An exact method for analysis following a two-stage phase II cancer clinical trial.

This paper presents an exact method for the analysis of a phase II cancer clinical trial conducted using a two-stage design in which early stopping may be allowed for either futility or efficacy. The method provides a point and interval estimate of the response probability associated with the treatment under investigation and a p-value for testing whether this exceeds some standard null value. Two-stage designs are often used in phase II trials in oncology for reasons of ethics and efficiency, but this design feature is seldom taken into account when the results are analyzed. After any two-stage design or multi-stage design, the method for analysis should take into account the previous interim analyses performed, otherwise the results will be biased. In this paper, an approximate approach based on a log-odds ratio parameterisation will be compared with an exact method through the calculation of the precise coverage probabilities of each approach.

[1]  R. Madsen,et al.  P values for tests using a repeated significance test design , 1982 .

[2]  E. S. Pearson,et al.  THE USE OF CONFIDENCE OR FIDUCIAL LIMITS ILLUSTRATED IN THE CASE OF THE BINOMIAL , 1934 .

[3]  Hua Jin,et al.  A design of phase II cancer trials using total and complete response endpoints , 2005, Statistics in medicine.

[4]  T M Therneau,et al.  Designs for group sequential phase II clinical trials. , 1987, Biometrics.

[5]  T R Fleming,et al.  One-sample multiple testing procedure for phase II clinical trials. , 1982, Biometrics.

[6]  R. A’Hern Sample size tables for exact single‐stage phase II designs , 2001, Statistics in medicine.

[7]  A. Agresti,et al.  Approximate is Better than “Exact” for Interval Estimation of Binomial Proportions , 1998 .

[8]  T. Chen,et al.  Optimal three-stage designs for phase II cancer clinical trials. , 1997, Statistics in medicine.

[9]  S Chen,et al.  An efficient multiple-stage procedure for phase II clinical trials that have high response rate objectives. , 1994, Controlled clinical trials.

[10]  Tatsuki Koyama,et al.  Proper inference from Simon's two‐stage designs , 2008, Statistics in medicine.

[11]  J Benichou,et al.  Application of the triangular test to phase II cancer clinical trials. , 1990, Statistics in medicine.

[12]  H. F. Dodge,et al.  A method of sampling inspection , 1929 .

[13]  Katherine S Panageas,et al.  An optimal two-stage phase II design utilizing complete and partial response information separately. , 2002, Controlled clinical trials.

[14]  T. Chen,et al.  Optimal two-stage designs for phase ii clinical trials with differentiation of complete and partial responses , 2000 .

[15]  R. Simon,et al.  Optimal two-stage designs for phase II clinical trials. , 1989, Controlled clinical trials.

[16]  W. Tsai,et al.  Interval estimation of binomial proportion in clinical trials with a two‐stage design , 2008, Statistics in medicine.

[17]  S. Green,et al.  Planned versus attained design in phase II clinical trials. , 1992, Statistics in medicine.