Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China.
JCO Precis Oncol. 2022 Mar;6:e2100394. doi: 10.1200/PO.21.00394.
With deeper insight into precision medicine, more innovative oncology trial designs have been proposed to contribute to the characteristics of novel antitumor drugs. Bayesian information borrowing is an indispensable part of these designs, which shows great advantages in improving the efficiency of clinical trials. Bayesian methods provide an effective framework when incorporating information. However, the key point lies in how to choose an appropriate method for complex oncology clinical trials.
We divided the borrowing information scenarios into concurrent and nonconcurrent scenarios according to whether the data to be borrowed are observed at the same time as in the current trial or not. Then, we provided an overview of the methods in each scenario. Performance comparison of different methods is carried out with regard to the type I error and power.
As demonstrated by the simulation results in each borrowing scenario, the Bayesian hierarchical model and its extensions are more appropriate for concurrent borrowing. The simulation results demonstrate that the Bayesian hierarchical model shows great advantages when the arms are homogeneous. However, such a method should be adopted with caution when heterogeneity exists. We recommend the other methods, considering heterogeneity. Borrow information from informative priors is more suggested for nonconcurrent borrowing scenarios. Multisource exchangeability models are more suitable for multiple historical trials, while meta-analytic-predictive prior should be carefully applied.
Bayesian information borrowing is useful and can improve the efficiency of clinical trial designs. However, we should carefully choose an appropriate information borrowing method when facing a practical innovative oncology trial, as an appropriate method is essential to provide ideal design performance.
随着对精准医学认识的不断深入,提出了更多创新的肿瘤临床试验设计,以适应新型抗肿瘤药物的特点。贝叶斯信息借用是这些设计不可或缺的一部分,它在提高临床试验效率方面具有很大的优势。贝叶斯方法在信息整合方面提供了一个有效的框架。然而,关键在于如何为复杂的肿瘤临床试验选择合适的方法。
我们根据将要借用的信息是否与当前试验同时观察,将信息借用场景分为并发和非并发场景。然后,我们对每种情况下的方法进行了概述。针对不同方法的Ⅰ型错误和功效进行了性能比较。
在每种借用场景的模拟结果中,贝叶斯分层模型及其扩展更适合并发借用。模拟结果表明,当臂之间同质时,贝叶斯分层模型具有很大的优势。然而,当存在异质性时,应谨慎采用这种方法。我们建议考虑异质性时采用其他方法。对于非并发借用场景,建议从信息先验中借用信息。多源可交换模型更适用于多个历史试验,而元分析预测先验则应谨慎应用。
贝叶斯信息借用是有用的,可以提高临床试验设计的效率。然而,当我们面对实际的创新肿瘤临床试验时,应仔细选择合适的信息借用方法,因为合适的方法对于提供理想的设计性能至关重要。