Cytel

Recent Posts

Infographic: 10 steps to consider before choosing an adaptive design

Posted by Cytel

Nov 21, 2016 11:42:00 AM

While adaptive designs can deliver significant benefits to clinical development-  including ethical benefits for patients, reduced costs, and improved likelihood of trial success- they are not suitable for every clinical trial.  In making the assessment of whether or not to choose an adaptive design, trial planners need to weigh the strategic benefits against the practical implications. 

We have previously discussed on the blog, the 10 steps proposed by Jim Bolognese and Ranganath Nayak to assist sponsors in making this decision. In this blog, we are delighted to share a simple infographic outlining the process. 

Read More

Topics: Clinical Research Services, Interim Analyses, Clinical Development Strategy, trial planning, adaptive designs, adaptive trials, DMC, infographic


Case Study: Dose-response modeling informs Phase 2 ulcerative colitis study design

Posted by Cytel

Nov 18, 2016 10:04:00 AM

 

Challenge

Our client had the following key questions which they wanted our pharmacometrics group to address for an upcoming phase 2 trial of their ulcerative colitis compound .

1) Can knowledge from pre-clinical and Phase 1 data inform on the optimal range of doses for an upcoming Phase 2 dose-ranging study?

2) How may the dose response observed in PD markers in Phase 1 healthy volunteers translate to the patient population?

Read More

Topics: Cytel Strategic Consulting, Case Study, pharmacometrics, biostatistics, PK/PD


Infographic: 9 Do's and Don'ts to Ensure Independence of QC in Statistical Programming

Posted by Cytel

Nov 14, 2016 8:13:29 AM

In our last blog, we shared some of Angelo Tinazzi and Cedric Marchand's recommendations on how to ensure independence of QC in statistical programming.  Now, we've put together an infographic highlighting some key do's and don'ts in a handy checklist.  

Read More

Topics: Statistical Programming, biostatistics, SDTM, ADaM


How to ensure independence of QC in statistical programming 

Posted by Cytel

Nov 11, 2016 10:05:14 AM

A solid and robust QC process is one vital component of ensuring quality programming delivery. Angelo Tinazzi and Cedric Marchand presented at the PhUSE conference recently on the topic of ‘What Auditors want’. As part of this well received presentation, the duo discussed the question of independence of QC and how to make sure this is fully observed.

In this blog we’ll walk through their recommendations to ensure independence of QC in programming.

Read More

Topics: Trial Quality, Statistical Programming, Statistical Analysis, CDM


New East Insights Video:Creating an SSR Design

Posted by Cytel

Nov 9, 2016 9:03:11 AM


Adaptive sample size re-estimation designs are an important part of the statistician's toolkit. In this first in a series of East Insight videos, Cytel Statistician Charles Liu walks us through the creation of an adaptive sample size re-estimation design in East with a 5 minute demo. Watch the video and download the accompanying slidedeck to recreate the steps. 

 

Read More

Topics: East, sample size re-estimation, adaptive sample size re-estimation, adaptive trials


Pharmacometrics tools of the trade: 4 factors to consider

Posted by Cytel

Nov 1, 2016 10:02:00 AM


Unlike statistics which has been around in some form for hundreds of years, pharmacometrics is, by comparison, a relatively new discipline and only entered the clinical development world in the last 30 years. Situated at the intersection of mathematical modeling, simulation, and big data, pharmacometrics leverages the best practices of translational research to generate clinical development strategy.

Read More

Topics: pharmacometrics, Biomarkers, adaptive trials, pharmacology, PK/PD


R Beyond Statistics

Posted by Cytel

Oct 25, 2016 7:59:00 AM

 

Use of R is a hot topic among statisticians and programmers in the pharmaceutical industry.  At the recent PhUSE conference in Barcelona there was a clear uplift in interest in the  language and a number of sessions explored introductory principles and examples of how R can be used in practice.  Cytel's Namrata Deshpande presented on the use of R beyond Statistics through a case study of the development of a user friendly tool deploying non-statistical packages in R to enable clinical decision making. The talk won first prize in the Trends and Technology track at the PhUSE conference.  In this blog, we'll discuss some of the aspects presented and share Namrata's slides for download.

Read More

Topics: Clinical Research Services, Statistical Programming, clinical development, Rstats, R


Cytel Infographic: 6 Hot Topics from PhUSE 2016

Posted by Cytel

Oct 18, 2016 9:38:00 AM

Read More

Topics: Statistical Programming, Clinical Data, SAS, Rstats, R


The evolving role of the modern statistical programmer

Posted by Cytel

Oct 13, 2016 9:16:00 AM

Statistical programmers play a key role in turning the data from clinical trials into knowledge and supporting the development of new medicines.  In a dynamic industry with demands such as CDISC compliance, data transparency initiatives, big data, and cost pressures the role is evolving to become ever more multi-dimensional. Statistical programmers now have the opportunity to follow their specific interests and specialize in a range of areas.

