurosurgery, University of California, San Francisco, San Francisco, California, USA
| | - Carl Koschmann
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Javad Nazarian
- Research Center for Genetic Medicine, Children’s National Health System, Washington, District of Columbia, USA
- Brain Tumor Institute, Children’s National Health System, Washington, District of Columbia, USA
- DMG Research Center, Department of Pediatrics, University Children’s Hospital, University of Zurich, Zürich, Switzerland
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2
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Su L, Chen X, Zhang J, Yan F. MIDAS-2: an enhanced Bayesian platform design for immunotherapy combinations with subgroup efficacy exploration. J Biopharm Stat 2023:1-21. [PMID: 38131109 DOI: 10.1080/10543406.2023.2292211] [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: 02/09/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
Although immunotherapy combinations have revolutionised cancer treatment, the rapid screening of effective and optimal therapies from large numbers of candidate combinations, as well as exploring subgroup efficacy, remains challenging. This necessitates innovative, integrated, and efficient trial designs. In this study, we extend the MIDAS design to include subgroup exploration and propose an enhanced Bayesian information borrowing platform design called MIDAS-2. MIDAS-2 enables quick and continuous screening of promising combination strategies and exploration of their subgroup effects within a unified platform design framework. We use a regression model to characterize the efficacy pattern in subgroups. Information borrowing is applied through Bayesian hierarchical modelling to improve trial efficiency considering the limited sample size in subgroups. Time trend calibration is also employed to avoid potential baseline drifts. Simulation results demonstrate that MIDAS-2 yields high probabilities for identifying the effective drug combinations as well as promising subgroups, facilitating appropriate selection of the best treatments for each subgroup. The proposed design is robust against small time trend drifts, and the type I error is successfully controlled after calibration when a large drift is expected. Overall, MIDAS-2 provides an adaptive drug screening and subgroup exploring framework to accelerate immunotherapy development in an efficient, accurate, and integrated fashion.
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Affiliation(s)
- Liwen Su
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Xin Chen
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jingyi Zhang
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Fangrong Yan
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
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3
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Cao H, Yao C, Yuan Y. Bayesian approach for design and analysis of medical device trials in the era of modern clinical studies. MEDICAL REVIEW (2021) 2023; 3:408-424. [PMID: 38283256 PMCID: PMC10810749 DOI: 10.1515/mr-2023-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/22/2023] [Indexed: 01/30/2024]
Abstract
Medical device technology develops rapidly, and the life cycle of a medical device is much shorter than drugs. It is necessary to evaluate the safety and effectiveness of a medical device in a timely manner to keep up with technology flux. Bayesian methods provides an efficient approach to addressing this challenge. In this article, we review the characteristics of the Bayesian approach and some Bayesian designs that were commonly used in medical device regulatory setting, including Bayesian adaptive design, Bayesian diagnostic design, Bayesian multiregional design, and Bayesian label expansion study. We illustrate these designs with medical devices approved by the US Food and Drug Administration (FDA). We also review several innovative Bayesian information borrowing methods, and briefly discuss the challenges and future directions of the Bayesian application in medical device trials. Our objective is to promote the use of the Bayesian approach to accelerate the development of innovative medical devices and their accessibility to patients for effective disease diagnoses and treatments.
