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Sarhadi S, Armani A, Jafari-Gharabaghlou D, Sadeghi S, Zarghami N. Cross-platform gene expression profiling of breast cancer: Exploring the relationship between breast cancer grades and gene expression pattern. Heliyon 2024; 10:e29736. [PMID: 38681607 PMCID: PMC11053269 DOI: 10.1016/j.heliyon.2024.e29736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024] Open
Abstract
Gene expression profiling is a powerful tool that has been extensively used to investigate the underlying biology and etiology of diseases, including cancer. Microarray gene expression analysis enables simultaneous measurement of thousands of mRNA levels. Sophisticated computational approaches have evolved in parallel with the rapid progress in bioassay technologies, enabling more effective analysis of the large and complex datasets that these technologies produce. In this study, we utilized systems biology approaches to examine gene expression profiles across different grades of breast cancer progression. We conducted a meta-analysis of publicly available microarray data to elucidate the molecular mechanisms underlying breast cancer grade classification. Our results suggest that while grade index is commonly used for evaluating cancer progression status in the clinic, the complexity of molecular mechanisms, histological characteristics, and other factors related to patient outcomes raises doubts about the utility of breast cancer grades as a foundation for formulating treatment protocols. Our study underscores the importance of advancing personalized strategies for breast cancer classification and management. More research is crucial to refine diagnostic tools and treatment modalities, aiming for greater precision and tailored care in patient outcomes.
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Affiliation(s)
- Shamim Sarhadi
- Institute of Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany
| | - Arta Armani
- Department of Medical Biology and Genetic, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey
| | - Davoud Jafari-Gharabaghlou
- Department of Clinical Biochemistry and Laboratory Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayeh Sadeghi
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nosratollah Zarghami
- Department of Clinical Biochemistry and Laboratory Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Biochemistry, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey
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2
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Sun S, Sechidis K, Chen Y, Lu J, Ma C, Mirshani A, Ohlssen D, Vandemeulebroecke M, Bornkamp B. Comparing algorithms for characterizing treatment effect heterogeneity in randomized trials. Biom J 2024; 66:e2100337. [PMID: 36437036 DOI: 10.1002/bimj.202100337] [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: 10/25/2021] [Revised: 10/04/2022] [Accepted: 10/16/2022] [Indexed: 11/29/2022]
Abstract
The identification and estimation of heterogeneous treatment effects in biomedical clinical trials are challenging, because trials are typically planned to assess the treatment effect in the overall trial population. Nevertheless, the identification of how the treatment effect may vary across subgroups is of major importance for drug development. In this work, we review some existing simulation work and perform a simulation study to evaluate recent methods for identifying and estimating the heterogeneous treatments effects using various metrics and scenarios relevant for drug development. Our focus is not only on a comparison of the methods in general, but on how well these methods perform in simulation scenarios that reflect real clinical trials. We provide the R package benchtm that can be used to simulate synthetic biomarker distributions based on real clinical trial data and to create interpretable scenarios to benchmark methods for identification and estimation of treatment effect heterogeneity.
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Affiliation(s)
- Sophie Sun
- Advanced Methodology and Data Science, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | | | - Yao Chen
- Advanced Methodology and Data Science, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Jiarui Lu
- Advanced Methodology and Data Science, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Chong Ma
- Early Development Analytics, Novartis Pharmaceuticals Corporation, Cambridge, Massachusetts, USA
| | - Ardalan Mirshani
- Advanced Methodology and Data Science, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - David Ohlssen
- Advanced Methodology and Data Science, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | | | - Björn Bornkamp
- Advanced Methodology and Data Science, Novartis Pharma AG, Basel, Switzerland
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3
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Kidwai S, Barbiero P, Meijerman I, Tonda A, Perez‐Pardo P, Lio ´ P, van der Maitland‐Zee AH, Oberski DL, Kraneveld AD, Lopez‐Rincon A. A robust mRNA signature obtained via recursive ensemble feature selection predicts the responsiveness of omalizumab in moderate-to-severe asthma. Clin Transl Allergy 2023; 13:e12306. [PMID: 38006387 PMCID: PMC10655633 DOI: 10.1002/clt2.12306] [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: 04/07/2023] [Revised: 09/01/2023] [Accepted: 10/11/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Not being well controlled by therapy with inhaled corticosteroids and long-acting β2 agonist bronchodilators is a major concern for severe-asthma patients. The current treatment option for these patients is the use of biologicals such as anti-IgE treatment, omalizumab, as an add-on therapy. Despite the accepted use of omalizumab, patients do not always benefit from it. Therefore, there is a need to identify reliable biomarkers as predictors of omalizumab response. METHODS Two novel computational algorithms, machine-learning based Recursive Ensemble Feature Selection (REFS) and rule-based algorithm Logic Explainable Networks (LEN), were used on open accessible mRNA expression data from moderate-to-severe asthma patients to identify genes as predictors of omalizumab response. RESULTS With REFS, the number of features was reduced from 28,402 genes to 5 genes while obtaining a cross-validated accuracy of 0.975. The 5 responsiveness predictive genes encode the following proteins: Coiled-coil domain- containing protein 113 (CCDC113), Solute Carrier Family 26 Member 8 (SLC26A), Protein Phosphatase 1 Regulatory Subunit 3D (PPP1R3D), C-Type lectin Domain Family 4 member C (CLEC4C) and LOC100131780 (not annotated). The LEN algorithm found 4 identical genes with REFS: CCDC113, SLC26A8 PPP1R3D and LOC100131780. Literature research showed that the 4 identified responsiveness predicting genes are associated with mucosal immunity, cell metabolism, and airway remodeling. CONCLUSION AND CLINICAL RELEVANCE Both computational methods show 4 identical genes as predictors of omalizumab response in moderate-to-severe asthma patients. The obtained high accuracy indicates that our approach has potential in clinical settings. Future studies in relevant cohort data should validate our computational approach.
