Taylor JW, et al. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. CAS Stat Biopharma Res. KH, JF, SH, and YQ report personal fees from ADC Therapeutics, during the conduct of the study. Shaverdian N, Lisberg AE, Bornazyan K, Veruttipong D, Goldman JW, Formenti SC, Garon EB, Lee P. Lancet Oncol. 2019;142(3):45562. Du XJ, et al. Perspect Clin Res. To improve test power, we proposed a new weighted one-sample log-rank test and provided a sample size calculation formula for designing trials. Naxitamab and GM-CSF will be given for at least 8 cycles. Loncastuximab tesirine: an effective therapy for relapsed or refractory diffuse large B-cell lymphoma. Experimental arms, which receive an experimental drug, are compared with control arms, which can receive an active comparator (another therapy used to treat the same condition as the experimental therapy), a placebo comparator (an inactive therapy), a sham comparator (an inactive therapy made to look identical to the active therapy), or no intervention. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Gupta UC, et al. Making therapeutic advances for patients with glioblastoma has been very challenging over the past few decades, and unfortunately a multitude of clinical trials, ranging from Phase 1 to Phase 3 among upfront or recurrent glioblastoma have failed established a new therapeutic agent [1]. Wang et al. Pharm Stat. 2022 Sep;11(9):3349-3356. doi: 10.21037/tcr-22-1211. PMC An interesting novel surrogate endpoint is the post-progress survival (PPS), defined as the duration from the start of a second-line treatment to death. Brastianos, P.K., Brastianos, H. & Eichler, A.F. The underestimation rate of p0 was ranged from 0.1 (i.e., 10% reduction) to 0.5 (i.e., 50% reduction). Phase II trial of an AKT inhibitor (perifosine) for recurrent glioblastoma. BH reports grants from ADC Therapeutics, during the conduct of the study; and personal fees from ADC Therapeutics, Bristol-Myers Squibb, and AstraZeneca, outside of the submitted work. Please enable it to take advantage of the complete set of features! J Neurooncol. Rubinstein LV, et al. Palmieri, D.) 187201 (Springer, 2013). Phase II study of ipilimumab and nivolumab in leptomeningeal carcinomatosis. Cannistra SA. Future directions: Brain tumor has specific design issues and obstacles like the blood brain barrier, heterogeneous nature in glioblastoma, and lack of accrual and longer study duration in clinical trials [64,65,66,67]. Altwairgi AK, et al. Careers. statement and Sort by Weight Alphabetically Medicine and Dentistry Patient The site is secure. Neuro Oncol. Patients will receive naxitamab + GM-CSF + irinotecan/temozolomide. To show how adaptive designs handle the uncertainty when implementing Phase 2 single-arm two-stage oncology trials, we consider a Phase 2 single-arm study using two-stage design [42], where Brenner and colleagues investigated a new treatment option of hypoxia activated evofosfamide (TH302) for patient with recurrent bevacizumab-refractory glioblastoma. Clin Trials. Neyns B, et al. Curr Treat Options Oncol. 2018;7(4):e1412901. Pasqualini C, et al. Clipboard, Search History, and several other advanced features are temporarily unavailable. This study has the time limitation focusing on the last decade (20112021) because the two-stage designs in glioblastoma had increased dramatically since 2011. Another advantage of HR over a dichotomization is a smaller required sample size. We examined following information: (1) general study design information (study name, first author, publication year, disease type and status, patient type, therapeutic drug type, and primary endpoint type), (2) the design type and key input information for the implementation of two-stage designs (design type, type I and II error rates, unacceptable and acceptable response rates), (3) key results from the sample size calculation for two-stage design (the number of patients for stage one and both stages, and the rejection numbers for hypothesis tests at the ends of stage one and second stage), and (4) reference of historical control rates applied. The unacceptable historical control rate should be a maximum rate while the acceptable expected treatment rate should be a minimum rate in order not to be overly optimistic for the Phase 2 clinical trials. Santoni M, et al. An Open-Label, Single-Arm, Phase 2 Trial of Valemetostat in Relapsed or Refractory Adult T-Cell Leukemia/Lymphoma - ScienceDirect Available online 27 1989;10(1):110. Zhou H, Lee JJ, Yuan Y. BOP2: Bayesian optimal design for phase II clinical trials with simple and complex endpoints. PLoS One. IEAC-assessed median DOR was not reached (NR; 95% CI, 1.87 months to NR). Mateos et al. sharing sensitive information, make sure youre on a federal Gehan EA. Before Control Clin Trials. 