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利用替代终点的治疗效果来规划一项评估最终终点治疗效果的研究。

Utilization of treatment effect on a surrogate endpoint for planning a study to evaluate treatment effect on a final endpoint.

作者信息

Quan Hui, Xu Zhixing, Luo Junxiang, Paux Gautier, Cho Meehyung, Chen Xun

机构信息

Biostatistics and Programming, Sanofi, Bridgewater, New Jersey, USA.

Biostatistics and Programming, Moderna, Cambridge, Massachusetts, USA.

出版信息

Pharm Stat. 2023 Jul-Aug;22(4):633-649. doi: 10.1002/pst.2298. Epub 2023 Mar 3.

Abstract

To design a phase III study with a final endpoint and calculate the required sample size for the desired probability of success, we need a good estimate of the treatment effect on the endpoint. It is prudent to fully utilize all available information including the historical and phase II information of the treatment as well as external data of the other treatments. It is not uncommon that a phase II study may use a surrogate endpoint as the primary endpoint and has no or limited data for the final endpoint. On the other hand, external information from the other studies for the other treatments on the surrogate and final endpoints may be available to establish a relationship between the treatment effects on the two endpoints. Through this relationship, making full use of the surrogate information may enhance the estimate of the treatment effect on the final endpoint. In this research, we propose a bivariate Bayesian analysis approach to comprehensively deal with the problem. A dynamic borrowing approach is considered to regulate the amount of historical data and surrogate information borrowing based on the level of consistency. A much simpler frequentist method is also discussed. Simulations are conducted to compare the performances of different approaches. An example is used to illustrate the applications of the methods.

摘要

为设计一项具有最终终点的III期研究并计算达到预期成功概率所需的样本量,我们需要对治疗对终点的效应进行良好估计。充分利用所有可用信息是谨慎之举,这些信息包括治疗的历史信息和II期信息以及其他治疗的外部数据。II期研究可能将替代终点用作主要终点且最终终点的数据很少或没有,这种情况并不罕见。另一方面,关于其他治疗在替代终点和最终终点的其他研究的外部信息可能可用于建立两种终点治疗效应之间的关系。通过这种关系,充分利用替代信息可能会提高对最终终点治疗效应的估计。在本研究中,我们提出一种双变量贝叶斯分析方法来全面处理该问题。考虑一种动态借用方法,根据一致性水平来调节历史数据和替代信息的借用量。还讨论了一种简单得多的频率论方法。进行模拟以比较不同方法的性能。通过一个例子来说明这些方法的应用。

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