Cytel Case Study Series II: Adaptive Bayesian Design with Informative Prior

Posted by Cytel

Sep 15, 2015 3:56:42 PM

 

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Topics: Bayesian Methods, Cytel Consulting, Case Study, Adaptive Clinical Trials


Special Update: US House of Representatives Passes 21st Century Cures Act

Posted by Cytel

Jul 10, 2015 12:54:00 PM

Here at Cytel, we are engaging in a small celebration this afternoon, as the US House of Representatives has just passed the FDA Reform Bill more generally known as the 21st Century Cures Act.

Although this bill is widely viewed as a reform bill, it will provide extensive funding to both the FDA and NIH to ensure that clinical and pharmaceutical research lives up to its potential to deliver...

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Topics: Bayesian Methods, Regulation, Medical Devices, Adaptive Clinical Trials


Why You Should Not Power for Superiority Upfront: Promising Zone Clinical Trials with "Adaptive Switch"

Posted by Esha Senchaudhuri

Jun 26, 2015 12:00:06 PM

Powering a trial for superiority can be financially risky. In some instances it may also prove unnecessary.

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Topics: Cyrus Mehta, Promising Zone, Cardiovascular, Adaptive Clinical Trials, Adaptive Finance


Aligning Clinical Development & Regulatory Objectives for Cardiovascular Outcome Trials

Posted by Esha Senchaudhuri

Jun 11, 2015 5:21:09 PM

When the FDA first began to require pharmaceuticals to perform cardiovascular outcome trials to establish the safety of certain new drugs, many worried that this new regulatory requirement would diminish investments in therapeutic areas like diabetes and obesity [1]. CVOTs are typically designed as massive time-to-event trials that need to enroll several thousands of patients to establish safety...

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Topics: Cardiovascular, Clinical Development Strategy, Adaptive Clinical Trials


Seamless Adaptive Clinical Trials: Now that we get the statistics, what’s really at stake?

Posted by Esha Senchaudhuri

May 20, 2015 5:56:47 PM

Seamless adaptive clinical trials have gained popularity for reducing the projected time it takes to complete the process of drug development.  However, a study by Cuffe et al., shows that despite a tremendous amount of statistical knowledge about seamless trials, sponsors remain unsure about how to calculate the financial and operational costs of a seamless clinical development program [1]....

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Topics: Phase 1, Early Phase Trials, Clinical Development Strategy, Phase 3, Adaptive Clinical Trials, phase 2


New Articles on Adaptive Clinical Trials & Adaptive Financing

Posted by Esha Senchaudhuri

Apr 30, 2015 5:00:00 PM

Adaptive financing (not to be confused with adaptive licensing) explores how biotechs, pharmaceuticals and potential investors, can use adaptive designs for more strategic financial decision-making, as well as for efficient drug development.  

“For example,” writes Zoran Antonijevic, Senior Director at Cytel Consulting, “Reduction in costs and development time can be accomplished by combining...

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Topics: Clinical Development Strategy, Adaptive Clinical Trials, Adaptive Finance


Dose-finding with Sequential Parallel Comparison Designs

Posted by Esha Senchaudhuri

Apr 23, 2015 3:53:00 PM

Last week the Cytel Blog discussed the benefits of using the Adaptive Maximizing Design [AM Design] for dose-finding trials involving clinical utility limiting therapies. However, there are other ways that a dose-finding trial can make use of frequent-adaptation maximizing designs. Here we look at what happens to early phase clinical development when an AM Design combines with another adaptive...

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Topics: Cytel Consulting, Early Phase Trials, Clinical Development Strategy, Adaptive Clinical Trials, psychiatry and neuroscience


Adaptive SSR for Small Sample Sizes?

Posted by Esha Senchaudhuri

Apr 21, 2015 6:09:28 PM

“We shouldn’t use an adaptive design, our sample size is too small.”

Most clinical trial planners have heard this line of reasoning so often it has come to be taken as true. Never mind the fact that the first product to receive FDA approval using an adaptive sample size re-estimation design, was for a genetic condition affecting fewer than two thousand children worldwide [1].

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Topics: Clinical Research Services, Rare Disease, Clinical Development Strategy, Adaptive Clinical Trials


Phase 2 Designs for Clinical Utility Limiting Therapies

Posted by Esha Senchaudhuri

Apr 16, 2015 5:28:00 PM

When testing certain types of new drugs it is known in advance that the adverse side-effects of the medication will limit dose selection. For example, it is well-established that for many new pain medications, the side effects of nausea and vomiting will place constraints on the selection of higher dose levels.

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Topics: Dose-Finding, Adaptive Clinical Trials


Statistical and Operational Challenges of the VALOR Trial: Mehta on the Promising Zone

Posted by Esha Senchaudhuri

Mar 26, 2015 4:00:00 PM

Last year Sunesis completed the VALOR trial, the first clinical study to make use of the groundbreaking promising zone design. The promising zone design implements an unblinded sample re-estimation after an interim look, but only if conditional power during the interim look falls within a designated promising zone. Although the VALOR trial did not confirm the efficacy of the new therapeutic, it...

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Topics: Promising Zone, Statistical Innovations in Clinical Development, Adaptive Clinical Trials


How Bayesian Strategies Can Expedite a Pediatric Clincial Trial Time by 20 - 40%

Posted by Esha Senchaudhuri

Mar 20, 2015 4:29:00 PM

Sometimes a new candidate drug for a pediatric study has already been tested on adults for safety and efficacy. We know that the drug is likely to work quite differently in children, but we do not know the degree to which the effects will be different. As a result, a conventional approach is to discard much of the information that has already gathered during studies of adults, and then to start...

