The Cytel blog keeps you up to speed with the latest developments in biostatistics and clinical biometrics.
Our Client's Challenge:
Can knowledge of the relationship between biomarkers and clinical endpoints help us to optimize an early development program and improve the probability of selecting the right dose in Phase 3?
Our client approached us hoping to expedite dose-finding with biomarkers in Phase 1b, and to design an optimal Phase 2b clinical endpoint trial to maximize probability of correct Phase 3 dose selection.
When approaching a Phase 3 clinical trial, the need to ‘de-risk’ the massive investment often leads sponsors on a quest for the perfect risk mitigating adaptation. While a strategically planned clinical trial design can be an important step in giving a new medicine its best possible chance of success, there are a number of other ways that a trial sponsor can minimize study risk.
The Journal of the American Medical Association recently published an article entitled ‘The Anatomy of Medical Research: US and International Comparisons.’ The stated objective of the study was to “quantify total public and private investment and personnel (economic inputs) and to evaluate resulting patents, publications, drug and device approvals, and value created (economic outputs)“ 
Amongst the many findings of this comprehensive study, a vital observation is the reduction of early phase spending by about 4% per year from 2004 to 2012. One attribution for this decline involves the financial constraints placed upon proof-of-concept trials, particularly when compared to the expected financial benefits of Phase 3 trials and medical devices. According to the authors, “Many new basic discoveries that have probable clinical value are stymied by financial constraints at the critical proof-of-concept stage, where utility in humans is demonstrated.”  They add that the number of new discoveries that will be underfunded at the proof-of-concept stage is expected to increase.