Abstract
Adaptive designs (AD) have received a great deal of attention in recent years because of the potential they offer to improve the efficiency of clinical drug development. In an increasingly challenging environment, characterized by escalating costs and decreasing likelihood of regulatory approval, sponsors and regulators alike have a keen interest in strategies to modernize drug development – the use of AD is a key one among them.
This chapter presents an overview of AD and their use in clinical drug development. It starts with some background and definitions, followed by sections on AD in the Learn and Confirm phases of clinical development. In later sections, the importance of trial simulations in the context of AD is discussed, followed by thoughts on the future of AD.
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References
Armitage P (1975) Sequential medical trials. Wiley, New York
Bauer P, Koehne K (1994) Evaluation of experiments with adaptive interim analyses. Biometrics 50:1029–1041
Berry DA, Mueller P, Grieve AP, Smith MK, Parke T, Krams M (2002) Bayesian designs for dose-ranging drug trials. In: Gatsonis C, Kass RE, Carlin B, Carriquiry A, Gelman A, Verdinelli I, West M (eds) Case studies in Bayesian statistics, vol 5. Springer, New York, pp 99–181
Bornkamp B, Bretz F, Dmitrienko A, Enas G, Gaydos B, Hsu CH, Koenig F, Krams M, Liu Q, Neuenschwander B, Parke T, Pinheiro J, Roy A, Sax R, Shen F (2007) Innovative approaches for designing and analyzing adaptive dose-ranging trials (with discussion). J Biopharm Stat 17:965–995
Brannath W, Zuber E, Branson M, Bretz F, Gallo P, Posch M, Racine-Poon A (2009) Confirmatory adaptive designs with Bayesian decision tools for a targeted therapy in oncology. Stat Med 28(10):1445–1463
Barnes PJ, Pocock SJ, Magnussen H, Iqbal A, Kramer B, Higgins M, Lawrence D (2010) Integrating Indacaterol dose selection in a clinical study in COPD using an adaptive seamless design. Pulmonary & Therapeutics 23:165–171
Bretz F, Pinheiro J, Branson M (2006a) Combining multiple comparisons and modeling techniques in dose-response studies. Biometrics 61(3):738–748
Bretz F, Schmidli H, König F, Racine A, Maurer W (2006b) Confirmatory seamless phase II/III clinical trials with hypotheses selection at interim: general concepts (with discussion). Biom J 48(4):623–634
Bretz F, König F, Brannath W, Glimm E, Posch M (2009) Adaptive designs for confirmatory clinical trials. Stat Med 28(8):1181–1217
Chevret S (2006) Statistical methods for dose-finding experiments. Wiley, Chichester, England
CHMP Working party on Efficacy of Medicinal Products (1995) Biostatistical methodology in clinical trials in applications for marketing authorizations for medicinal products. Stat Med 14:1659–1682
Cross J, Lee H, Westelinck A, Nelson J, Grudzinkas C, Peck C (2002) Postmarketing drug dosage changes of 499 FDA-approved new molecular entities, 1980–1999. Pharmacoepidemiol Drug Saf 11(6):439–446
Cui L, Hung HMJ, Wang S-J (1999) Modification of sample size in group sequential clinical trials. Biometrics 55:853–857
Dette H, Bretz F, Pepelyshev A, Pinheiro J (2008) Optimal designs for dose finding studies. J Am Stat Assoc 103:1225–1237
Dmitrienko A, Tamhane AC, Bretz F (eds) (2009) Multiple testing problems in pharmaceutical statistics. Taylor & Francis, New York
Dunnett CW (1955) A multiple comparison procedure for comparing several treatments with a control. J Am Stat Assoc 50:1096–1121
EMEA/CHMP (2007) Reflection paper on methodological issues in confirmatory clinical trials with flexible design and analysis plan (draft CHMP/EWP/2459/02, 23-Mar-2006). www.ema.europa.eu/pdfs/human/ewp/245902en.pdf
FDA (2004) Innovation/stagnation: critical path opportunities report. www.fda.gov/downloads/ScienceResearch/SpecialTopics/CriticalPathInitiative/CriticalPathOpportunitiesReports/UCM077258.pdf
FDA (2006) Guidance for clinical trial sponsors on the establishment and operation of clinical trial data monitoring committees. www.fda.gov/downloads/RegulatoryInformation/Guidances/UCM127073.pdf