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Affiliation(s)
- Han Cao
- Department of Biostatistics, Peking University First Hospital, Beijing, China
- Medical Data Science Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Chen Yao
- Department of Biostatistics, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute, Beijing, China
- Hainan Institute of Real World Data, Qionghai, Hainan Province, China
| | - Ying Yuan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA
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4
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Racine-Poon A, D’Amelio A, Sverdlov O, Haas T. OPTIM-ARTS—An Adaptive Phase II Open Platform Trial Design With Application to a Metastatic Melanoma Study. Stat Biopharm Res 2022. [DOI: 10.1080/19466315.2020.1749722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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5
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Zhao Y, Tang RS, Du Y, Yuan Y. A bayesian platform trial design to simultaneously evaluate multiple drugs in multiple indications with mixed endpoints. Biometrics 2022. [PMID: 35546501 DOI: 10.1111/biom.13694] [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: 04/24/2021] [Accepted: 04/22/2022] [Indexed: 11/29/2022]
Abstract
In the era of targeted therapies and immunotherapies, the traditional drug development paradigm of testing one drug at a time in one indication has become increasingly inefficient. Motivated by a real-world application, we propose a master-protocol-based Bayesian platform trial design with mixed endpoints (PDME) to simultaneously evaluate multiple drugs in multiple indications, where different subsets of efficacy measures (e.g., objective response and landmark progression-free survival) may be used by different indications as single or multiple endpoints. We propose a Bayesian hierarchical model to accommodate mixed endpoints and reflect the trial structure of indications that are nested within treatments. We develop a two-stage approach that first clusters the indications into homogeneous subgroups and then applies the Bayesian hierarchical model to each subgroup to achieve precision information borrowing. Patients are enrolled in a group-sequential way and adaptively assigned to treatments according to their efficacy estimates. At each interim analysis, the posterior probabilities that the treatment effect exceeds prespecified clinically relevant thresholds are used to drop ineffective treatments and "graduate" effective treatments. Simulations show that the PDME design has desirable operating characteristics compared to existing method. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yujie Zhao
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, United States
| | - Rui Sammi Tang
- Servier Pharmaceuticals, Boston, MA, 02210, United States
| | - Yeting Du
- Servier Pharmaceuticals, Boston, MA, 02210, United States
| | - Ying Yuan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, United States
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6
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Meyer EL, Mesenbrink P, Dunger‐Baldauf C, Glimm E, Li Y, König F. Decision rules for identifying combination therapies in open-entry, randomized controlled platform trials. Pharm Stat 2022; 21:671-690. [PMID: 35102685 PMCID: PMC9304586 DOI: 10.1002/pst.2194] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 10/29/2021] [Accepted: 01/09/2022] [Indexed: 12/28/2022]
Abstract
Platform trials have become increasingly popular for drug development programs, attracting interest from statisticians, clinicians and regulatory agencies. Many statistical questions related to designing platform trials-such as the impact of decision rules, sharing of information across cohorts, and allocation ratios on operating characteristics and error rates-remain unanswered. In many platform trials, the definition of error rates is not straightforward as classical error rate concepts are not applicable. For an open-entry, exploratory platform trial design comparing combination therapies to the respective monotherapies and standard-of-care, we define a set of error rates and operating characteristics and then use these to compare a set of design parameters under a range of simulation assumptions. When setting up the simulations, we aimed for realistic trial trajectories, such that for example, a priori we do not know the exact number of treatments that will be included over time in a specific simulation run as this follows a stochastic mechanism. Our results indicate that the method of data sharing, exact specification of decision rules and a priori assumptions regarding the treatment efficacy all strongly contribute to the operating characteristics of the platform trial. Furthermore, different operating characteristics might be of importance to different stakeholders. Together with the potential flexibility and complexity of a platform trial, which also impact the achieved operating characteristics via, for example, the degree of efficiency of data sharing this implies that utmost care needs to be given to evaluation of different assumptions and design parameters at the design stage.