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Affiliation(s)
- Sarah Kidwai
- Division of PharmacologyUtrecht Institute for Pharmaceutical ScienceFaculty of ScienceUtrecht UniversityUtrechtThe Netherlands
| | - Pietro Barbiero
- Department of Computer Science and TechnologyUniversity of CambridgeCambridgeUK
| | - Irma Meijerman
- Division of PharmacologyUtrecht Institute for Pharmaceutical ScienceFaculty of ScienceUtrecht UniversityUtrechtThe Netherlands
| | | | - Paula Perez‐Pardo
- Division of PharmacologyUtrecht Institute for Pharmaceutical ScienceFaculty of ScienceUtrecht UniversityUtrechtThe Netherlands
| | - Pietro Lio ´
- Department of Computer Science and TechnologyUniversity of CambridgeCambridgeUK
| | | | - Daniel L. Oberski
- Department of Data ScienceUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Aletta D. Kraneveld
- Division of PharmacologyUtrecht Institute for Pharmaceutical ScienceFaculty of ScienceUtrecht UniversityUtrechtThe Netherlands
| | - Alejandro Lopez‐Rincon
- Division of PharmacologyUtrecht Institute for Pharmaceutical ScienceFaculty of ScienceUtrecht UniversityUtrechtThe Netherlands
- Department of Data ScienceUniversity Medical Center UtrechtUtrechtThe Netherlands
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4
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Margaritelis NV. Personalized redox biology: Designs and concepts. Free Radic Biol Med 2023; 208:112-125. [PMID: 37541453 DOI: 10.1016/j.freeradbiomed.2023.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/06/2023]
Abstract
Personalized interventions are regarded as a next-generation approach in almost all fields of biomedicine, such as clinical medicine, exercise, nutrition and pharmacology. At the same time, an increasing body of evidence indicates that redox processes regulate, at least in part, multiple aspects of human physiology and pathology. As a result, the idea of applying personalized redox treatments to improve their efficacy has gained popularity among researchers in recent years. The aim of the present primer-style review was to highlight some crucial yet underappreciated methodological, statistical, and interpretative concepts within the redox biology literature, while also providing a physiology-oriented perspective on personalized redox biology. The topics addressed are: (i) the critical issue of investigating the potential existence of inter-individual variability; (ii) the importance of distinguishing a genuine and consistent response of a subject from a chance finding; (iii) the challenge of accurately quantifying the effect of a redox treatment when dealing with 'extreme' groups due to mathematical coupling and regression to the mean; and (iv) research designs and analyses that have been implemented in other fields, and can be reframed and exploited in a redox biology context.
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Affiliation(s)
- Nikos V Margaritelis
- Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Agios Ioannis, 62122, Serres, Greece.
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5
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Segal JB, Varadhan R, Groenwold RH, Henderson NC, Li X, Nomura K, Kaplan S, Ardeshirrouhanifard S, Heyward J, Nyberg F, Burcu M. Assessing Heterogeneity of Treatment Effect in Real-World Data. Ann Intern Med 2023; 176:536-544. [PMID: 36940440 PMCID: PMC10273137 DOI: 10.7326/m22-1510] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
Increasing availability of real-world data (RWD) generated from patient care enables the generation of evidence to inform clinical decisions for subpopulations of patients and perhaps even individuals. There is growing opportunity to identify important heterogeneity of treatment effects (HTE) in these subgroups. Thus, HTE is relevant to all with interest in patients' responses to interventions, including regulators who must make decisions about products when signals of harms arise postapproval and payers who make coverage decisions based on expected net benefit to their beneficiaries. Prior work discussed HTE in randomized studies. Here, we address methodological considerations when investigating HTE in observational studies. We propose 4 primary goals of HTE analyses and the corresponding approaches in the context of RWD: to confirm subgroup effects, to describe the magnitude of HTE, to discover clinically important subgroups, and to predict individual effects. We discuss other possible goals including exploring prognostic score- and propensity score-based treatment effects, and testing the transportability of trial results to populations different from trial participants. Finally, we outline methodological needs for enhancing real-world HTE analysis.