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Topics: Bayesian Methods, Adaptive Clinical Trials, Pediatric


How Proposed Regulatory Reforms Will Affect Your Clinical Trial

Posted by Esha Senchaudhuri

Feb 17, 2015 6:40:00 PM

21st Century Cures (also called Cures2015) is a bipartisan initiative undertaken by the Committee on Energy and Commerce of the US House of Representatives. Amongst the many factors motivating this landmark legislation is the concern  that regulatory procedures must keep up to date with innovations in clinical development. Cures2015 aims to reform the regulation of drugs, biologics and medical...

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Topics: Bayesian Methods, Regulation, Medical Devices, Adaptive Clinical Trials


Clinical Development & Statistical Methodology for Cardiovascular Risk Assessment

Posted by Cytel

Feb 3, 2015 2:00:00 PM

A new publication co-authored by Cytel Co-Founder and President Cyrus Mehta considers a range of clinical development methods for cardiovascular outcome trials. Cardiovascular outcome trials, (often referred to as CVOTs), reflect safety standards implemented by the FDA and EMA to determine whether or not new drugs impose undue cardiovascular risk on patients. CVOTs typically occur after Phase 3...

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Topics: Cardiovascular, Group Sequential, Adaptive Clinical Trials


Adaptive Design and Bayesian Statistics: 5 Years Later (Podcast)

Posted by Esha Senchaudhuri

Jan 29, 2015 4:00:00 PM

February 2015 marks the five year anniversary of the FDA’s Guidance on Adaptive Design Clinical Trials for Drug and Biologics, as well as the FDA’s Guidance on the Use of Bayesian Statistics in Medical Device Clinical Trials. In honor of the five year anniversary of both sets of guidance, the DIA will hold a special joint conference between its Adaptive Design working group and its working group...

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Topics: Bayesian Methods, Adaptive Clinical Trials


Early Phase Development Strategy: Bayesian Methods for Go/No-Go Rules

Posted by Esha Senchaudhuri

Dec 18, 2014 3:40:00 PM

Earlier this week, we at Cytel enjoyed a riveting in-house discussion on the uses of Bayesian decision rules for Go/No-Go (GNG) decision-making. GNG rules establish the trajectory of a particular clinical program’s development by assessing whether or not a trial has met particular objects (e.g. target regions for PK, PD and safety endpoints.)

Traditionally, statisticians have used p-values and...

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Topics: Early Phase Trials, Clinical Development Strategy, Adaptive Clinical Trials


Adaptive Designs for Infectious Diseases Clinical Development Strategy

Posted by Esha Senchaudhuri

Dec 11, 2014 1:14:00 PM

 

A common framework for the clinical development of vaccines involves the study of several candidate compounds in Phase 1 followed by the selection of potential vaccine regimens for study in Phase 2 and Phase 3. In the attached presentation, Cytel Consulting’s Jim Bolognese compares traditional and adaptive Phase 1/Phase 2 studies for vaccines and infectious diseases, providing simulations...

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Topics: Infectious Diseases, Clinical Development Strategy, Adaptive Clinical Trials


Drug Supply Planning for Dose-Ranging Adaptive Trials

Posted by Esha Senchaudhuri

Dec 9, 2014 12:17:28 PM

When planning a conventional trial, one can anticipate the drug supply necessary for the trial by determining how the number of patients reflected in the sample size will distribute across the trial sites. Implementing an adaptive trial, by contrast, raises many challenges for predicting the necessary drug supply. It can require planning for different sample sizes depending on the outcome of...

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Topics: Nitin Patel, Access to Slides PDF, Bayesian Methods, Interim Analyses, optimization, Dose-Finding, Adaptive Clinical Trials


Ranking Adaptive Dose-Finding Designs using Clinical Utility Functions

Posted by Esha Senchaudhuri

Nov 12, 2014 4:04:25 PM

Clinical utility functions provide Phase 2 trial sponsors with an intuitive metric by which to measure the quality of a selected dose. Such functions reveal the efficacy-to-tolerability ratio of doses under consideration, thereby enabling trials to move forward with doses that are highly effective and which have minimal side-effects. While this is arguably the most popular use of clinical utility...

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Topics: Dose-Finding, Adaptive Clinical Trials


New Exploratory Trial Method Translates into Better Financial Strategy

Posted by Esha Senchaudhuri

Nov 4, 2014 8:30:00 AM

A key stage of exploratory drug development is implementing a proof-of-concept study to demonstrate the safety of a drug. Given the importance of accurate dose-finding for Phase 3 success, methodological improvements to proof-of-concept studies in Phase 2 can translate into greater likelihood of getting a drug to market. 

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Topics: Oncology, Access to Slides PDF, Enrichment, Safety, Precision Medicine, Entrepreneurship, R&D, Adaptive Clinical Trials


Michael Proschan on 'Blinded Adaptations, Permutations and t-tests' (Link to Slides)

Posted by Cytel

Oct 30, 2014 10:28:00 AM

 During last week’s East Users Group Meeting, Michael Proschan of the NIH and NIAID, gave a presentation on ‘Blinded Adaptations, Permutations and t-tests.’ Given the close connection between adaptive t-tests and adaptive permutation tests, Proschan argued that it is possible to determine the validity of an adaptive t-test from the validity of an adaptive permutation test. Proschan concludes that...

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Topics: permutations, Blind and Unblind Trials, t-tests, Adaptive Clinical Trials


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