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 (eg, 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.
Original language | English (US) |
---|---|
Pages (from-to) | 1459-1471 |
Number of pages | 13 |
Journal | Biometrics |
Volume | 79 |
Issue number | 2 |
DOIs | |
State | Published - Jun 2023 |
Keywords
- Bayesian hierarchical model
- master protocol
- multiple indication combination therapy
- phase II trials
- platform design
ASJC Scopus subject areas
- Statistics and Probability
- General Biochemistry, Genetics and Molecular Biology
- General Immunology and Microbiology
- General Agricultural and Biological Sciences
- Applied Mathematics
MD Anderson CCSG core facilities
- Biostatistics Resource Group