Bayesian Phase II optimization for time-to-event data based on historical information

2017 ◽  
Vol 28 (4) ◽  
pp. 1272-1289
Author(s):  
Anja Bertsche ◽  
Frank Fleischer ◽  
Jan Beyersmann ◽  
Gerhard Nehmiz
Keyword(s):  
Phase Ii ◽  
Treatment Effect ◽  
Control Treatment ◽  
Design Parameters ◽  
Proof Of Concept ◽  
Event Data ◽  
Time To Event ◽  
Historical Information ◽  
Time To Event Data ◽  
The Right

After exploratory drug development, companies face the decision whether to initiate confirmatory trials based on limited efficacy information. This proof-of-concept decision is typically performed after a Phase II trial studying a novel treatment versus either placebo or an active comparator. The article aims to optimize the design of such a proof-of-concept trial with respect to decision making. We incorporate historical information and develop pre-specified decision criteria accounting for the uncertainty of the observed treatment effect. We optimize these criteria based on sensitivity and specificity, given the historical information. Specifically, time-to-event data are considered in a randomized 2-arm trial with additional prior information on the control treatment. The proof-of-concept criterion uses treatment effect size, rather than significance. Criteria are defined on the posterior distribution of the hazard ratio given the Phase II data and the historical control information. Event times are exponentially modeled within groups, allowing for group-specific conjugate prior-to-posterior calculation. While a non-informative prior is placed on the investigational treatment, the control prior is constructed via the meta-analytic-predictive approach. The design parameters including sample size and allocation ratio are then optimized, maximizing the probability of taking the right decision. The approach is illustrated with an example in lung cancer.

Group sequential monitoring based on the maximum of weighted log-rank statistics with the Fleming–Harrington class of weights in oncology clinical trials

2020 ◽  
Vol 29 (12) ◽  
pp. 3525-3532
Author(s):  
Thomas J Prior
Keyword(s):  
Clinical Trials ◽  
Treatment Effect ◽  
Proportional Hazards ◽  
Rank Test ◽  
Event Data ◽  
Time To Event ◽  
Survival Curves ◽  
Delayed Treatment ◽  
Time To Event Data ◽  
Log Rank Test

Clinical trials in oncology often involve the statistical analysis of time-to-event data such as progression-free survival or overall survival to determine the benefit of a treatment or therapy. The log-rank test is commonly used to compare time-to-event data from two groups. The log-rank test is especially powerful when the two groups have proportional hazards. However, survival curves encountered in oncology studies that differ from one another do not always differ by having proportional hazards; in such instances, the log-rank test loses power, and the survival curves are said to have “non-proportional hazards”. This non-proportional hazards situation occurs for immunotherapies in oncology; immunotherapies often have a delayed treatment effect when compared to chemotherapy or radiation therapy. To correctly identify and deliver efficacious treatments to patients, it is important in oncology studies to have available a statistical test that can detect the difference in survival curves even in a non-proportional hazards situation such as one caused by delayed treatment effect. An attempt to address this need was the “max-combo” test, which was originally described only for a single analysis timepoint; this article generalizes that test to preserve type I error when there are one or more interim analyses, enabling efficacious treatments to be identified and made available to patients more rapidly.

Approximate Bayesian inference for joint linear and partially linear modeling of longitudinal zero-inflated count and time to event data

2021 ◽  
pp. 096228022110028
Author(s):  
T Baghfalaki ◽  
M Ganjali
Keyword(s):  
Linear Model ◽  
Joint Modeling ◽  
Partially Linear Model ◽  
Event Data ◽  
Time To Event ◽  
Data Set ◽  
Partially Linear ◽  
Time To Event Data ◽  
Count Response ◽  
Approximate Bayesian

Joint modeling of zero-inflated count and time-to-event data is usually performed by applying the shared random effect model. This kind of joint modeling can be considered as a latent Gaussian model. In this paper, the approach of integrated nested Laplace approximation (INLA) is used to perform approximate Bayesian approach for the joint modeling. We propose a zero-inflated hurdle model under Poisson or negative binomial distributional assumption as sub-model for count data. Also, a Weibull model is used as survival time sub-model. In addition to the usual joint linear model, a joint partially linear model is also considered to take into account the non-linear effect of time on the longitudinal count response. The performance of the method is investigated using some simulation studies and its achievement is compared with the usual approach via the Bayesian paradigm of Monte Carlo Markov Chain (MCMC). Also, we apply the proposed method to analyze two real data sets. The first one is the data about a longitudinal study of pregnancy and the second one is a data set obtained of a HIV study.

scholarly journals Mitigation of biases in estimating hazard ratios under non-sensitive and non-specific observation of outcomes–applications to influenza vaccine effectiveness

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ulrike Baum ◽  
Sangita Kulathinal ◽  
Kari Auranen
Keyword(s):  
False Positive ◽  
False Positive Rate ◽  
Vaccine Effectiveness ◽  
Partial Likelihood ◽  
Event Data ◽  
Time To Event ◽  
Positive Events ◽  
Time To Event Data ◽  
Hazard Ratios ◽  
Positive Rate

Abstract Background Non-sensitive and non-specific observation of outcomes in time-to-event data affects event counts as well as the risk sets, thus, biasing the estimation of hazard ratios. We investigate how imperfect observation of incident events affects the estimation of vaccine effectiveness based on hazard ratios. Methods Imperfect time-to-event data contain two classes of events: a portion of the true events of interest; and false-positive events mistakenly recorded as events of interest. We develop an estimation method utilising a weighted partial likelihood and probabilistic deletion of false-positive events and assuming the sensitivity and the false-positive rate are known. The performance of the method is evaluated using simulated and Finnish register data. Results The novel method enables unbiased semiparametric estimation of hazard ratios from imperfect time-to-event data. False-positive rates that are small can be approximated to be zero without inducing bias. The method is robust to misspecification of the sensitivity as long as the ratio of the sensitivity in the vaccinated and the unvaccinated is specified correctly and the cumulative risk of the true event is small. Conclusions The weighted partial likelihood can be used to adjust for outcome measurement errors in the estimation of hazard ratios and effectiveness but requires specifying the sensitivity and the false-positive rate. In absence of exact information about these parameters, the method works as a tool for assessing the potential magnitude of bias given a range of likely parameter values.

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