基于二元替代终点的瘤临床试验中的多重性控制
Weibin Zhong1, Jing-Ou Liu1, Chenguang Wang1
1Biostatistics and Data Management, Regeneron Pharmaceuticals, Tarrytown, New York, USA.
Statistics in medicine
|September 5, 2025
概括
通过评估多个剂量,可适应的2/3无设计可以改善瘤剂量选择. "放弃失败者"的方法可以提前确定有效的治疗方法,优化针对性药物和免疫疗法的临床试验.
科学领域:
- 临床试验方法
- 癌症药物开发
- 生物统计学
背景情况:
- 传统的1期瘤研究通常选择单一的最大耐受剂量用于后期阶段.
- 针对性药物和免疫疗法的增加需要评估多种剂量以进行最佳选择.
- 2期随机研究通常用于这种剂量评估,但适应性设计提供了潜在的效率.
研究的目的:
- 评估适应性2/3无设计用于瘤学中的剂量选择.
- 在这种适应性框架内评估"放弃失败者"战略.
- 分析I型错误的通货膨胀和影响这些设计的因素.
主要方法:
- 应用适应性2/3无设计,特别是"放弃失败者"的方法.
- 使用二元替代终点 (例如总体响应) 进行早期选择.
- 理论推导I型错误膨胀量和模拟研究以评估设计性能.
- 通过肺癌试验示例和实施软件的介绍.
主要成果:
- 适应性设计的理论I型错误膨胀尺度的量化
- 模拟研究说明了各种因素对I类错误通胀的影响.
- 通过肺癌试验设计的实践应用.
结论:
- 适应性2/3无设计,特别是"放弃失败者"方法,为瘤学中剂量选择提供了一个结构化的方法.
- 了解和量化I类错误的通货膨胀对于稳健的实施至关重要.
- 拟议的设计和相关软件有助于为新型癌症疗法进行高效和有效的剂量选择.
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