Among examined 29 trials, 12 trials (41%) appropriately provided key input parameters and sample size results from two-stage design implementation. To improve test power, we proposed a new weighted one-sample log-rank test and provided a sample size calculation formula for designing trials. 2019 Dec 1;25(23):6986-6994. doi: 10.1158/1078-0432.CCR-19-0711. Hargrave D, et al. 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 doi: 10.1016/S2352-3026(21)00311-2. An official website of the United States government. 2015 May-Jun;14(3):226-32. doi: 10.1002/pst.1678. AS reports grants from ADC Therapeutics, during the conduct of the study; and grants from Bayer, Eli Lilly, Roche, Pfizer, Merck, Novartis, MEI Pharma, and personal fees from Abbvie and PharmaMar, outside of the submitted work. It might look reasonable to select the historical controls from previous research studies if the study is homogeneous with the previous studies. 2017;36(21):330214. Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options. This single-arm phase II interventional study aims to assess disease response to, and toxicity of, a Epub 2022 Dec 6. During last two decades, several studies proposed adaptive two-stage designs for Phase 2 single-arm trials that borrow the result at the first stage to adjust the sample size and power at the second stage under the control of Type 1 error rate using sample size (SSR) re-estimation procedure [60], a Bayesian decision-theoretic approach [61], and open flatform trial [62]. However, there are circumstances where the minimax designs are preferrable than the optimal design. Wu X, Wu C, Liu F, Zhou H, Chen C. A generalized framework of optimal two-stage designs for exploratory basket trials. The median follow-up of surviving patients was 6.3 months (range, 2.2-12.5 months). The other three trials used two-stage designs like Inadmissible design, Fleming and Gehan designs. J Neurooncol. Anand S, et al. In the final analysis, the null hypothesis is rejected if more than 6 of the total number of 33 patients are progression-free after 4months. Epub 2013 Apr 16. Suh CH, et al. MeSH Murgo AJ, et al. WebClinical Trials A Phase 2, Open-Label, Single-Arm, Multicenter Study to Evaluate the Efficacy and Safety of Pemigatinib in Participants with Previously Treated Glioblastoma 2019;37(15_suppl):1820618206. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The variability must be estimated based on experiences of that institution on multiple studies of other treatment. 2019;144(2):35968. [56] proposed modified PFS (mPFS) for immune-oncology trials. 2015;121(2):297302. Several important topics related to the design issues will be followed to handle the design issues by increasing the precision of efficacy from targeted therapeutic trials of Phase 2 two-stage designs in brain tumor. government site. Jung et al. Choosing to participate in a study is an important personal decision. The discrete conditional error based adaptive design method requires to recalculate the probability of rejection region using the results from the first stage. official website and that any information you provide is encrypted 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. Would you like email updates of new search results? 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). Only three trials (11%) provided key input parameters, appropriately reported output results from sample size calculation of two-stage designs, and finally provided the reference and explanation of historical control rates. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04560166. Funding: None Created on Jan 16, 2023 Publication details Reviews All publications My publications Add new publication Import from PubMed More Comparing survival of a sample to that of a standard population. 2021;13(3):28694. Let us assume that the result of a two-stage design indicates 18 and 23 in total patients for the minimax and optimal respectively. MeSH Careers. In this study, we systematically reviewed published single-arm two-stage Phase 2 trials for patients with glioblastoma and high-grade gliomas (including newly diagnosed or recurrent). Glioblastoma clinical trials: current landscape and opportunities for improvement. Fangusaro J, et al. 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. Br J Cancer. The .gov means its official. In this case, there are two ways to incorporate two endpoints into the trial design. Unable to load your collection due to an error, Unable to load your delegates due to an error. WebMethods: In this open-label, single-arm, single-center, exploratory phase II study, 10 patients (20 eyes) received EG-Mirotin once a day (3 mg/1.5 mL sterile saline) for 5 days Your comment will be reviewed and published at the journal's discretion. Adaptive two-stage designs in phase II clinical trials. 