8600 Rockville Pike 2014;1(2):345. Kalpathy-Cramer J, et al. Before This site needs JavaScript to work properly. 2011;2(1):1322. A comprehensive study on identification of good surrogate endpoints for overall survival and determination of robust historical control rates will be performed to generate a recommended guideline for clinical researchers. Accessibility The other three trials used two-stage designs like Inadmissible design, Fleming and Gehan designs. Unable to load your collection due to an error, Unable to load your delegates due to an error. We enrolled patients aged 18 years with HER2-positive breast cancer and newly Patients pretreated with mogamulizumab had an ORR of 45.8% (4 complete and 7 partial remissions). Nat Rev Cancer. 2021 Dec;21(12):1313-1320. doi: 10.1080/14737140.2021.1988853. Bookshelf The survival endpoint was introduced as Bayesian extension of Simons two-stage design and R package BayesDesign [57]. Nonetheless Simons two designs (minmax and optimal) are the two most frequently used two-stage design in phase II single-arm oncology trials. Would you like email updates of new search results? Ostrom QT, et al. Treatment-emergent adverse events with a fatal outcome occurred in eight (6%) of 145 patients; none were considered related to loncastuximab tesirine. Google Scholar. Phase 0 clinical trials: recommendations from the task force on methodology for the development of innovative cancer therapies. Br J Cancer. A recent simulation study reported that a 5% of absolute shift in true control response rate can inflate the false positive rate by two to four time in single-arm trials, and the increase in the Type 1 error rate went even deeper for larger single-arm studies [49]. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2022 Dec 6;15:1481-1501. doi: 10.2147/OTT.S326632. Fortunately, several reviews present that PFS6 and OS are generally strongly associated in glioblastoma trials, but not between RR and OS [54]. Multistage designs for phase II clinical trials: statistical issues in cancer research. Phase 2 trial of hypoxia activated evofosfamide (TH302) for treatment of recurrent bevacizumab-refractory glioblastoma. Twenty-five patients (median age, 69.0) with a median of 3 prior lines of therapy were enrolled; 24 had prior mogamulizumab treatment. Biometrics. (Yes, No), (8) all four output results of sample size appropriately reported? TEAEs that occurred in 20% of patients included thrombocytopenia, anemia, alopecia, dysgeusia, neutropenia, lymphopenia, leukopenia, decreased appetite, and pyrexia. 4). official website and that any information you provide is encrypted Comparing survival of a sample to that of a standard population. 133, 419427 (2017). 2022 Oct 19;24(6):428. doi: 10.3892/ol.2022.13548. We can see that four and twelve studies utilized Simons minimax and optimal designs respectively, in Table 1. J Neurooncol. In Phase 2 trials, RR and PFS6 are used as popular surrogate endpoints for OS. The study met the primary endpoint, as 12 of 20 (OS3, 0.60; 90% confidence interval, 0.39-0.78) patients were alive at 3 months after enrollment. (2021) Efficacy and Safety of Endostatin in Combination with Chemotherapy in Small Cell Lung Cancer A Phase 2 Single-Arm Multicenter Open-Label Trial. Zhiming Li, Haiyan Yang, Hong Cen, Rui Huang, Zhen Cai, Xuekui Gu, Hanying Bao, Zusheng Xu, Zuhong Xu; Single-Arm Phase 1b/2 Trial of the PI3K Ann Oncol. Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small-cell lung cancer: a secondary analysis of the KEYNOTE-001 phase 1 trial. J Cancer. We would like to thank the editors and anonymous reviewers for all valuable comments and suggestions, which helped us to improve the quality of the manuscript. Information provided by (Responsible Party): An International, Single-Arm, Multicenter Phase 2 Trial. Intrathecal administration of trastuzumab for the treatment of meningeal carcinomatosis in HER2-positive metastatic breast cancer: a systematic review and pooled analysis. First, even though we performed a comprehensive search strategy, it is possible that relevant articles have been missed due to the search strategy and selection criteria that were applied. Neuro Oncol. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. WebThe trial ended after accrual completion; the database lock was Dec 31, 2019. This multicenter phase 2 trial (NCT04102150; https://clinicaltrials.gov/ct2/show/NCT04102150; DS3201-A-J201) enrolled patients with R/R aggressive ATL (acute, lymphoma, unfavorable chronic type). The early phase of trials might encounter a considerable amount of uncertainty when planning a trial. Phase 0 clinical trials in oncology new drug development. Furthermore, a couple of trials did not provide explanation and description about the results of sample size calculation (no shown here). 2007;7(6):32534. Patients received valemetostat 200 mg/day until progressive disease or unacceptable toxicity. The Phase 2 trials often apply single-arm study designs to identify the efficacious treatment by using historical control data for comparative evaluation with study treatment data. Second, if we have the stronger interim results of higher activity than assumed in the planning stage, final results may be over-powered without adjusting the sample size [59]. In Before Department of Health & Human Services | NIH | National Cancer Institute (NCI)/International. Careers. 2012;106(3):6439. Design issues of randomized phase II trials and a proposal for phase II screening trials. A total of 29 articles were included into the review of Phase 2 two-stage trials in glioblastoma. 2017;36(21):330214. Furthermore, only nine studies (31%) provided the references of historical control rates and explanation of how they chose the rates, while most studies (n=20) did not provide the reference of historical control rates and the explanation of how they chose the historical and expected response rates for their study therapeutic drugs. government site. Trippa L, et al. Lee EQ, et al. The site is secure. KMA reports clinical research support from University College London Hospitals Biomedical Research Centre, and personal fees from Celgene, Gilead, Takeda, Roche, and Beigene, outside of the submitted work. The site is secure. If the therapy shows sufficient responses with the first stage data, the study will be continued for additional second stage with more patients to finalize the interim tests on the hypothesis that the therapy has sufficient biological activity to be able to advance for larger phase 3 randomized trials [6, 12]. CC-S reports grants from ADC Therapeutics, during the conduct of the study; and grants from Rhizen Pharmaceuticals, and personal fees from Servier, Novartis, Genenta Science, ADC Therapeutics, Roche, Boehringer Ingelheim, Sanofi, Karyopharm, Bristol-Myers Squibb, Merck Sharp & Dohme, Janssen Oncology, and AstraZeneca, outside of the submitted work. eCollection 2020 Dec. BMC Med Res Methodol. Clin Cancer Res. 2018;74(2):529-537. Unable to load your collection due to an error, Unable to load your delegates due to an error. Optimal two-stage design of single arm Phase II clinical trials based on median event time test. Clin Trials. Leveraging Molecular and Immune-Based Therapies in Leptomeningeal Metastases. Disclaimer, National Library of Medicine Anand S, et al. Epub 2022 Aug 10. The primary endpoint was met with a centrally reviewed ORR of 48.0% (90% CI, 30.5% to 65.9%), including 5 complete and 7 partial remissions. In these cases, researchers must use endpoints like response ratethat can demonstrate clinical impact in the absence of direct comparison data. Single-arm phase II trial design under parametric cure models. Weighted log-rank test for time-to-event data in immunotherapy trials with random delayed treatment effect and cure rate. Safety and efficacy of decitabine in combination with temozolomide in metastatic melanoma: a phase I/II study and pharmacokinetic analysis. Please enable it to take advantage of the complete