期刊
STATISTICS IN BIOSCIENCES
卷 8, 期 1, 页码 159-180出版社
SPRINGER
DOI: 10.1007/s12561-014-9117-1
关键词
Adaptive designs; Bayesian inference; Biomarkers; Posterior; Subgroup identification; Targeted therapies
资金
- NCI NIH HHS [R01 CA132897, R01 CA157458] Funding Source: Medline
- NCRR NIH HHS [S10 RR029030] Funding Source: Medline
Targeted therapies based on biomarker profiling are becoming a mainstream direction of cancer research and treatment. Depending on the expression of specific prognostic biomarkers, targeted therapies assign different cancer drugs to subgroups of patients even if they are diagnosed with the same type of cancer by traditional means, such as tumor location. For example, Herceptin is only indicated for the subgroup of patients with HER2+ breast cancer, but not other types of breast cancer. However, subgroups like HER2+ breast cancer with effective targeted therapies are rare, and most cancer drugs are still being applied to large patient populations that include many patients who might not respond or benefit. Also, the response to targeted agents in humans is usually unpredictable. To address these issues, we propose subgroup-based adaptive (SUBA), designs that simultaneously search for prognostic subgroups and allocate patients adaptively to the best subgroup-specific treatments throughout the course of the trial. The main features of SUBA include the continuous reclassification of patient subgroups based on a random partition model and the adaptive allocation of patients to the best treatment arm based on posterior predictive probabilities. We compare the SUBA design with three alternative designs including equal randomization, outcome-adaptive randomization, and a design based on a probit regression. In simulation studies, we find that SUBA compares favorably against the alternatives.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据