Cost-effective design strategies for development of breakthrough personalized medicines
View Presentation *Cong Chen, Merck & Co. Keywords: bayesian, decision analysis, false discovery rate, pathway In this presentation, we will discuss two issues associated with the development of breakthrough personalized medicines in the oncology therapeutic area. First, how to design Phase II POC trials efficiently given that the number of possible POC hypotheses often far exceeds available public or private resources? We explicitly maximize the return on socioeconomic investment via risk adjusted benefit-cost ratio, and arrive at a cost-effective design that has a ~5% type I error rate (one-sided) and ~80% power for detecting an effect size ~50% greater than under conventional design. Second, how to get a personalized medicine approved in as many indications and as fast as possible? We propose a basket design for Phase III that enrolls patients by a common biomarker across multiple tumor types into a single study after POC is demonstrated. Each tumor has adequate power for detecting a clinically meaningful treatment effect in an accepted surrogate endpoint (e.g., PFS) at 2.5% (one-sided). Unlike a conventional design, OS for an individual tumor in the proposed design is under powered which easily cuts the sample size by 60-80%. The drug may be approved in all the tumors investigated if PFS is positive in each tumor, and OS is positive in the pooled population and generally consistent across the tumors. The drug may have a narrower label or be rejected otherwise.
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Key Dates
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November 1 - December 17, 2013
Online proposal submission for a session, short course and Town Hall Open -
January 6 - March 11, 2014
Online proposal submission for Roundtables Open -
April 30 - May 28, 2014
Abstract Submission Open -
June 4, 2014
Online Registration Opens -
August 8 - August 22, 2014
Invited Abstract Editing -
August 11, 2014
Short Course materials due from Instructors -
September 1, 2014
Housing Deadline -
September 15, 2014
Cancellation Deadline and Registration Closes @ 11:59 pm EDT -
September 22 - September 24, 2014
Marriott Wardman Park, Washington, DC