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Affiliation(s)
- Jodi B. Segal
- Johns Hopkins University School of Medicine, Baltimore, and Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Ravi Varadhan
- Johns Hopkins University School of Medicine, Baltimore, and Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | - Xiaojuan Li
- Harvard Medical School Department of Population Medicine and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Kaori Nomura
- Jikei University School of Medicine, Tokyo, Japan
| | - Sigal Kaplan
- Teva Pharmaceutical Industries, Petah Tikva, Israel
| | | | - James Heyward
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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6
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Vishwakarma GK, Bhattacharjee A, Tank F, Pashchenko AF. Subgroup identification of targeted therapy effects on biomarker for time to event data. Cancer Biomark 2023; 38:413-424. [PMID: 37980650 DOI: 10.3233/cbm-230181] [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: 11/21/2023]
Abstract
BACKGROUND The initiation biomarker-driven trials have revolutionized oncology drug development by challenging the traditional phased approach and introducing basket studies. Notable successes in non-small cell lung cancer (NSCLC) with ALK, ALK/ROS1, and EGFR inhibitors have prompted the need to expand this approach to other cancer sites. OBJECTIVES This study explores the use of dose response modeling and time-to-event algorithms on the biomarker molecular targeted agent (MTA). By simulating subgroup identification in MTA-related time-to-event data, the study aims to develop statistical methodology supporting biomarker-driven trials in oncology. METHODS A total of n patients are selected assigned for different doses. A dataset is prepared to mimic the situation on Subgroup Identification of MTA for time to event data analysis. The response is measured through MTA. The MTA value is also measured through ROC. The Markov Chain Monte Carlo (MCMC) techniques are prepared to perform the proposed algorithm. The analysis is carried out with a simulation study. The subset selection is performed through the Threshold Limit Value (TLV) by the Bayesian approach. RESULTS The MTA is observed with range 12-16. It is expected that there is a marginal level shift of the MTA from pre to post-treatment. The Cox time-varying model can be adopted further as causal-effect relation to establishing the MTA on prolonging the survival duration. The proposed work in the statistical methodology to support the biomarker-driven trial for oncology research. CONCLUSION This study extends the application of biomarker-driven trials beyond NSCLC, opening possibilities for implementation in other cancer sites. By demonstrating the feasibility and efficacy of utilizing MTA as a biomarker, the research lays the foundation for refining and validating biomarker use in clinical trials. These advancements aim to enhance the precision and effectiveness of cancer treatments, ultimately benefiting patients.
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Affiliation(s)
| | | | | | - Alexander F Pashchenko
- Laboratory of Intellectual Control Systems and Simulation, V. A. Trapeznikov Institute of Control Sciences of Russian Academy of Sciences, Moscow, Russia
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7
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Peng X, Wang HJ. A Generalized Quantile Tree Method for Subgroup Identification. J Comput Graph Stat 2022. [DOI: 10.1080/10618600.2022.2032723] [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)
- Xiang Peng
- Department of Statistics, George Washington University
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8
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Sassu CM, Palaia I, Boccia SM, Caruso G, Perniola G, Tomao F, Di Donato V, Musella A, Muzii L. Role of Circulating Biomarkers in Platinum-Resistant Ovarian Cancer. Int J Mol Sci 2021; 22:ijms222413650. [PMID: 34948446 PMCID: PMC8707281 DOI: 10.3390/ijms222413650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/18/2021] [Accepted: 12/19/2021] [Indexed: 02/07/2023] Open
Abstract
Ovarian cancer (OC) is the second most common cause of death in women with gynecological cancer. Considering the poor prognosis, particularly in the case of platinum-resistant (PtR) disease, a huge effort was made to define new biomarkers able to help physicians in approaching and treating these challenging patients. Currently, most data can be obtained from tumor biopsy samples, but this is not always available and implies a surgical procedure. On the other hand, circulating biomarkers are detected with non-invasive methods, although this might require expensive techniques. Given the fervent hope in their value, here we focused on the most studied circulating biomarkers that could play a role in PtR OC.
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9
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Resting-state functional connectivity predictors of treatment response in schizophrenia - A systematic review and meta-analysis. Schizophr Res 2021; 237:153-165. [PMID: 34534947 DOI: 10.1016/j.schres.2021.09.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/18/2021] [Accepted: 09/06/2021] [Indexed: 11/21/2022]
Abstract
We aimed to systematically synthesize and quantify the utility of pre-treatment resting-state functional magnetic resonance imaging (rs-fMRI) in predicting antipsychotic response in schizophrenia. We searched the PubMed/MEDLINE database for studies that examined the magnitude of association between baseline rs-fMRI assessment and subsequent response to antipsychotic treatment in persons with schizophrenia. We also performed meta-analyses for quantifying the magnitude and accuracy of predicting response defined continuously and categorically. Data from 22 datasets examining 1280 individuals identified striatal and default mode network functional segregation and integration metrics as consistent determinants of treatment response. The pooled correlation coefficient for predicting improvement in total symptoms measured continuously was ~0.47 (12 datasets; 95% CI: 0.35 to 0.59). The pooled odds ratio of predicting categorically defined treatment response was 12.66 (nine datasets; 95% CI: 7.91-20.29), with 81% sensitivity and 76% specificity. rs-fMRI holds promise as a predictive biomarker of antipsychotic treatment response in schizophrenia. Future efforts need to focus on refining feature characterization to improve prediction accuracy, validate prediction models, and evaluate their implementation in clinical practice.
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10
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Thomas M, Bornkamp B, Ickstadt K. Identifying treatment effect heterogeneity in dose-finding trials using Bayesian hierarchical models. Pharm Stat 2021; 21:17-37. [PMID: 34258861 DOI: 10.1002/pst.2150] [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] [Received: 09/16/2020] [Revised: 04/09/2021] [Accepted: 06/14/2021] [Indexed: 11/12/2022]
Abstract
An important task in drug development is to identify patients, which respond better or worse to an experimental treatment. Identifying predictive covariates, which influence the treatment effect and can be used to define subgroups of patients, is a key aspect of this task. Analyses of treatment effect heterogeneity are however known to be challenging, since the number of possible covariates or subgroups is often large, while samples sizes in earlier phases of drug development are often small. In addition, distinguishing predictive covariates from prognostic covariates, which influence the response independent of the given treatment, can often be difficult. While many approaches for these types of problems have been proposed, most of them focus on the two-arm clinical trial setting, where patients are given either the treatment or a control. In this article we consider parallel groups dose-finding trials, in which patients are administered different doses of the same treatment. To investigate treatment effect heterogeneity in this setting we propose a Bayesian hierarchical dose-response model with covariate effects on dose-response parameters. We make use of shrinkage priors to prevent overfitting, which can easily occur, when the number of considered covariates is large and sample sizes are small. We compare several such priors in simulations and also investigate dependent modeling of prognostic and predictive effects to better distinguish these two types of effects. We illustrate the use of our proposed approach using a Phase II dose-finding trial and show how it can be used to identify predictive covariates and subgroups of patients with increased treatment effects.
