Huang Huiyao, Liu Meiruo, Li Xiyan, Meng Xinyu, Cui Dandan, Leng Ye, Tang Yu, Li Ning
Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang 065001, China.
Zhongguo Fei Ai Za Zhi. 2022 Oct 20;25(10):730-734. doi: 10.3779/j.issn.1009-3419.2022.102.43.
Bayesian statistics is an approach for learning from evidences as it accumulates, combining prior distribution with current information on a quantity of interest, in which posterior distribution and inferences are being updated each time new data become available using Bayes' Theorem. Though frequentist approach has dominated medical studies, Bayesian approach has been more and more widely recognized by its flexibility and efficiency. Research and development (R&D) on anti-cancer new drugs have been so hot globally in recent years in spite of relatively high failure rate. It is the common demand of pharmaceutical enterprises and researchers to identify the optimal dose, regime and right population in the early-phase R&D stage more accurately and efficiently, especially when the following three major changes have been observed. The R&D on anticancer drugs have transformed from chemical drugs to biological products, from monotherapy to combination therapy, and the study design has also gradually changed from traditional way to innovative and adaptive mode. This also raises a number of subsequent challenges on decision-making of early R&D, such as inability to determine MTD, flexibility to deal with delayed toxicity, delayed response and dose-response changing relationships. It is because of the above emerging changes and challenges that the Bayesian approach is getting more and more attention from the industry. At least, Bayesian approach has more information for decision-making, which could potentially help enterprises achieve higher efficiency, shorter period and lower investment. This study also expounds the application of Bayesian statistics in the early R&D on anticancer new drugs, and compares and analyzes its idea and application scenarios with frequentist statistics, aiming to provide macroscopic and systematic reference for all related stakeholders. .
贝叶斯统计是一种随着证据积累而进行学习的方法,它将先验分布与关于感兴趣量的当前信息相结合,每次有新数据可用时,利用贝叶斯定理更新后验分布和推断。尽管频率主义方法在医学研究中占据主导地位,但贝叶斯方法因其灵活性和效率越来越受到广泛认可。尽管抗癌新药研发的失败率相对较高,但近年来全球范围内抗癌新药的研发热度一直很高。在早期研发阶段更准确、高效地确定最佳剂量、给药方案和合适的人群是制药企业和研究人员的共同需求,尤其是当观察到以下三个主要变化时。抗癌药物研发已从化学药物转向生物制品,从单一疗法转向联合疗法,研究设计也逐渐从传统方式转变为创新和适应性模式。这也给早期研发决策带来了一些后续挑战,比如无法确定最大耐受剂量、应对延迟毒性、延迟反应以及剂量 - 反应变化关系的灵活性。正是由于上述新出现的变化和挑战,贝叶斯方法越来越受到业界关注。至少,贝叶斯方法在决策时有更多信息,这有可能帮助企业提高效率、缩短周期并降低投入。本研究还阐述了贝叶斯统计在抗癌新药早期研发中的应用,并将其理念和应用场景与频率主义统计进行比较分析,旨在为所有相关利益者提供宏观和系统的参考。