Flexible weighted log-rank tests optimal for detecting early and/or late survival differences

At the present time, many AIDS clinical trials compare drug therapies by a time-to-event primary endpoint that measures the durability of suppression of HIV replication. For such studies, survival differences tend to occur early and/or late in the follow-up period due to drug differences in initial potency and/or durability of efficacy, and detecting these differences is of primary interest. We propose a weighted log-rank statistic that emphasizes early and/or late survival differences. We also consider some versatile tests that also emphasize these differences but are sensitive to a wider range of alternatives. The performances of the new tests are evaluated in numerical studies. For the alternatives of interest, the new tests show greater power and flexibility than commonly used weighted log-rank tests and related versatile tests. When the main interest is in detecting early and/or late survival differences, these tests may be preferable to the other versatile and weighted log-rank tests that have been studied.