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Using biomarkers to allocate patients in a response-adaptive clinical trial

Contributors

Jackson, Holly; Bowen, S; Jaki, T

Published in

Communications in statistics. Simulation and computation, vol. 52, no. 12, p. 5946-5965

Publication date

2023-12-02

First online date

2021-11-25

Abstract

In this paper, we discuss a response adaptive randomization method, and why it should be used in clinical trials for rare diseases compared to a randomized controlled trial with equal fixed randomization. The developed method uses a patient's biomarkers to alter the allocation probability to each treatment, in order to emphasize the benefit to the trial population. The method starts with an initial burn-in period of a small number of patients, who with equal probability, are allocated to each treatment. We then use a regression method to predict the best outcome of the next patient, using their biomarkers and the information from the previous patients. This estimated best treatment is assigned to the next patient with high probability. A completed clinical trial for the effect of catumaxomab on the survival of cancer patients is used as an example to demonstrate the use of the method and the differences to a controlled trial with equal allocation. Different regression procedures are investigated and compared to a randomized controlled trial, using efficacy and ethical measures.

Keywords

  • Biomarker
  • Patient benefit
  • Personalized medicine
  • Response adaptive clinical trial

UNIGE affiliation entities

Not a UNIGE publication

UNIGE research groups

Funding

  • UK Medical Research Council [MC_UU_00002/14]
  • National Institute for Health Research
  • Engineering and Physical Sciences Research Council [EP/L015692/1]
  • National Institute for Health Research (NIHR)
  • Medical Research Council [NIHR-SRF-2015-08-001]

Citation (ISO format)

JACKSON, Holly, BOWEN, S, JAKI, T. Using biomarkers to allocate patients in a response-adaptive clinical trial. In: Communications in statistics. Simulation and computation, 2023, vol. 52, n° 12, p. 5946–5965. doi: 10.1080/03610918.2021.2004420

Main files (1)

Article (Published version)
CC BY-4.0

Identifiers

Additional URL for this publication

https://www.tandfonline.com/doi/full/10.1080/03610918.2021.2004420

Journal ISSN

0361-0918
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184downloads

Technical informations

Creation

28/01/2025 16:06:06

First validation

28/02/2025 08:56:18

Update

28/02/2025 08:56:18

Status update

28/02/2025 08:56:18

Last indexation

28/02/2025 08:56:19
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