Let the trial learn: response-adaptive allocation across many combination arms
As results come in, the trial sends more new patients to the arms that are working and fewer to those that are not, so more people benefit and bad arms die faster.
Multi-armed bandit and Bayesian response-adaptive randomisation, used in I-SPY 2 and in the REMAP-CAP platform during COVID-19, allocate patients towards promising arms while maintaining control of false positives. With ten or more combination arms, adaptive allocation shortens time to identify winners and reduces the number of patients on futile arms. Regulators accept these designs with pre-specified simulation of operating characteristics.
- Too many combinations to test · There are thousands of possible drug pairs and sequences. Trials can test a few dozen a year.
- Trial design, endpoints and cost · A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.
Pages like this
not linked directly; found by shared links- IdeaA standing platform trial for every major cancer, funded as infrastructure
Shares Basket, umbrella, and platform trials, Too many combinations to test, Trial design, endpoints and cost.
- IdeaA permanent platform trial for supportive-care interventions inside cooperative groups
Shares Basket, umbrella, and platform trials, Trial design, endpoints and cost.
- IdeaTwo-week pre-operative windows to compare combination biology head to head
Shares Pre-surgery platform trials that test combinations on pathological response in months, Too many combinations to test.
- IdeaStandards for external control arms built from federated real-world data
Shares Basket, umbrella, and platform trials, Trial design, endpoints and cost.
- IdeaA RECOVERY-style permanent platform trial of cheap drugs added to cancer care
Shares Basket, umbrella, and platform trials, Trial design, endpoints and cost.
- IdeaOne ethics approval and one consent form for a platform trial across countries
Shares Basket, umbrella, and platform trials, Too many combinations to test.
- IdeaCompeting sponsors share one control arm in the same indication
Shares Basket, umbrella, and platform trials, Trial design, endpoints and cost.
- IdeaA perpetual platform trial in every major cancer, funded as infrastructure
Shares Basket, umbrella, and platform trials, Too many combinations to test, Trial design, endpoints and cost.