Read More

Topics: Clinical Research Services, Statistical Programming, clinical development, SAS


Simulations to optimize clinical trial programs

Posted by Cytel

Oct 11, 2016 9:31:00 AM

Its important to take a strategic  approach to clinical development  in order to minimize the potential for Phase 3 attrition. The below infographic, previously published on the blog highlights some of the approvability and economic reasons cited for Phase 3 failure , and the clinical development issues which may have had an impact. 

Read More

Topics: Clinical Development Strategy, Phase 3, Dose Selection, phase 2, Simulations


Adaptive Designs: A Data Management Perspective

Posted by Cytel

Oct 7, 2016 8:29:00 AM


Adaptive designs have the potential to accelerate clinical development, and improve the probability of trial success. While the principle is simple- to reduce the uncertainty in clinical development by obtaining additional information from the ongoing trial- the statistical methodologies can be complex, and expert support is often required to conduct the clinical trial design. There's also complexity in the data collection itself, so knowledgable data management support is needed to successfully execute an innovative trial design.  In this blog, we take a look at 5 top considerations for successful adaptive trial data management. 

Read More

Topics: Data Management, Clinical Development Strategy, Clinical Data, Adaptive Clinical Trials, EDC, data manager, adaptive designs, adaptive trials


Challenges in Neuroscience Clinical Trials

Posted by Cytel

Oct 5, 2016 9:48:00 AM

 While some progress has been made in terms of scientific development in Neuroscience and Neuropsychiatry indications, the pace of translation into more effective treatments  remains elusive.

 At the recent Cytel seminar co-hosted with Pfizer, Abdul J. Sankoh of Sage Therapeutics presented on some of the challenges in these therapeutic areas and discusses strategies moving forward.  He bases his presentation on his broad industry experience. 

Read More

Topics: Clinical Research Services, psychiatry and neuroscience, biostatistics, adaptive designs, adaptive trials


Case studies:Learning from less-well understood adaptive designs

Posted by Cytel

Sep 29, 2016 9:28:14 AM

A paper "Best practices case studies for 'less well-understood' Adaptive designs", has been published by the DIA Scientific Working Group on Adaptive Designs as a twin document to the previously discussed "Challenges and Opportunities of 'Less Well Understood' Adaptive Designs".  This publication furthers understanding by reviewing 10 important case studies and sharing details on their design and operational characteristics, as well as related regulatory interactions.  

To read an abstract and details of the full publication click here. 

 In this blog we'll take a look at some of the case studies under discussion. 

Read More

Topics: Rare Disease, Clinical Development Strategy, Adaptive Clinical Trials, Multi-Arm Studies, adaptive sample size re-estimation, Multi-Arm Multi-Stage Studies, EAST 6.4, adaptive designs, adaptive trials, Seamless designs


Practical Challenges of the LUNG-MAP study

Posted by Cytel

Sep 27, 2016 9:24:00 AM

The Lung-MAP  trial is an innovative biomarker driven 'precision medicine' study which evaluates five novel agents for the treatment of patients with advanced squamous cell carcinoma of the lung.  As well as exploring therapeutic options for this indication, it also aims to improve the drug development process. 

At a Cytel seminar earlier in the year, Antje Hoering of CRAB presented to delegates on some of the practical challenges of the Lung-MAP study.

Read More

Topics: Oncology, Precision Medicine, Clinical Development Strategy, Phase 3, phase 2, EDC


An efficient tool for model based meta-analysis

Posted by Cytel

Sep 20, 2016 9:42:00 AM

 

Drug development is an expensive and risky business.  To maximize a compound’s ultimate chances of commercial as well as regulatory success it’s imperative that sponsors are building up a strong understanding of its characteristics relative to competitors.  This knowledge can support critical decisions along the development path, such as optimizing dosing, and selecting the best active control. Importantly, it also ensures the sponsor can build a body of evidence and quantify the benefits of the compound in the context of other treatment options.  This knowledge can streamline the path to drug approval and support the drug’s chances of commercial success when it reaches the market.

 Model based meta- analysis (MBMA) is becoming an increasingly utilized strategy to conduct this competitive benchmarking. 

Read More

Topics: Clinical Development Strategy, pharmacometrics, clinical development, pharmacology


Case Study:Exposure Response Modeling in Hematology

Posted by Cytel

Sep 13, 2016 10:15:00 AM

 

Exposure-response data gained from clinical studies can provide a basis for model-based analysis and simulation, helping to predict the expected relationships between exposure and response.  Using this approach, it may be possible to optimize dosage regimens and to individualize treatment in specific patient subsets for which there are limited data.  In this blog, we examine a case study of an exposure response modeling project conducted by our Quantitative Pharmacology and Pharmacometrics team. 

