A Seamless Phase II/III Design with Dose Optimization for Oncology Drug Development

Fuente: arXiv
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Main Authors: Li, Yuhan, Zhang, Yiding, Mi, Gu, Lin, Ji
Format: Preprint
Published: 2024
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author Li, Yuhan
Zhang, Yiding
Mi, Gu
Lin, Ji
author_facet Li, Yuhan
Zhang, Yiding
Mi, Gu
Lin, Ji
contents The US FDA's Project Optimus initiative that emphasizes dose optimization prior to marketing approval represents a pivotal shift in oncology drug development. It has a ripple effect for rethinking what changes may be made to conventional pivotal trial designs to incorporate a dose optimization component. Aligned with this initiative, we propose a novel Seamless Phase II/III Design with Dose Optimization (SDDO framework). The proposed design starts with dose optimization in a randomized setting, leading to an interim analysis focused on optimal dose selection, trial continuation decisions, and sample size re-estimation (SSR). Based on the decision at interim analysis, patient enrollment continues for both the selected dose arm and control arm, and the significance of treatment effects will be determined at final analysis. The SDDO framework offers increased flexibility and cost-efficiency through sample size adjustment, while stringently controlling the Type I error. This proposed design also facilitates both Accelerated Approval (AA) and regular approval in a "one-trial" approach. Extensive simulation studies confirm that our design reliably identifies the optimal dosage and makes preferable decisions with a reduced sample size while retaining statistical power.
format Preprint
id arxiv_https___arxiv_org_abs_2406_00196
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle A Seamless Phase II/III Design with Dose Optimization for Oncology Drug Development
Li, Yuhan
Zhang, Yiding
Mi, Gu
Lin, Ji
Methodology
Applications
The US FDA's Project Optimus initiative that emphasizes dose optimization prior to marketing approval represents a pivotal shift in oncology drug development. It has a ripple effect for rethinking what changes may be made to conventional pivotal trial designs to incorporate a dose optimization component. Aligned with this initiative, we propose a novel Seamless Phase II/III Design with Dose Optimization (SDDO framework). The proposed design starts with dose optimization in a randomized setting, leading to an interim analysis focused on optimal dose selection, trial continuation decisions, and sample size re-estimation (SSR). Based on the decision at interim analysis, patient enrollment continues for both the selected dose arm and control arm, and the significance of treatment effects will be determined at final analysis. The SDDO framework offers increased flexibility and cost-efficiency through sample size adjustment, while stringently controlling the Type I error. This proposed design also facilitates both Accelerated Approval (AA) and regular approval in a "one-trial" approach. Extensive simulation studies confirm that our design reliably identifies the optimal dosage and makes preferable decisions with a reduced sample size while retaining statistical power.
title A Seamless Phase II/III Design with Dose Optimization for Oncology Drug Development
topic Methodology
Applications
url https://arxiv.org/abs/2406.00196