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Affiliation(s)
- Marius Thomas
- Clinical Development and Analytics, Novartis Pharma AG, Basel, Switzerland
| | - Björn Bornkamp
- Clinical Development and Analytics, Novartis Pharma AG, Basel, Switzerland
| | - Katja Ickstadt
- Faculty of Statistics, TU Dortmund University, Dortmund, Germany
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11
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Barbolina MV. Dichotomous role of microtubule associated protein tau as a biomarker of response to and a target for increasing efficacy of taxane treatment in cancers of epithelial origin. Pharmacol Res 2021; 168:105585. [PMID: 33798735 PMCID: PMC8165012 DOI: 10.1016/j.phrs.2021.105585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/19/2022]
Abstract
Cancer is the second leading cause of death worldwide, and the World Health Organization estimates that one in six deaths globally is due to cancer. Chemotherapy is one of the major modalities used to treat advanced cancers and their metastasis. However, the existence of acquired and intrinsic resistance to anti-cancer drugs often diminishes their therapeutic effect. In order to pre-select patients who could benefit the most from these treatments, the efforts of many research groups have been focused on identification of biomarkers of therapy response. Taxanes paclitaxel (Taxol) and docetaxel (Taxotere) have been introduced as chemotherapy for treatment of cancers of ovary in 1992 and breast in 1996, respectively. Since then, clinical use of taxanes has expanded to include lung, prostate, gastric, head and neck, esophageal, pancreatic, and cervical cancers, as well as Kaposi sarcoma. Several independent molecular mechanisms have been shown to support taxane chemoresistance. One such mechanism is dependent on microtubule associated protein tau. Tau binds to the same site on the inner side of the microtubules that is also occupied by paclitaxel or docetaxel, and several studies have demonstrated that low/no tau expression significantly correlated with better response to the taxane treatment, suggesting that levels of tau expression could have a predictive value in pre-selecting patient cohorts that are likely to benefit from the treatment. However, several other studies have found no correlation between tau expression and taxane response, introducing a controversy and precluding its wide use as a predictive biomarker. Based on the knowledge of tau biology accumulated thus far, in this review we attempt to critically analyze the studies that evaluated tau as a biomarker of taxane response. Further, we identify yet unknown aspects of tau biology understanding of which is necessary for improvement of development of tau as a biomarker of response and a target for increasing response to taxane treatment.
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Affiliation(s)
- Maria V Barbolina
- University of Illinois at Chicago, College of Pharmacy, Department of Pharmaceutical Sciences, 833 South Wood Street, Chicago, IL 60612, USA.
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12
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Huang YS, Cheng WC, Lin CY. Androgenic Sensitivities and Ovarian Gene Expression Profiles Prior to Treatment in Japanese Eel (Anguilla japonica). MARINE BIOTECHNOLOGY (NEW YORK, N.Y.) 2021; 23:430-444. [PMID: 34191211 DOI: 10.1007/s10126-021-10035-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 04/28/2021] [Indexed: 06/13/2023]
Abstract
Androgens stimulate ovarian development in eels. Our previous report indicated a correlation between the initial (debut) ovarian status (determined by kernel density estimation (KDE), presented as a probability density of oocyte size) and the consequence of 17MT treatment (change in ovary). The initial ovarian status appeared to be an important factor influencing ovarian androgenic sensitivity. We postulated that the sensitivities of initial ovaries are correlated with their gene expression profiles. Japanese eels underwent operation to sample the initial ovarian tissues, and the samples were stored in liquid nitrogen. Using high-throughput next-generation sequencing (NGS) technology, ovarian transcriptomic data were mined and analyzed based on functional gene classification with cutoff-based differentially expressed genes (DEGs); the ovarian status was transformed into gene expression profiles globally or was represented by a set of gene list. Our results also implied that the initial ovary might be an important factor influencing the outcomes of 17MT treatments, and the genes related with neuronal activities or neurogenesis seemed to play an essential role in the positive effect.
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Affiliation(s)
- Yung-Sen Huang
- Department of Life Science, National University of Kaohsiung, No. 700 Kaohsiung University Road, Nan Tzu Dist, 811, Kaohsiung, Taiwan.
| | - Wen-Chih Cheng
- Institute of Information Science, Academia Sinica, No. 128 Academia Road, Section 2, Nankang Dist., 115, Taipei, Taiwan
| | - Chung-Yen Lin
- Institute of Information Science, Academia Sinica, No. 128 Academia Road, Section 2, Nankang Dist., 115, Taipei, Taiwan
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13
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Ruberg SJ. Assessing and communicating heterogeneity of treatment effects for patient subpopulations: The hardest problem there is. Pharm Stat 2021; 20:939-944. [PMID: 33655601 DOI: 10.1002/pst.2110] [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: 08/08/2020] [Revised: 11/24/2020] [Accepted: 02/15/2021] [Indexed: 11/09/2022]
Abstract
Heterogeneity is an enormously complex problem because there are so many dimensions and variables that can be considered when assessing which ones may influence an efficacy or safety outcome for an individual patient. This is difficult in randomized controlled trials and even more so in observational settings. An alternative approach is presented in which the individual patient becomes the "subgroup," and similar patients are identified in the clinical trial database or electronic medical record that can be used to predict how that individual patient may respond to treatment.