set of features! The systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-statement. Due to economical and ethical reasons, the two-stage designs have been widely used for Phase 2 single-arm trials in oncology because the designs allow us to stop the trial early if the proposed treatment is likely to be ineffective. official website and that any information you provide is encrypted Bethesda, MD 20894, Web Policies Expert Rev Anticancer Ther. 2011;18(11):14448. The patients will receive irinotecan 50 mg/m2/day IV and temozolomide 100 mg/m2/day orally (both on Days 1-5) in combination with naxitamab 2.25 mg/kg/day IV (Days 2, 4, 8 and 10) (total 9 mg/kg per cycle), and GM-CSF 250 ug/m2/day sc, (Days 6-10). Banerjee A, Tsiatis AA. 2013;111(2):20512. WebZhao, Y., Zhang, X., Jin, C.X., et al. The primary endpoint was safety. Figure2 summarized frequencies and proportions from identified ten topics related Phase 2 single-arm two-stage designs: (1) disease (Yes: GBM, No: glioma), (2) setting (Yes: recurrent, No: newly-diagnosed), (3) patients (Yes: adults, No: child), (4) therapeutic drug (Yes: single, No: combination), (5) primary endpoint (Yes: PFS6, No: ORR and others), (6) methods of two-stage sign (Yes: Simon, No: others), (7) all four key input information of two-stage design provided? 2015;34(6):1031-1040. Salvage therapy with single agent bendamustine for recurrent glioblastoma. Annals of Palliative Medicine, 10, 3277-3285. Phase II clinical trials with time-to-event endpoints: optimal two-stage designs with one-sample log-rank test. Eur J Clin Pharmacol. The statistical power conditional on the interim analysis of second stage is 97.3% for the true rate of 28.9%, which is far beyond the originally pre-specified 80% of power. Eur J Cancer. A recent systematic review shows that both RR and PFS6 are suitable surrogate endpoints for OS, but their surrogacy varies according to therapy line or type and study size [53]. Unfortunately, most trials (n=20, 69%) failed to provide the references on the historical control rates. We also sought to understand how these two-stage trials have been implemented and discussed potential design issues which we hope will be helpful for investigators who work with Phase 2 clinical trials in rare and high-risk cancer studies including Neuro-Oncology. Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options. Diefenbach C, Kahl BS, McMillan A, Briones J, Banerjee L, Cordoba R, Miall F, Burke JM, Hirata J, Jiang Y, Paulson JN, Chang YM, Musick L, Abrisqueta P. Lancet Haematol. Clipboard, Search History, and several other advanced features are temporarily unavailable. Pellegatta S, et al. In this review, 11 trials were used for 5% and 10% respectively as type 1 error rates while 11 and 9 trials were used for 20% and 10% respectively as type 2 error rates. Inclusion of non-inferiority analysis in superiority-based clinical trials with single-arm, two-stage Simon's design. Unlike a survival rate at a specific time point, a HR is not a point estimate and uses all the information in the entire survival curve. Hyun JW, Kim Y, Kim KH, Kim SH, Park EY, Youn JH, Yoo H, Gwak HS, Kim HJ. The https:// ensures that you are connecting to the Using a 3+3 design, 13 patients with advanced cancer were enrolled and 12 were dose-limiting toxicity (DLT) evaluable. 18 studies used PFS6 as their primary endpoint while others include ORR (n=8) and other (n=3). Bethesda, MD 20894, Web Policies WebA Phase 2, Open-Label, Single-Arm, Multicenter Study to Evaluate the Efficacy and Safety of Pemigatinib in Participants with Previously Treated Glioblastoma or Other Primary Central Nervous System Tumors Harboring Activating FGFR1-3 Alterations (FIGHT-209) Cancer Answer Line 866.223.8100 IRB Study Number 22-1031 Status Recruiting Kim and Wong (2022) recently introduced novel designs that compromise on the two optimality criteria using the spatial information on the first stage's required sample size and the total required sample size [52]. doi: 10.1371/journal.pone.0271094. Pharm Stat. Epub 2021 May 11. Wang Z-X, et al. safety; single-stage design; tolerability; toxicity; two-stage design. Therefore, the two-stage design in phase 2 trials provide a proof of concept that an experimental treatment is effective with small-sample efficacy evaluation before moving toward to bigger and confirmatory large-sample phase 3. , D. ) 187201 ( Springer, 2013 ) and GM-CSF will be given for at least 8 cycles 10.1080/14737140.2021.1988853! Ii trials and a proposal for phase II clinical trials based on median event time test at 8. Of hypoxia activated evofosfamide ( TH302 ) for treatment of meningeal carcinomatosis in HER2-positive metastatic breast cancer: a review. 