FDA (2010) Adaptive design clinical trials for drug and biologics draft guidance. www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM201790.pdf
Friede T, Kieser M (2006) Sample size recalculation in internal pilot study designs: a review. Biom J 48(4):537–555
Gallo P, Chuang-Stein C, Dragalin V, Gaydos B, Ktams M, Pinheiro J (2006) Adaptive designs in clinical drug development – an executive summary of the PhRMA Working Group. J Biopharm Stat 16:275–283
Gallo P, Fardipour P, Dragalin V, Krams M, Litman GS, Bretz F (2010) Data monitoring in adaptive dose ranging trials. Stat Biopharm Res (in press)
Garret-Mayer E (2006) The continual reassessment method for dose-finding studies: a tutorial. Clin Trials 3(1):57–71
Heerdink ER, Urquhart J, Leufkens HG (2002) Changes in prescribed dose after market introduction. Pharmacoepidemiol Drug Saf 11(6):447–453
ICH E-9 Expert Working Group (1999) Statistical principles for clinical trials (ICH Harmonized Tripartite Guideline E-9). Stat Med 18:1905–1942
Jennison C, Turnbull BW (2000) Group sequential methods with applications to clinical trials. Chapman & Hall/CRC, Florida
Kraiczi H, Jang T, Ludden T, Peck CC (2003) Randomized concentration-controlled trials: motivations, use, and limitations. Clin Pharmacol Theory 74:203–214
Krams M, Lees KR, Hacke W, Grieve AP, Orgogozo JM, Ford GA for the ASTIN Study investigators (2003) ASTIN: an adaptive dose-response study of UK-279, 276 in acute ischemic stroke. Stroke 34:2543–2548
Lan K, DeMets DL (1983) Discrete sequential boundaries for clinical trials. Biometrika 70:659–663
Lehmacher W, Wassmer G (1999) Adaptive sample size calculations in group sequential trials. Biometrics 55:1286–1290
Miller F, Guilbaud O, Dette H (2007) Optimal designs for estimating the interesting part of a dose-effect curve. J Biopharm Stat 17:1097–1115
Mueller HH, Schaefer H (2004) A general statistical principle for changing a design any time during the course of a trial. Stat Med 23:2497–2508
O’Brien PC, Fleming TR (1979) A multiple testing procedure for clinical trials. Biometrics 35:549–556
Pinheiro J, Sax R, Antonijevic Z, Bornkamp B, Bretz F, Chuang-Stein C, Dragalin V, Fardipour P, Gallo P, Gillespie W, Hsu CH, Miller F, Padmanabhan SK, Patel N, Perevozskaya I, Roy A, Sanil A, Smith JR (2010) Adaptive and model-based dose ranging trials: quantitative evaluation and recommendations (with discussion). Stat Biopharm Res (in press)
Pocock SJ (1977) Group sequential methods in the design and analysis of clinical trials. Biometrika 64:191–199
Posch M, Koenig F, Branson M, Brannath W, Dunger-Baldauf C, Bauer P (2005) Testing and estimation in flexible group sequential designs with adaptive treatment selection. Stat Med 24:3697–3714
Posch M, Maurer W, Bretz F (2010) Type I error rate control in adaptive designs for confirmatory clinical trials with treatment selection at interim. Pharm Stat (in press) 10.1002/pst.413
Proschan M (2005) Two-stage sample size reestimation based on a nuisance parameter: a review. J Biopharm Stat 15:559–574
Proschan MA, Hunsberger SA (1995) Designed extension of studies based on conditional power. Biometrics 51:1315–1324
Wang SJ, O’Neill RT, Hung JHM (2007) Approaches to evaluation of treatment effect in randomized clinical trials with genomic subset. Pharm Stat 6:227–244
Wang SJ, Hung HMJ, O’Neill R (2009) Adaptive patient enrichment designs in therapeutic trials. Biom J 51:358–374
Wassmer G, Vandemeulebroecke M (2006) A brief review of software developments for group sequential and adaptive designs. Biom J 48(4):732–737
Wittes J, Brittain E (1990) The role of internal pilot studies in increasing the efficiency of clinical trials. Stat Med 9:65–72
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Pinheiro, J.C., Bretz, F., Hsu, CH. (2011). Adaptive Trial Designs. In: Kimko, H., Peck, C. (eds) Clinical Trial Simulations. AAPS Advances in the Pharmaceutical Sciences Series, vol 1. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7415-0_6
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