Read More

Topics: Cytel Strategic Consulting, Phase 3, pharmacometrics, biostatistics, pharmacology, PK/PD


Case Study:Seamless Phase 2/3 Design in Rare Disease

Posted by Cytel

Sep 9, 2016 9:24:00 AM

 

Challenge:

Our client, an emerging biotechnology company, was preparing for the next stage of development for their novel compound in a rare disease.  They had two major concerns which they wanted the clinical trial design to address- an anticipated difficulty in recruiting subjects to the trial, and  the cost and time investment associated with running separate phase 2 and phase 3 trials.  They approached Cytel’s strategic consulting team for an innovative solution.

Solution:

An inferentially seamless Phase 2/ 3 design with promising zone was proposed as a means to address the sponsor’s objectives. Because of uncertainty regarding which dose would be selected and what the effect size of the selected dose would be, the team proposed design options which allowed for adjustment of the sample size using information learned at the interim analysis.  Several seamless phase 2/3 designs, with and without adaptive sample size re-estimation were evaluated through simulations using East 6.4.

The simulations evaluated various design parameters such as maximal sample size, timing of the interim analysis, size of the promising zone, and efficacy and futility boundaries. Designs were compared on the basis of overall power, average sample size, conditional power, probability of entering each interim zone, and number of overruns.

Value Added:

The inferentially seamless design has the potential to accelerate clinical development by removing the ‘white space’ between phases 2 and 3.  Where the sample size is increased adaptively at the interim analysis by a specified percentage of the original pre-planned sample size, an overall increase in power could also be achieved.  The sample size re-estimation design provided a boost to power where the interim results fell  in the promising zone.  The client benefited from a design which only calls for additional investment of patients and resources when this investment would meaningfully boost the chances of success.

Cytel's statistical consulting team help you decide if an adaptive approach is right for your trial. Read further examples of our work by clicking below. 

Read More

Topics: Clinical Research Services, Cytel Strategic Consulting, Phase 3, phase 2, biostatistics, EAST 6.4, adaptive trials, Seamless designs


Overcoming challenges of 'Less Well Understood' Adaptive Designs

Posted by Cytel

Sep 7, 2016 8:00:00 AM

In the 2010 draft FDA ‘Guidance for Industry on Adaptive Design Clinical Trials for Drugs and Biologics',  the agency makes an important distinction between ‘well understood’ and ‘less well understood’ adaptive designs.

‘Well understood” adaptive designs may include such approaches as adaptation of eligibility criteria, adaptation for stopping early and adaptations to maintain study power based on blinded interim analyses of aggregate data. For these 'well-understood designs', there is little concern from the FDA about their potential to be implemented in adequate and well-controlled trials.  On the other hand, at the time of the drafting of the guidance at least, ‘ less well understood designs' (which include such approaches as adaptations for dose selection studies, adaptation of patient population based on treatment-effect estimates,  and adaptation for end-point selection based on interim estimates of treatment effect) gave greater concern. Interestingly, the FDA  Adaptive Designs for Medical Device Clinical Studies : Guidance for Industry and Food and Drug Administration Staff does not adopt this distinction. 

A recent article, Addressing Challenges and Opportunities of “Less Well-Understood” Adaptive Designs (He et al 2016) (1) takes a look at some of the perceived challenges of these designs and ways in which they may be overcome.  The publication is the result of work by a best practice sub-team formed by the DIA Adaptive Design Scientific Working group in January 2014. Cytel's Yannis Jemiai is a member of this group, and one of the co-authors of the article. 

In this blog, we take a look at a few of the challenges outlined and some of the suggested mitigations.  One aspect covered in the publication is seamless designs- and given the scope we'll devote a separate blog to this area. 

Read More

Topics: sample size re-estimation, Clinical Research Services, type 1 error, Software Simulations, patient enrollment, adaptive designs, adaptive trials, DMC


Case Study: BLRM for Phase 1/2a Oncology Study

Posted by Cytel

Sep 2, 2016 10:30:00 AM

 

Read More

Topics: Oncology, Dose-Escalation, East ESCALATE, CRM, Early Phase Trials, Eearly Development, BLRM, biostatistics, EAST 6.4, adaptive trials


An Introduction to BLRM

Posted by Cytel

Aug 31, 2016 1:11:57 PM

Traditional rule-based approaches to dose escalation such as 3+3 are widely used in early clinical development. They can be appealing due to the simplicity of execution. However, estimates produced may be highly variable and the targeting of true Maximum Tolerated Dose may be poor.  Bayesian dose escalation approaches in early phase trials can offer an effective alternative to determining the maximum tolerable dose of a new drug more quickly, as well as ensuring that all of the information available to trial clinicians is taken into account so that the patients enrolled in the trial receive the best possible treatment.

Read More

Topics: Dose-Escalation, East ESCALATE, CRM, BLRM, biostatistics, EAST 6.4, adaptive trials


The Cytel blog keeps you up to speed with the latest developments in biostatistics and clinical biometrics.  Sign up for updates direct to your inbox. You can unsubscribe at any time.

 

Posts by Topic

see all

Recent Posts