Monotonicity conditions for avoiding counterintuitive decisions in basket trials.

Bayesian statistics basket trial clinical trial design information borrowing

Journal

Biometrical journal. Biometrische Zeitschrift
ISSN: 1521-4036
Titre abrégé: Biom J
Pays: Germany
ID NLM: 7708048

Informations de publication

Date de publication:
06 2022
Historique:
revised: 11 02 2022
received: 17 09 2021
accepted: 05 03 2022
entrez: 12 6 2022
pubmed: 13 6 2022
medline: 15 6 2022
Statut: ppublish

Résumé

In a basket trial, a new treatment is tested in different subgroups, called the baskets. In oncology, the baskets usually comprise patients with different primary tumor sites but a common biomarker. Most basket trials are uncontrolled phase II trials and investigate a binary endpoint such as tumor response. To combine the data of baskets that show a similar response to the treatment, many basket trial designs use Bayesian borrowing methods. This increases the power compared to a basketwise analysis. However, it can lead to posterior probabilities that are not monotonically increasing in the number of responses. We show that, as a consequence, two types of counterintuitive decisions can arise-one that occurs within a single trial and one that occurs when the results are compared between different trials. We propose two monotonicity conditions for the inference in basket trials. Using a design recently proposed by Fujikawa and colleagues, we investigate the case of a single-stage basket trial with equal sample sizes in all baskets and show that, as the number of baskets increases, these conditions are violated for a wide range of different borrowing strengths. We show that in the investigated scenarios pruning baskets can help to ensure that the monotonicity conditions hold and investigate how this affects type I error rate and power.

Identifiants

pubmed: 35692061
doi: 10.1002/bimj.202100287
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

934-947

Informations de copyright

© 2022 The Authors. Biometrical Journal published by Wiley-VCH GmbH.

Références

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Auteurs

Lukas Baumann (L)

Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.

Johannes Krisam (J)

Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.

Meinhard Kieser (M)

Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.

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