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Affiliation(s)
- Elias Laurin Meyer
- Center for Medical Statistics, Informatics, and Intelligent SystemsMedical University of ViennaViennaAustria
| | - Peter Mesenbrink
- Analytics DepartmentNovartis Pharmaceuticals CorporationEast HanoverNew JerseyUSA
| | | | - Ekkehard Glimm
- Analytics DepartmentNovartis Pharma AGBaselSwitzerland
- Institute of Biometry and Medical InformaticsUniversity of MagdeburgMagdeburgGermany
| | - Yuhan Li
- Analytics DepartmentNovartis Pharmaceuticals CorporationEast HanoverNew JerseyUSA
| | - Franz König
- Center for Medical Statistics, Informatics, and Intelligent SystemsMedical University of ViennaViennaAustria
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7
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An Adaptive Information Borrowing Platform Design for Testing Drug Candidates of COVID-19. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:9293681. [PMID: 35462681 PMCID: PMC9029212 DOI: 10.1155/2022/9293681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/16/2022] [Indexed: 12/15/2022]
Abstract
Background There have been thousands of clinical trials for COVID-19 to target effective treatments. However, quite a few of them are traditional randomized controlled trials with low efficiency. Considering the three particularities of pandemic disease: timeliness, repurposing, and case spike, new trial designs need to be developed to accelerate drug discovery. Methods We propose an adaptive information borrowing platform design that can sequentially test drug candidates under a unified framework with early efficacy/futility stopping. Power prior is used to borrow information from previous stages and the time trend calibration method deals with the baseline effectiveness drift. Two drug development strategies are applied: the comprehensive screening strategy and the optimal screening strategy. At the same time, we adopt adaptive randomization to set a higher allocation ratio to the experimental arms for ethical considerations, which can help more patients to receive the latest treatments and shorten the trial duration. Results Simulation shows that in general, our method has great operating characteristics with type I error controlled and power increased, which can select effective/optimal drugs with a high probability. The early stopping rules can be successfully triggered to stop the trial when drugs are either truly effective or not optimal, and the time trend calibration performs consistently well with regard to different baseline drifts. Compared with the nonborrowing method, borrowing information in the design substantially improves the probability of screening promising drugs and saves the sample size. Sensitivity analysis shows that our design is robust to different design parameters. Conclusions Our proposed design achieves the goal of gaining efficiency, saving sample size, meeting ethical requirements, and speeding up the trial process and is suitable and well performed for COVID-19 clinical trials to screen promising treatments or target optimal therapies.
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8
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Su L, Chen X, Zhang J, Yan F. Comparative Study of Bayesian Information Borrowing Methods in Oncology Clinical Trials. JCO Precis Oncol 2022; 6:e2100394. [PMID: 35263169 PMCID: PMC8926037 DOI: 10.1200/po.21.00394] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
With deeper insight into precision medicine, more innovative oncology trial designs have been proposed to contribute to the characteristics of novel antitumor drugs. Bayesian information borrowing is an indispensable part of these designs, which shows great advantages in improving the efficiency of clinical trials. Bayesian methods provide an effective framework when incorporating information. However, the key point lies in how to choose an appropriate method for complex oncology clinical trials.
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Affiliation(s)
- Liwen Su
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Xin Chen
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jingyi Zhang
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Fangrong Yan
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
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9
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Meyer EL, Mesenbrink P, Mielke T, Parke T, Evans D, König F. Systematic review of available software for multi-arm multi-stage and platform clinical trial design. Trials 2021; 22:183. [PMID: 33663579 PMCID: PMC7931508 DOI: 10.1186/s13063-021-05130-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/13/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In recent years, the popularity of multi-arm multi-stage, seamless adaptive, and platform trials has increased. However, many design-related questions and questions regarding which operating characteristics should be evaluated to determine the potential performance of a specific trial design remain and are often further complicated by the complexity of such trial designs. METHODS A systematic search was conducted to review existing software for the design of platform trials, whereby multi-arm multi-stage trials were also included. The results of this search are reported both on the literature level and the software level, highlighting the software judged to be particularly useful. RESULTS In recent years, many highly specialized software packages targeting single design elements on platform studies have been released. Only a few of the developed software packages provide extensive design flexibility, at the cost of limited access due to being commercial or not being usable as out-of-the-box solutions. CONCLUSIONS We believe that both an open-source modular software similar to OCTOPUS and a collaborative effort will be necessary to create software that takes advantage of and investigates the impact of all the flexibility that platform trials potentially provide.
