Abstract
This article focuses on statistical analysis of clinical trials pursuing tailored therapy objectives, wherein evaluation of treatment effect occurs in the overall population as well as in a predefined subpopulation(s). The design and analysis principles presented provide a framework for decision making based on these novel multipopulation tailoring trial designs, considering the particular case of confirmatory trials. These principles include traditional multiple testing considerations, as well as 2 new analysis principles.
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Maitnourim A, Simon R. On the efficiency of targeted clinical trials. Statistics in Medicine. 2005;24:329–339.
Herceptin. U.S. prescribing information; 1998. https://doi.org/www.gene.com/gene/products/information/pdf/herceptin-prescribing.pdf. Accessed July 12, 2012.
Xalkori. U.S. prescribing information; 2011. https://doi.org/www.accessdata.fda.gov/drugsatfda_docs/label/2011/202570s000lbl.pdf. Accessed July 12, 2012.
Zelboraf. U.S. prescribing information; 2011. https://doi.org/www.accessdata.fda.gov/drugsatfda_docs/label/2011/202429s000lbl.pdf. Accessed July 12, 2012.
Alimta. U.S. prescribing information; 2004. https://doi.org/pi.lilly.com/us/alimta-pi.pdf. Accessed July 12, 2012.
Cappuzzo F, Ciuleanu T, Stelmakh L, et al. SATURN: a double-blind, randomized, phase III study of maintenance erlotinib versus placebo following nonprogression with first-line platinum-based chemotherapy in patients with advanced NSCLC. J Clin Oncol. 2009;27 (15 S):8001.
Wang S, O’Neill R, Hung H. Approaches to evaluation of treatment effect in randomized clinical trials with genomic subset. Pharm Stat. 2007;6:227–244.
Wang S, Hung H, O’Neill R. Adaptive patient enrichment designs in therapeutic trials. Biom J. 2009;51:358–374.
Song Y, Chi GY. A method for testing a prespecified subgroup in clinical trials. Stat Med. 2007;26:3535–3549.
Alosh M, Huque M. A flexible strategy for testing subgroups and overall population. Stat Med. 2009;28:3–23.
Zhao YD, Dmitrienko A, Tamura R. On optimal designs of clinical trials with a sensitive subgroup. Stat Biopharm Res. 2010;2:72–83.
Freidlin B, Simon R. Adaptive signature design: an adaptive clinical trial design for generating and prospectively testing a gene expression signature for sensitive patients. Clin Cancer Res. 2005;11:7872–7878.
Jiang W, Freidlin B, Simon R. Biomarker-adaptive threshold design: a procedure for evaluating treatment with possible biomarker-defined subset effect. J Natl Cancer Inst. 2007;99:1036–1043.
Dmitrienko A, Bretz F, Westfall PH, et al. Multiple testing methodology. In: Dmitrienko A, Tamhane AC, Bretz F, eds. Multiple Testing Problems in Pharmaceutical Statistics. New York, NY:Chapman and Hall/CRC Press; 2009:35–98.
Wiens B. A fixed-sequence Bonferroni procedure for testing multiple endpoints. Pharm Stat. 2003;2:211–215.
Wiens B, Dmitrienko A. The fallback procedure for evaluating a single family of hypotheses. J Biopharm Stat. 2003;15:929–942.
Huque MF, Alosh M. A flexible fixed-sequence testing method for hierarchically ordered correlated multiple endpoints in clinical trials. J Stat Plann Inference. 2008;138:321–335.
Millen BA, Dmitrienko A. Chain procedures: a class of flexible closed testing procedures with clinical trial applications. Stat Biopharm Res. 2011;3:14–30.
Bretz F, Maurer W, Brannath W, Posch M. A graphical approach to sequentially rejective multiple test procedures. Stat Med. 2009;28:586–604.
Burman CF, Sonesson C, Guilbaud O. A recycling framework for the construction of Bonferroni-based multiple tests. Stat Med. 2009;28:739–761.
Gail M, Simon R. Testing for qualitative interactions between treatment effects and patient subsets. Biometrics. 1985;41:361–372.
Piantadosi S, Gail MH. A comparison of the power of two tests for qualitative interaction. Stat Med. 1993;12:1239–1248.
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Millen, B.A., Dmitrienko, A., Ruberg, S. et al. A Statistical Framework for Decision Making in Confirmatory Multipopulation Tailoring Clinical Trials. Ther Innov Regul Sci 46, 647–656 (2012). https://doi.org/10.1177/0092861512454116
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DOI: https://doi.org/10.1177/0092861512454116