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Activity Number: 16
Type: Topic Contributed
Date/Time: Sunday, July 31, 2016 : 2:00 PM to 3:50 PM
Sponsor: Section on Bayesian Statistical Science
Abstract #318634
Title: Robust Treatment Comparison Based on Utilities of Semi-Competing Risks in Non-Small-Cell Lung Cancer
Author(s): Thomas Murray* and Peter F. Thall and Ying Yuan and Daniel Gomez and Sarah McAvoy
Companies: MD Anderson Cancer Center and MD Anderson Cancer Center and MD Anderson Cancer Center and MD Anderson Cancer Center and MD Anderson Cancer Center
Keywords: Bayesian Analysis ; Group Sequential ; Piecewise Exponential ; Radiation Oncology ; Randomized Trial ; Utility Elicitation

A design is presented for a randomized clinical trial comparing two second-line treatments, chemotherapy versus chemotherapy plus reirradiation, for treatment of recurrent non-small-cell lung cancer. The research question is whether the potential efficacy benefit that adding reirradiation to chemotherapy may provide justifies its potential for increasing the risk of toxicity. The design uses two co-primary outcomes: time to disease progression or death, and time to severe toxicity. Because follow-up ends at disease progression or death, the two outcomes are semi-competing risks. A conditionally conjugate Bayesian model that is robust to misspecification is formulated using piecewise exponential distributions. A numerical utility function is elicited from the physicians that characterizes desirabilities of the possible co-primary outcome realizations. A comparative test based on posterior mean utilities is proposed. A simulation study is presented to evaluate test performance for a variety of treatment differences, and a sensitivity assessment to the elicited utility function is performed. General guidelines are given for constructing a design in similar settings.

Authors who are presenting talks have a * after their name.

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