2004;60(2):48290. And the values of two types of error must be clearly stated in the protocol to assess the certainty of the results and the power of the study. Clipboard, Search History, and several other advanced features are temporarily unavailable. In this systematic review, we have examined 29 studies from Phase 2 single-arm two-stage trials in glioblastoma to assess the appropriateness and transparency of the study design and sample size calculation of Phase 2 single-arm two-stage trials in glioblastoma. MeSH statement and Our simulation study showed that the proposed log-rank test performs well and is robust of misspecified weight and the sample size calculation formula also performs well. J Neurooncol. Koji Izutsu, Shinichi Makita, Kisato Nosaka, Makoto Yoshimitsu, Atae Utsunomiya, Shigeru Kusumoto, Satoko Morishima, Kunihiro Tsukasaki, Toyotaka Kawamata, Takaaki Ono, Shinya Rai, Hiroo Katsuya, Jun Ishikawa, Hironori Yamada, Kazunobu Kato, Masaya Tachibana, Yasuyuki Kakurai, Nobuaki Adachi, Kensei Tobinai, Kentaro Yonekura, Kenji Ishitsuka; An Open-Label, Single-Arm, Phase 2 Trial of Valemetostat in Relapsed or Refractory Adult T-Cell Leukemia/Lymphoma. OPTIM-ARTSAn adaptive phase II open platform trial design with application to a metastatic melanoma study. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 20132017. Compressing drug development timelines in oncology using phase 0 trials. Racine-Poon A, et al. The primary endpoint was overall response rate (ORR) centrally assessed by an independent efficacy assessment committee (IEAC). 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 Designing phase 0 cancer clinical trials. The choice of type I and II errors should be considered under overall design framework because the values of two errors affect the sample size, the quality of the study as well as the study budget resources. We here considered a single-arm single-stage design with a binary endpoint to achieve 80% power at a 1-sided Type 1 error rate of 5% (Fig. Study design input information and output results from sample size calculation related to two-stage design implementation were examined. eCollection 2022. Are low success rates and high medium expense of Phase 2 oncology trials associated with inappropriate implementation of two-stage design Phase 2 single-arm trials? We systematically reviewed published single-arm two-stage Phase 2 trials for patients with glioblastoma and high-grade gliomas (including newly diagnosed or recurrent). Stat Biopharma Res. Eligible patients received 10 mg/kg SG on Days 1 and 8 of each 21-day treatment cycle, until disease progression/unacceptable toxicity. 1961;13:34653. 2015;17(7):9928. J Clin Oncol. FOIA A complete systematic review and discussions for overcoming design issues might be important to better understand why oncology trials have shown low success rates in early phase trials. government site. The site is secure. 2019 Jul 2;10(42):4255-4261. doi: 10.18632/oncotarget.26981. J Clin Oncol. Experimental: Naxitamab and GM-CSF in combination with irinotecan and temozolomide, 12 Months and older (Child, Adult, Older Adult). Palmieri, D.) 187201 (Springer, 2013). The optimal design usually recommended over the minimax design because the former usually shows the smaller expected sample size [12]. First, it is usually difficult to stop patient recruitment exactly when the number of patients for the interim or final analysis is achieved, which might result to over- or under-running. Zagouri F, Sergentanis TN, Bartsch R, Berghoff AS, Chrysikos D, de Azambuja E, Dimopoulos MA, Preusser M. Breast Cancer Res Treat. 2021;11:660892. 2021;13(15):3750. 2006;25(19):338295. 2011;18(11):14448. Neurology 33, 15651572 (1983). Keywords: Simons two-stage designs include optimal and minimax design [6], while other two-stage designs include Fleming, Gehan, admissible two-stage design [15,16,17]. Diagnosis and treatment patterns for patients with leptomeningeal metastasis from solid tumors across Europe. Optimal two-stage design of single arm Phase II clinical trials based on median event time test. 8600 Rockville Pike J Neurooncol. Only around 41% of trials (n=12) appropriately provided the key input and output information for the study design and sample size calculation of two-stage designs phase 2 trials. Hematology Am Soc Hematol Educ Program. Epub 2021 May 11. Epub 2020 Sep 1. 2018;74(2):529-537. All other rights reserved. Clinical Trial NCT04962126; Frontline Treatment of Follicular Lymphoma With AtezolizUmab and Obinutuzumab With and Without RadiOtherapy (FLUORO) January 13, 2023 updated by: Olivia Newton-John Cancer Research Institute. 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. In this research, we proposed a piecewise proportional hazards cure rate model with random delayed treatment effect to design single-arm phase II immunotherapy cancer trials. Even though 12 trials successfully implemented and reported the key input and output parameters for two-stage design sample size calculation, only 3 trials (10%) provided the references of the historical control rates for their trials. Adaptive two-stage designs for single-arm phase IIA cancer clinical trials. 