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14
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Zhang C, Mayo MS, Wick JA, Gajewski BJ. Designing and analyzing clinical trials for personalized medicine via Bayesian models. Pharm Stat 2021; 20:573-596. [PMID: 33463906 DOI: 10.1002/pst.2095] [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: 07/19/2019] [Revised: 09/21/2020] [Accepted: 12/31/2020] [Indexed: 11/11/2022]
Abstract
Patients with different characteristics (e.g., biomarkers, risk factors) may have different responses to the same medicine. Personalized medicine clinical studies that are designed to identify patient subgroup treatment efficacies can benefit patients and save medical resources. However, subgroup treatment effect identification complicates the study design in consideration of desired operating characteristics. We investigate three Bayesian adaptive models for subgroup treatment effect identification: pairwise independent, hierarchical, and cluster hierarchical achieved via Dirichlet Process (DP). The impact of interim analysis and longitudinal data modeling on the personalized medicine study design is also explored. Interim analysis is considered since they can accelerate personalized medicine studies in cases where early stopping rules for success or futility are met. We apply integrated two-component prediction method (ITP) for longitudinal data simulation, and simple linear regression for longitudinal data imputation to optimize the study design. The designs' performance in terms of power for the subgroup treatment effects and overall treatment effect, sample size, and study duration are investigated via simulation. We found the hierarchical model is an optimal approach to identifying subgroup treatment effects, and the cluster hierarchical model is an excellent alternative approach in cases where sufficient information is not available for specifying the priors. The interim analysis introduction to the study design lead to the trade-off between power and expected sample size via the adjustment of the early stopping criteria. The introduction of the longitudinal modeling slightly improves the power. These findings can be applied to future personalized medicine studies with discrete or time-to-event endpoints.
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Affiliation(s)
- Chuanwu Zhang
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA.,Sanofi, Waltham, Massachusetts, USA
| | - Matthew S Mayo
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jo A Wick
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Byron J Gajewski
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
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15
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Current status of development of methylation biomarkers for in vitro diagnostic IVD applications. Clin Epigenetics 2020; 12:100. [PMID: 32631437 PMCID: PMC7336678 DOI: 10.1186/s13148-020-00886-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/17/2020] [Indexed: 02/06/2023] Open
Abstract
A significant volume of research clearly shows that disease-related methylation changes can be used as biomarkers at all stages of clinical disease management, including risk assessment and predisposition screening through early diagnostics to personalization of patient care and monitoring of the relapse and chronic disease. Thus disease-related methylation changes are an attractive source of the biomarkers that can have significant impact on precision medicine. However, the translation of the research findings in methylation biomarkers field to clinical practice is at the very least not satisfactory. That is mainly because the evidence generated in research studies indicating the utility of the disease-related methylation change to predict clinical outcome is in majority of the cases not sufficient to postulate the diagnostic use of the biomarker. The research studies need to be followed by well-designed and systematic investigations of clinical utility of the biomarker that produce data of sufficient quality to meet regulatory approval for the test to be used to make clinically valid decision. In this review, we describe methylation-based IVD tests currently approved for IVD use or at the advanced stages of the development for the diagnostic use. For each of those tests, we analyze the technologies that the test utilizes for methylation detection as well as describe the types of the clinical studies that were performed to show clinical validity of the test and warrant regulatory approval. The examples reviewed here should help with planning of clinical investigations and delivery of the clinical evidence required for the regulatory approval of potential methylation biomarker based IVD tests.
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16
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Sultana N, Sun C, Katsube T, Wang B. Biomarkers of Brain Damage Induced by Radiotherapy. Dose Response 2020; 18:1559325820938279. [PMID: 32694960 PMCID: PMC7350401 DOI: 10.1177/1559325820938279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/26/2020] [Accepted: 06/05/2020] [Indexed: 12/18/2022] Open
Abstract
Radiotherapy remains currently a critical component for both primary and metastatic brain tumors either alone or in combination with surgery, chemotherapy, and molecularly targeted agents, while it could cause simultaneously normal brain tissue injury leading to serious health consequences, that is, development of cognitive impairments following cranial radiotherapy is considered as a critical clinical disadvantage especially for the whole brain radiotherapy. Biomarkers can help to detect the accurate physiology or conditions of patients with brain tumor and develop effective treatment procedures for these patients. In the near future, biomarkers will become one of the prime driving forces of cancer treatment. In this minireview, we analyze the documented work on the acute brain damage and late consequences induced by radiotherapy, identify the biomarkers, in particular, the predictive biomarkers for the damage, and summarize the biological significance of the biomarkers. It is expected that translation of these research advance to radiotherapy would assist stratifying patients for optimized treatment and improving therapeutic efficacy and the quality of life.
