Title: Adaptive treatment allocation and selection in multi-arm clinical trials: A Bayesian perspective
Authors: Elja Arjas - University of Oslo (Norway) [presenting]
Abstract: Clinical trials are an instrument for making informed decisions. Here we consider adaptive designs mainly from the perspective of multi-arm Phase II clinical trials, in which one or more experimental treatments are compared to a control. The same ideas can be applied, essentially without change, in confirmatory Phase III trials, where only a single experimental treatment is compared to a control. Still, the planned size of the trial is larger. In both situations, treatment allocation of individual patients is assumed to take place according to a fixed block randomization, albeit with an important twist: The performance of each treatment arm is assessed after every measured outcome, in terms of the posterior distribution of a corresponding model parameter. Different treatments arms are then compared to each other according to pre-defined criteria. If a treatment arm in such a comparison is found to be sufficiently clearly inferior to the currently best candidate, it can be closed off either temporarily or permanently from further patient accrual.