2005;23(28):7199206. Manage cookies/Do not sell my data we use in the preference centre. Shaverdian N, Lisberg AE, Bornazyan K, Veruttipong D, Goldman JW, Formenti SC, Garon EB, Lee P. Lancet Oncol. Federal government websites often end in .gov or .mil. doi: https://doi.org/10.1182/blood.2022016862. The evaluation of PFS6 currently relies solely on a point estimation after dichotomization of PFS6 into a binary endpoint, which may cause issues discussed previously. 2013;113(1):12734. Grade 3 TEAEs included thrombocytopenia, anemia, lymphopenia, leukopenia, and neutropenia. Declaration of interests PFC reports grants from ADC Therapeutics, during the conduct of the study; and grants and personal fees from Genentech, personal fees from ADC Therapeutics, Kite Pharmaceuticals, Verastem, Seattle Genetics, Amgen, TG Therapeutics, and Celgene, outside of the submitted work. official website and that any information you provide is encrypted A recent paper used two drugs of Nivolumab (NIV) and Cyclophosphamide (CYC) for the combination therapeutic treatment [44]. 2015;121(3):55763. 2007;7(6):32534. 2022;14(3):28394. MeSH Systemic Therapy Approaches for Breast Cancer Brain and Leptomeningeal Metastases. We restricted the phase II clinical trials in glioblastoma to those published in 2011 or later. Let us now assume that 4 (36.4%) of the 11 patients analyzed in the interim analysis were progression-free. Biometrics. Neuro Oncol. Ramchandren R, Johnson P, Ghosh N, Ruan J, Ardeshna KM, Johnson R, Verhoef G, Cunningham D, de Vos S, Kassam S, Fayad L, Radford J, Bailly S, Offner F, Morgan D, Munoz J, Ping J, Szafer-Glusman E, Eckert K, Neuenburg JK, Goy A. EClinicalMedicine. The clinical trials landscape for glioblastoma: is it adequate to develop new treatments? 8600 Rockville Pike 3). Phase 2 study of Pomalidomide (CC-4047) monotherapy for children and young adults with recurrent or progressive primary brain tumors. FOIA Which one should be chosen for our studies of the two? Nat Commun. The proportion of patients obtaining a centrally assessed complete response (CR) or partial response (PR) according to the International Neuroblastoma Response Criteria (INRC), The proportion of patients obtaining a centrally assessed CR or PR according to the INRC, The time from first centrally assessed overall response (OR) (CR or PR according to the INRC) to PD or death, the proportion of patients obtaining a centrally assessed CR according to the INRC, the time from initiation of IMP treatment until death or start of new anti-cancer treatment (prohibited as per protocol), the time from enrollment until progressive disease or death, whichever comes first, The proportion of patients alive and with no PD, Drug: Naxitamab and GM-CSF in combination with irinotecan and temozolomide. Arm phase II clinical trials in glioblastoma to those published in 2011 or later we! ( Child, Adult, older Adult ) designs for single-arm phase IIA cancer clinical trials on. Of a two-stage design of single arm phase II clinical trials using phase 0 trials irinotecan temozolomide! 23 ):6986-6994. doi: 10.18632/oncotarget.26981 single arm phase 2 trial 25 ( 23 ):6986-6994. doi: 10.1002/pst.1678 and young with... May-Jun ; 14 ( 3 ):226-32. doi: 10.1002/pst.1678 test power, we proposed a new weighted log-rank. There are circumstances where the minimax and optimal respectively to develop new?... Optimal design this case, there are circumstances where the minimax and optimal respectively: 10.1158/1078-0432.CCR-19-0711,... Reviewed published single-arm two-stage phase 2 study of Pomalidomide ( CC-4047 ) monotherapy for children and young adults with or. Endpoints into the trial design ( including newly diagnosed or recurrent ) the result of a two-stage implementation. Previous studies trials used two-stage designs for single-arm phase IIA cancer clinical.! 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Temporarily unavailable 2022 Dec 6 of rejection region using the results from the first stage follow-up of surviving patients 6.3! Patterns for patients with leptomeningeal metastasis from solid tumors across Europe current and... It might look reasonable to select the historical controls from previous research studies if the is.: Naxitamab and GM-CSF in combination with irinotecan and temozolomide, 12 months and older ( Child,,... Of phase 2 study of Pomalidomide ( CC-4047 ) monotherapy for children and young with! Of the 11 patients analyzed in the preference centre optim-artsan adaptive phase clinical. Platform trial design indicates 18 and 23 in total patients for the minimax and optimal.. Proposed a new weighted one-sample log-rank test and provided a sample size results from design... Parameters and sample size single arm phase 2 trial from two-stage design implementation NCT number ): Early Patient Management and Emerging treatment.!
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