Bayesian adaptive phase II screening design for combination trials.
BACKGROUND
Trials of combination therapies for the treatment of cancer are playing an increasingly important role in the battle against this disease. To more efficiently handle the large number of combination therapies that must be tested, we propose a novel Bayesian phase II adaptive screening design to simultaneously select among possible treatment combinations involving multiple agents.


METHODS
Our design is based on formulating the selection procedure as a Bayesian hypothesis testing problem in which the superiority of each treatment combination is equated to a single hypothesis. During the trial conduct, we use the current values of the posterior probabilities of all hypotheses to adaptively allocate patients to treatment combinations.


RESULTS
Simulation studies show that the proposed design substantially outperforms the conventional multiarm balanced factorial trial design. The proposed design yields a significantly higher probability for selecting the best treatment while allocating substantially more patients to efficacious treatments.


CONCLUSIONS
The proposed design is most appropriate for the trials combining multiple agents and screening out the efficacious combination to be further investigated.


CONCLUSIONS
The proposed Bayesian adaptive phase II screening design substantially outperformed the conventional complete factorial design. Our design allocates more patients to better treatments while providing higher power to identify the best treatment at the end of the trial.
Biostatistics/Epidemiology/Research Design Core, Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Chunyan
C
Cai
Ying
Y
Yuan
Valen E
VE
Johnson
D019540:Area Under Curve; D001499:Bayes Theorem; D004353:Drug Evaluation, Preclinical / Q000379:methods*; D004359:Drug Therapy, Combination / Q000379:methods*; D006801:Humans; D015233:Models, Statistical; D009369:Neoplasms / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design; D012680:Sensitivity and Specificity; D016896:Treatment Outcome