Between-arm comparisons in randomized Phase II trials.

Between-arm comparisons in randomized Phase II trials.
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DOI:
10.1080/10543400902802391
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发表时间:
2009
影响因子:
1.1
通讯作者:
George SL
George SL
中科院分区:
医学4区
文献类型:
--
作者:
Jung SH;George SL

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在II期试验中,我们可能会将患者随机分配到多组实验性疗法中,并评估其疗效,以确定是否有任何一种疗法值得进行大规模的III期试验。通常,此类研究的主要目的是确定与历史对照相比有效的实验性疗法。使用单臂II期试验的标准设计,例如Simon的最优或最大最小设计,独立评估每个组。当通过这样的随机试验接受超过一个组时,我们可能希望从中选择赢家。文献中有一些方法用于臂间比较,但大多数方法都有缺点。当竞争组的疗效差异很小,或者在选择过程中使用的统计检验不能正确反映试验的小样本量和多阶段设计时,它们有很大的错误选择概率(I型错误)。在本文中,我们提出了在随机II期试验中进行选择的组间比较方法来解决这些问题。
In a phase II trial, we may randomize patients to multiple arms of experimental therapies and evaluate their efficacy to determine if any of them is worth of a large scale phase III trial. Usually the primary objective of such study is to identify experimental therapies that are efficacious compared to a historical control. Each arm is independently evaluated using a standard design for single-arm phase II trial, e.g. Simon’s optimal or minimax design. When more than one arms are accepted through such a randomized trial, we may want to select the winner(s) among them. There are methods for between-arm comparisons in the literature, but most of them have drawbacks. They have a large false selection probability (type I error) when the competing arms have a small difference in efficacy, or the statistical tests used in the selection procedure do not properly reflect the small sample sizes and multi-stage design of the trials. In this paper, we propose between-arm comparison methods for selection in randomized phase II trials addressing these issues.
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