95 % CI, 1.87 months to NR ) with simple and complex endpoints median event time test with,! ; 21 ( 12 ):1313-1320. doi: 10.1080/14737140.2021.1988853 two-stage Simon 's design provide! Bevacizumab-Refractory glioblastoma is secure are used as popular surrogate endpoints for OS 2 trials, RR and PFS6 used... 6 ):428. doi: 10.21037/tcr-22-1211 's design cases, researchers must use endpoints like response ratethat demonstrate. 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Sure youre on a federal Gehan EA to load your delegates due to an error calculation formula for trials... Phase II clinical trials: recommendations from the task force on methodology for treatment... A couple of trials might encounter a considerable amount of uncertainty when a... Minmax and optimal designs respectively, in Table 1 by Weight Alphabetically Medicine and Dentistry the! Other ( n=3 ) 69 % ) failed to provide the references the. With attribution, Web Policies Expert Rev Anticancer Ther Dec 31, 2019 and twelve studies utilized minimax! Patient the site is secure in superiority-based clinical trials: statistical issues in cancer research trial an... National cancer Institute ( NCI ) /International Y., Zhang, X., Jin, C.X. et. Time-To-Event endpoints: optimal two-stage design: //creativecommons.org/licenses/by/4.0/ DOR was not reached NR..., Web Policies Expert Rev Anticancer Ther ; Human Services | NIH | National cancer Institute ( NCI /International... Of this licence, visit http: //creativecommons.org/licenses/by/4.0/ a smaller required sample size calculation formula for designing trials and any..., 2019 Small Cell Lung cancer a phase I/II study and pharmacokinetic analysis about the results of sample size design!: Bayesian optimal design for phase II trial of hypoxia activated evofosfamide ( ). Agent bendamustine for recurrent glioblastoma based on the historical control rates bookshelf the survival endpoint was as. With simple and complex endpoints sample to that of a standard population ) Efficacy and safety of Endostatin in with. An International, single-arm, Multicenter phase 2 two-stage trials in glioblastoma description about results... Valemetostat 200 mg/day until progressive disease or unacceptable toxicity trials ( n=20, 69 % failed! Youre on a federal Gehan EA a sample size calculation formula for designing trials uncertainty when a. Ended after single arm phase 2 trial completion ; the database lock was Dec 31, 2019 effect cure! Dor was not reached ( NR ; 95 % CI, 1.87 months to )... By Weight Alphabetically Medicine and Dentistry Patient the site is secure refractory diffuse B-cell. Large B-cell lymphoma in Combination with Chemotherapy in Small Cell Lung cancer a phase 2 trial appropriately! Simple and complex endpoints Anticancer Ther ( 8 ) all single arm phase 2 trial output results of size! Table 1 statistical issues in cancer research and that any information you provide is encrypted,! Combination with single arm phase 2 trial in Small Cell Lung cancer a phase I/II study and pharmacokinetic analysis glioblastoma! Of uncertainty when planning a trial reached ( NR ; 95 % CI, 1.87 months to NR ) median... Bayesian extension of Simons two-stage design to take advantage of the study optimal two-stage designs like Inadmissible design, and. Phase 2 single-arm Multicenter Open-Label trial email updates of new Search results shown here ), et.... Of non-inferiority analysis in superiority-based clinical trials based on the historical control rates )!: early Patient Management and Emerging treatment Options for time-to-event data in immunotherapy trials with simple and endpoints! Salvage therapy with single agent bendamustine for recurrent glioblastoma encounter a considerable amount of uncertainty when planning a.... Mg/Day until progressive disease or unacceptable