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Affiliation(s)
- Nahida Sultana
- Institute of Food and Radiation Biology, Atomic Energy Research Establishment, Bangladesh Atomic Energy Commission, Dhaka, People’s Republic of Bangladesh
| | - Chao Sun
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, People’s Republic of China
| | - Takanori Katsube
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Bing Wang
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
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17
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Rebuzzi SE, Perrone F, Bersanelli M, Bregni G, Milella M, Buti S. Prognostic and predictive molecular biomarkers in metastatic renal cell carcinoma patients treated with immune checkpoint inhibitors: a systematic review. Expert Rev Mol Diagn 2019; 20:169-185. [PMID: 31608727 DOI: 10.1080/14737159.2019.1680286] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: In recent years, the treatment landscape of metastatic renal cell carcinoma (mRCC) has been improved using immune-checkpoint inhibitors (ICI). Nevertheless, the number of patients experiencing clinical benefit from immunotherapy is still limited, while others obtain more benefit from tyrosine kinase inhibitors (TKI). The identification of prognostic and predictive factors would be crucial to better select patients most likely to benefit from immunotherapy among the other potentially available therapeutic options.Areas covered: This systematic review summarizes the current knowledge (2010-2019) on molecular prognostic and predictive biomarkers, assessed in peripheral blood and/or from tumor tissue, in mRCC patients treated with ICI.Expert opinion: Among all the biomarkers analyzed, PD-L1 expression on tumor tissue is the most studied. It has an unfavorable prognostic role for patients treated with TKI, which seems to be overcome by ICI-based combinations. Nevertheless, no clear predictive role of immunotherapy efficacy has been observed for PD-L1 in mRCC. Emerging evidence regarding pro-angiogenic or pro-immunogenic genomic and transcriptomic signatures suggests a potential predictive role in patients treated with ICI-based combinations. The rationale for TKI-ICI combinations is based on tumor microenvironment and genomic background, which represent the target of these two main therapeutic options for mRCC.
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Affiliation(s)
- Sara Elena Rebuzzi
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy.,Department of Medical Oncology, IRCCS San Martino IST, Genova, Italy
| | - Fabiana Perrone
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Melissa Bersanelli
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy; Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Giacomo Bregni
- Department of Medical Oncology, IRCCS San Martino IST, Genova, Italy
| | - Michele Milella
- Section of Medical Oncology, Department of Medicine, University of Verona and University Hospital Trust, Verona, Italy
| | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
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18
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Vandemeulebroecke M, Baillie M, Margolskee A, Magnusson B. Effective Visual Communication for the Quantitative Scientist. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2019; 8:705-719. [PMID: 31329354 PMCID: PMC6813169 DOI: 10.1002/psp4.12455] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 06/29/2019] [Indexed: 11/07/2022]
Abstract
Effective visual communication is a core competency for pharmacometricians, statisticians, and, more generally, any quantitative scientist. It is essential in every step of a quantitative workflow, from scoping to execution and communicating results and conclusions. With this competency, we can better understand data and influence decisions toward appropriate actions. Without it, we can fool ourselves and others and pave the way to wrong conclusions and actions. The goal of this tutorial is to convey this competency. We posit three laws of effective visual communication for the quantitative scientist: have a clear purpose, show the data clearly, and make the message obvious. A concise "Cheat Sheet," available on https://graphicsprinciples.github.io, distills more granular recommendations for everyday practical use. Finally, these laws and recommendations are illustrated in four case studies.
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Affiliation(s)
| | - Mark Baillie
- Biostatistical Sciences and PharmacometricsNovartis Pharma AGBaselSwitzerland
| | - Alison Margolskee
- Biostatistical Sciences and PharmacometricsNovartis Institutes for Biomedical ResearchCambridgeMassachusettsUSA
| | - Baldur Magnusson
- Biostatistical Sciences and PharmacometricsNovartis Pharma AGBaselSwitzerland
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19
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Assessing heterogeneous effects and their determinants via estimation of potential outcomes. Eur J Epidemiol 2019; 34:823-835. [PMID: 31420761 PMCID: PMC6759690 DOI: 10.1007/s10654-019-00551-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 08/08/2019] [Indexed: 11/19/2022]
Abstract
When analyzing effect heterogeneity, the researcher commonly opts for stratification or a regression model with interactions. While these methods provide valuable insights, their usefulness can be somewhat limited, since they typically fail to take into account heterogeneity with respect to many dimensions simultaneously, or give rise to models with complex appearances. Based on the potential outcomes framework and through imputation of missing potential outcomes, our study proposes a method for analyzing heterogeneous effects by focusing on treatment effects rather than outcomes. The procedure is easy to implement and generates estimates that take into account heterogeneity with respect to all relevant dimensions at the same time. Results are easily interpreted and can additionally be represented by graphs, showing the overall magnitude and pattern of heterogeneity as well as how this relates to different factors. We illustrate the method both with simulations and by examining heterogeneous effects of obesity on HDL cholesterol in the Malmö Diet and Cancer cardiovascular cohort. Obesity was associated with reduced HDL in almost all individuals, but effects varied with smoking, risky alcohol consumption, higher education, and energy intake, with some indications of non-linear effects. Our approach can be applied by any epidemiologist who wants to assess the role and strength of heterogeneity with respect to a multitude of factors.