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Affiliation(s)
- Elias Laurin Meyer
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Peter Mesenbrink
- Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, USA
| | | | | | | | - Franz König
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
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10
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Hamamoto R, Suvarna K, Yamada M, Kobayashi K, Shinkai N, Miyake M, Takahashi M, Jinnai S, Shimoyama R, Sakai A, Takasawa K, Bolatkan A, Shozu K, Dozen A, Machino H, Takahashi S, Asada K, Komatsu M, Sese J, Kaneko S. Application of Artificial Intelligence Technology in Oncology: Towards the Establishment of Precision Medicine. Cancers (Basel) 2020; 12:E3532. [PMID: 33256107 PMCID: PMC7760590 DOI: 10.3390/cancers12123532] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 02/07/2023] Open
Abstract
In recent years, advances in artificial intelligence (AI) technology have led to the rapid clinical implementation of devices with AI technology in the medical field. More than 60 AI-equipped medical devices have already been approved by the Food and Drug Administration (FDA) in the United States, and the active introduction of AI technology is considered to be an inevitable trend in the future of medicine. In the field of oncology, clinical applications of medical devices using AI technology are already underway, mainly in radiology, and AI technology is expected to be positioned as an important core technology. In particular, "precision medicine," a medical treatment that selects the most appropriate treatment for each patient based on a vast amount of medical data such as genome information, has become a worldwide trend; AI technology is expected to be utilized in the process of extracting truly useful information from a large amount of medical data and applying it to diagnosis and treatment. In this review, we would like to introduce the history of AI technology and the current state of medical AI, especially in the oncology field, as well as discuss the possibilities and challenges of AI technology in the medical field.
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Affiliation(s)
- Ryuji Hamamoto
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
- Department of NCC Cancer Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Kruthi Suvarna
- Indian Institute of Technology Bombay, Powai, Mumbai 400 076, India;
| | - Masayoshi Yamada
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Department of Endoscopy, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku Tokyo 104-0045, Japan
| | - Kazuma Kobayashi
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
- Department of NCC Cancer Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Norio Shinkai
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
- Department of NCC Cancer Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Mototaka Miyake
- Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;
| | - Masamichi Takahashi
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Shunichi Jinnai
- Department of Dermatologic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;
| | - Ryo Shimoyama
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
| | - Akira Sakai
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Department of NCC Cancer Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Ken Takasawa
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Amina Bolatkan
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Kanto Shozu
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
| | - Ai Dozen
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
| | - Hidenori Machino
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Satoshi Takahashi
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Ken Asada
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Masaaki Komatsu
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Jun Sese
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Humanome Lab, 2-4-10 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Syuzo Kaneko
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; (M.Y.); (K.K.); (N.S.); (M.T.); (R.S.); (A.S.); (K.T.); (A.B.); (K.S.); (A.D.); (H.M.); (S.T.); (K.A.); (M.K.); (J.S.); (S.K.)
- Cancer Translational Research Team, RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
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Mu R, Pan H, Xu G. A Bayesian adaptive phase I/II platform trial design for pediatric immunotherapy trials. Stat Med 2020; 40:382-402. [PMID: 33094528 DOI: 10.1002/sim.8780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/23/2020] [Accepted: 10/01/2020] [Indexed: 11/11/2022]
Abstract
Immunotherapy is the most promising new cancer treatment for various pediatric tumors and has resulted in an unprecedented surge in the number of novel immunotherapeutic treatments that need to be evaluated in clinical trials. Most phase I/II trial designs have been developed for evaluating only one candidate treatment at a time, and are thus not optimal for this task. To address these issues, we propose a Bayesian phase I/II platform trial design, which accounts for the unique features of immunotherapy, thereby allowing investigators to continuously screen a large number of immunotherapeutic treatments in an efficient and seamless manner. The elicited numerical utility is adopted to account for the risk-benefit trade-off and to quantify the desirability of the dose. During the trial, inefficacious or overly toxic treatments are adaptively dropped from the trial and the promising treatments are graduated from the trial to the next stage of development. Once an experimental treatment is dropped or graduated, the next available new treatment can be immediately added and tested. Extensive simulation studies have demonstrated the desirable operating characteristics of the proposed design.
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Affiliation(s)
- Rongji Mu
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China
| | - Haitao Pan
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Guoying Xu
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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