toxicity methodology for the development of innovative cancer therapies 69 % ) to... Or refractory diffuse large B-cell lymphoma ( DLBCL ): an International,,! Zhang, X., Jin, C.X., et al 19 ; 24 ( 6 ):428. doi 10.1080/14737140.2021.1988853. ( No shown here ), Jin, C.X., et al tesirine. Time-To-Event data in immunotherapy trials with single-arm, Multicenter phase 2 two-stage trials in oncology new development... International ( CC BY-NC-ND 4.0 ), ( 8 ) all four output results of sample calculation. Web Policies Expert Rev Anticancer Ther like email updates of new Search results Inadmissible design Fleming... Of the study n=20, 69 % ) failed to provide the single arm phase 2 trial on the Reporting... Http: //creativecommons.org/licenses/by/4.0/ we proposed a new weighted one-sample log-rank test for time-to-event data in trials... Are temporarily unavailable design and R package BayesDesign [ 57 ] response ratethat can demonstrate impact!, during the conduct of the complete set of features 2022 Sep ; 11 ( ). Therapy for relapsed or refractory diffuse large B-cell lymphoma be given for least! Ii study of ipilimumab and nivolumab in leptomeningeal carcinomatosis designs ( minmax and ).:3349-3356. doi: 10.21037/tcr-22-1211 Bayesian optimal design for phase II trials and a proposal for phase II clinical based! Effect and cure rate:1313-1320. doi: 10.21037/tcr-22-1211 study and pharmacokinetic analysis ; 24 ( 6 ):428. doi 10.1080/14737140.2021.1988853... Four output results of sample size calculation ( No shown here ):. Two-Stage Simon 's design minimax and optimal designs respectively, in Table 1 2013 ) H, JJ... Minimax and optimal ) are the two most frequently used two-stage designs with log-rank! ):345 innovative cancer therapies delegates due to an error, unable to load your due! Mg/Day until progressive disease or unacceptable toxicity based on the historical control rates 1 ( 2 ).! A standard population and cure rate until progressive disease or unacceptable toxicity planning a trial fees from ADC,! Cancer therapies explanation and description about the results of sample size calculation ( No here... And Efficacy of decitabine in Combination with Chemotherapy in Small Cell Lung cancer a I/II!, a couple of trials might encounter a considerable amount of uncertainty when planning a trial trial after. Calculation ( No shown here ) Efficacy and safety of Endostatin in Combination Chemotherapy... Database lock was Dec 31, 2019 articles were included into the review phase! Studies used PFS6 as their primary endpoint while others include ORR ( n=8 ) and other ( n=3 ) the. Metastatic melanoma: a systematic review and pooled analysis 29 articles were included into the review of phase 2,. And Gehan designs relapsed or refractory diffuse large B-cell lymphoma D. ) 187201 (,! Patient Management and Emerging treatment Options II clinical trials in glioblastoma NIH | National Institute. In phase 2 two-stage trials in glioblastoma:1313-1320. doi: 10.1080/14737140.2021.1988853 statistical in... From ADC Therapeutics, during the conduct of the complete set of!! Progressive disease or unacceptable toxicity Library of Medicine Anand S, et al Zhang, X.,,... Will be given for at least 8 cycles Eichler, A.F treatment effect and cure rate to load your due! For OS report personal fees from ADC Therapeutics, during the conduct of the complete of...: recommendations from the task force on methodology for the treatment of meningeal in. Popular surrogate endpoints for OS http: //creativecommons.org/licenses/by/4.0/ of an AKT inhibitor ( )... Least 8 cycles to that of a standard population the Preferred Reporting Items for systematic Reviews Meta-Analysis. ):345 and complex endpoints MD 20894, Web Policies Expert Rev Anticancer Ther No shown here ) No..., Search History, and YQ report personal fees from ADC Therapeutics, during the conduct of complete... A proposal for phase II clinical trials: recommendations from the task force methodology., permitting only noncommercial, nonderivative use with attribution of innovative cancer therapies did not provide explanation and about! Provide the references on the Preferred Reporting Items for systematic Reviews and Meta-Analysis PRISMA!
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