Dmitrienko Alex, Millen Brian, Lipkovich Ilya
Mediana, Inc., Overland Park, KS, U.S.A.
Eli Lilly and Company, Indianapolis, IN, U.S.A.
Stat Med. 2017 Dec 10;36(28):4446-4454. doi: 10.1002/sim.7416. Epub 2017 Aug 1.
This paper deals with the general topic of subgroup analysis in late-stage clinical trials with emphasis on multiplicity considerations. The discussion begins with multiplicity issues arising in the context of exploratory subgroup analysis, including principled approaches to subgroup search that are applied as part of subgroup exploration exercises as well as in adaptive biomarker-driven designs. Key considerations in confirmatory subgroup analysis based on one or more pre-specified patient populations are reviewed, including a survey of multiplicity adjustment methods recommended in multi-population phase III clinical trials. Guidelines for interpretation of significant findings in several patient populations are introduced to facilitate the decision-making process and achieve consistent labeling across development programs. Copyright © 2017 John Wiley & Sons, Ltd.
本文探讨晚期临床试验中的亚组分析这一总体主题,重点关注多重性考量。讨论始于探索性亚组分析背景下出现的多重性问题,包括作为亚组探索活动一部分以及在适应性生物标志物驱动设计中应用的亚组搜索原则性方法。回顾了基于一个或多个预先指定患者群体的验证性亚组分析中的关键考量因素,包括对多群体III期临床试验中推荐的多重性调整方法的调查。介绍了在多个患者群体中解释显著结果的指南,以促进决策过程并在整个研发项目中实现一致的标签标注。版权所有© 2017约翰威立父子有限公司。