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20
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Wojdacz TK. Methylation biomarker development in the context of the EU regulations for clinical use of in-vitro diagnostic devices. Expert Rev Mol Diagn 2019; 19:439-441. [PMID: 31092067 DOI: 10.1080/14737159.2019.1618188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Tomasz K Wojdacz
- a Head of Clinical Epigenetics Laboratory , Pomeranian Medical University , Szczecin , Poland
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21
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Ritz C, Astrup A, Larsen TM, Hjorth MF. Weight loss at your fingertips: personalized nutrition with fasting glucose and insulin using a novel statistical approach. Eur J Clin Nutr 2019; 73:1529-1535. [DOI: 10.1038/s41430-019-0423-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 01/09/2023]
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22
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Toward an Understanding of Adversarial Examples in Clinical Trials. MACHINE LEARNING AND KNOWLEDGE DISCOVERY IN DATABASES 2019. [DOI: 10.1007/978-3-030-10925-7_3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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23
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Sechidis K, Papangelou K, Metcalfe PD, Svensson D, Weatherall J, Brown G. Distinguishing prognostic and predictive biomarkers: an information theoretic approach. Bioinformatics 2018; 34:3365-3376. [PMID: 29726967 PMCID: PMC6157098 DOI: 10.1093/bioinformatics/bty357] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/12/2018] [Accepted: 04/30/2018] [Indexed: 11/29/2022] Open
Abstract
Motivation The identification of biomarkers to support decision-making is central to personalized medicine, in both clinical and research scenarios. The challenge can be seen in two halves: identifying predictive markers, which guide the development/use of tailored therapies; and identifying prognostic markers, which guide other aspects of care and clinical trial planning, i.e. prognostic markers can be considered as covariates for stratification. Mistakenly assuming a biomarker to be predictive, when it is in fact largely prognostic (and vice-versa) is highly undesirable, and can result in financial, ethical and personal consequences. We present a framework for data-driven ranking of biomarkers on their prognostic/predictive strength, using a novel information theoretic method. This approach provides a natural algebra to discuss and quantify the individual predictive and prognostic strength, in a self-consistent mathematical framework. Results Our contribution is a novel procedure, INFO+, which naturally distinguishes the prognostic versus predictive role of each biomarker and handles higher order interactions. In a comprehensive empirical evaluation INFO+ outperforms more complex methods, most notably when noise factors dominate, and biomarkers are likely to be falsely identified as predictive, when in fact they are just strongly prognostic. Furthermore, we show that our methods can be 1-3 orders of magnitude faster than competitors, making it useful for biomarker discovery in 'big data' scenarios. Finally, we apply our methods to identify predictive biomarkers on two real clinical trials, and introduce a new graphical representation that provides greater insight into the prognostic and predictive strength of each biomarker. Availability and implementation R implementations of the suggested methods are available at https://github.com/sechidis. Supplementary information Supplementary data are available at Bioinformatics online.
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Affiliation(s)
| | | | - Paul D Metcalfe
- Advanced Analytics Centre, Global Medicines Development, AstraZeneca, Cambridge, UK
| | - David Svensson
- Advanced Analytics Centre, Global Medicines Development, AstraZeneca, Cambridge, UK
| | - James Weatherall
- Advanced Analytics Centre, Global Medicines Development, AstraZeneca, Cambridge, UK
| | - Gavin Brown
- School of Computer Science, University of Manchester, Manchester, UK
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24
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Gibson E, Bretz F, Looby M, Bornkamp B. Key Aspects of Modern, Quantitative Drug Development. STATISTICS IN BIOSCIENCES 2018. [DOI: 10.1007/s12561-017-9203-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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25
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Sverdlov O, van Dam J, Hannesdottir K, Thornton-Wells T. Digital Therapeutics: An Integral Component of Digital Innovation in Drug Development. Clin Pharmacol Ther 2018; 104:72-80. [PMID: 29377057 DOI: 10.1002/cpt.1036] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/23/2018] [Accepted: 01/23/2018] [Indexed: 12/27/2022]
Abstract
Digital therapeutics represent a new treatment modality in which digital systems such as smartphone apps are used as regulatory-approved, prescribed therapeutic interventions to treat medical conditions. In this article we provide a critical overview of the rationale for investing in such novel modalities, including the unmet medical needs addressed by digital therapeutics and the potential for reducing current costs of medical care. We also discuss emerging pathways to regulatory approval and how innovative business models are enabling further growth in the development of digital therapeutics. We conclude by providing some recent examples of digital therapeutics that have gained regulatory approval and highlight opportunities for the near future.
