A Bayesian adaptive design for biomarker trials with linked treatments
British Journal of Cancer
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Wason, J., Abraham, J., Baird, R., Gournaris, I., Vallier, A., Brenton, J., Earl, H., & et al. (2015). A Bayesian adaptive design for biomarker trials with linked treatments. British Journal of Cancer, 113 699-705. https://doi.org/10.1038/bjc.2015.278
background: Response to treatments is highly heterogeneous in cancer. Increased availability of biomarkers and targeted treatments has led to the need for trial designs that efficiently test new treatments in biomarker-stratified patient subgroups. methods: We propose a novel Bayesian adaptive randomisation (BAR) design for use in multi-arm phase II trials where biomarkers exist that are potentially predictive of a linked treatment’s effect. The design is motivated in part by two phase II trials that are currently in development. The design starts by randomising patients to the control treatment or to experimental treatments that the biomarker profile suggests should be active. At interim analyses, data from treated patients are used to update the allocation probabilities. If the linked treatments are effective, the allocation remains high; if ineffective, the allocation changes over the course of the trial to unlinked treatments that are more effective. results: Our proposed design has high power to detect treatment effects if the pairings of treatment with biomarker are correct, but also performs well when alternative pairings are true. The design is consistently more powerful than parallel-groups stratified trials. conclusions: This BAR design is a powerful approach to use when there are pairings of biomarkers with treatments available for testing simultaneously.
adaptive design, adaptive randomisation, Bayesian, biomarkers, phase II, stratified medicine
This work was supported by the Medical Research Council (grant number G0800860) and the NIHR Cambridge Biomedical Research Centre.
Cancer Research UK (C14303_do not transfer)
Medical Research Council (MR/J004979/1)
External DOI: https://doi.org/10.1038/bjc.2015.278
This record's URL: https://www.repository.cam.ac.uk/handle/1810/252323
Attribution 2.0 UK: England & Wales
Licence URL: http://creativecommons.org/licenses/by/2.0/uk/
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