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Affiliation(s)
- Oleksandr Sverdlov
- Early Development Biostatistics, Novartis Pharmaceuticals, East Hanover, New Jersey, USA
| | - Joris van Dam
- Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
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26
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Thomas M, Bornkamp B, Seibold H. Subgroup identification in dose-finding trials via model-based recursive partitioning. Stat Med 2018; 37:1608-1624. [DOI: 10.1002/sim.7594] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 10/24/2017] [Accepted: 11/29/2017] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - Heidi Seibold
- Universität Zürich; Hirschengraben 84 Zürich CH-8001 Switzerland
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27
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Tanniou J, van der Tweel I, Teerenstra S, Roes KC. Estimates of subgroup treatment effects in overall nonsignificant trials: To what extent should we believe in them? Pharm Stat 2017; 16:280-295. [DOI: 10.1002/pst.1810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 03/16/2017] [Accepted: 04/03/2017] [Indexed: 11/12/2022]
Affiliation(s)
- Julien Tanniou
- Julius Center for Health Sciences and Primary Care, Department of Biostatistics; UMC Utrecht; Utrecht Netherlands
- Medicines Evaluation Board; College ter Beoordeling van Geneesmiddelen; Utrecht Netherlands
| | - Ingeborg van der Tweel
- Julius Center for Health Sciences and Primary Care, Department of Biostatistics; UMC Utrecht; Utrecht Netherlands
| | - Steven Teerenstra
- Medicines Evaluation Board; College ter Beoordeling van Geneesmiddelen; Utrecht Netherlands
- Radboud Institute for Health Sciences, Department of Health Evidence, section Biostatistics; Radboud UMC; Nijmegen Netherlands
| | - Kit C.B. Roes
- Julius Center for Health Sciences and Primary Care, Department of Biostatistics; UMC Utrecht; Utrecht Netherlands
- Medicines Evaluation Board; College ter Beoordeling van Geneesmiddelen; Utrecht Netherlands
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28
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Thomas M, Bornkamp B. Comparing Approaches to Treatment Effect Estimation for Subgroups in Clinical Trials. Stat Biopharm Res 2017. [DOI: 10.1080/19466315.2016.1251490] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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29
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Lei Y, Mayo MS, Carlson SE, Gajewski BJ. Personalized Medicine Enrichment Design for DHA Supplementation Clinical Trial. Contemp Clin Trials Commun 2017; 5:116-122. [PMID: 28217765 PMCID: PMC5308793 DOI: 10.1016/j.conctc.2017.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 11/23/2016] [Accepted: 01/03/2017] [Indexed: 11/25/2022] Open
Abstract
Personalized medicine aims to match patient subpopulation to the most beneficial treatment. The purpose of this study is to design a prospective clinical trial in which we hope to achieve the highest level of confirmation in identifying and making treatment recommendations for subgroups, when the risk levels in the control arm can be ordered. This study was motivated by our goal to identify subgroups in a DHA (docosahexaenoic acid) supplementation trial to reduce preterm birth (gestational age<37 weeks) rate. We performed a meta-analysis to obtain informative prior distributions and simulated operating characteristics to ensure that overall Type I error rate was close to 0.05 in designs with three different models: independent, hierarchical, and dynamic linear models. We performed simulations and sensitivity analysis to examine the subgroup power of models and compared results to a chi-square test. We performed simulations under two hypotheses: a large overall treatment effect and a small overall treatment effect. Within each hypothesis, we designed three different subgroup effects scenarios where resulting subgroup rates are linear, flat, or nonlinear. When the resulting subgroup rates are linear or flat, dynamic linear model appeared to be the most powerful method to identify the subgroups with a treatment effect. It also outperformed other methods when resulting subgroup rates are nonlinear and the overall treatment effect is big. When the resulting subgroup rates are nonlinear and the overall treatment effect is small, hierarchical model and chi-square test did better. Compared to independent and hierarchical models, dynamic linear model tends to be relatively robust and powerful when the control arm has ordinal risk subgroups.
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Affiliation(s)
- Yang Lei
- Department of Biostatistics, The University of Kansas Medical Center, School of Medicine, Mail Stop 1026, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Matthew S. Mayo
- Department of Biostatistics, The University of Kansas Medical Center, School of Medicine, Mail Stop 1026, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Susan E. Carlson
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Byron J. Gajewski
- Department of Biostatistics, The University of Kansas Medical Center, School of Medicine, Mail Stop 1026, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
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30
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Bornkamp B, Ohlssen D, Magnusson BP, Schmidli H. Model averaging for treatment effect estimation in subgroups. Pharm Stat 2016; 16:133-142. [DOI: 10.1002/pst.1796] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 10/18/2016] [Accepted: 10/26/2016] [Indexed: 11/09/2022]
Affiliation(s)
| | - David Ohlssen
- Novartis Pharmaceuticals Corporation East Hanover New Jersey 07936-1080 USA
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31
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Lipkovich I, Dmitrienko A, B R. Tutorial in biostatistics: data-driven subgroup identification and analysis in clinical trials. Stat Med 2016; 36:136-196. [PMID: 27488683 DOI: 10.1002/sim.7064] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 06/23/2016] [Accepted: 07/05/2016] [Indexed: 02/05/2023]
Abstract
It is well known that both the direction and magnitude of the treatment effect in clinical trials are often affected by baseline patient characteristics (generally referred to as biomarkers). Characterization of treatment effect heterogeneity plays a central role in the field of personalized medicine and facilitates the development of tailored therapies. This tutorial focuses on a general class of problems arising in data-driven subgroup analysis, namely, identification of biomarkers with strong predictive properties and patient subgroups with desirable characteristics such as improved benefit and/or safety. Limitations of ad-hoc approaches to biomarker exploration and subgroup identification in clinical trials are discussed, and the ad-hoc approaches are contrasted with principled approaches to exploratory subgroup analysis based on recent advances in machine learning and data mining. A general framework for evaluating predictive biomarkers and identification of associated subgroups is introduced. The tutorial provides a review of a broad class of statistical methods used in subgroup discovery, including global outcome modeling methods, global treatment effect modeling methods, optimal treatment regimes, and local modeling methods. Commonly used subgroup identification methods are illustrated using two case studies based on clinical trials with binary and survival endpoints. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | - Ralph B
- Boston University, Boston, MA, U.S.A
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32
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Liu Y, Tang SY, Man M, Li YG, Ruberg SJ, Kaizar E, Hsu JC. Thresholding of a Continuous Companion Diagnostic Test Confident of Efficacy in Targeted Population. Stat Biopharm Res 2016. [DOI: 10.1080/19466315.2016.1206486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Yi Liu
- Department of Biostatistics, Takeda Pharmaceuticals International Co., Cambridge, MA, USA
| | | | - Michael Man
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | - Eloise Kaizar
- Department of Statistics, The Ohio State University, OH, USA
| | - Jason C. Hsu
- Eli Lilly and Company, Indianapolis, IN, USA
- Department of Statistics, The Ohio State University, OH, USA
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