Peter F. Thall - Böcker

Clinical trials have two purposes - to treat the patients in the trial, and to obtain information which increases our understanding of the disease and, especially, how patients respond to treatment. Statistical design provides a means to achieve both these aims, while statistical data analysis provides methods for extracting useful information from the trial data. Recent advances in statistical computing have enabled statisticians to implement a broad array of methods which previously were either impractical or impossible. Biostatisticians are now able to provide much greater support to medical researchers working in both clinical and laboratory settings. As the collective tool-kit of techniques for analyzing data has grown, it has become increasingly difficult for biostatisticians to keep up with all the developments in our own field. This text aims to bring together biostatisticians' research and explain some of the more recent developments in biostatistics to clinicians and scientists who work in clinical trials.

Reliably optimizing a new treatment in humans is a critical first step in clinical evaluation since choosing a suboptimal dose or schedule may lead to failure in later trials. At the same time, if promising preclinical results do not translate into a real treatment advance, it is important to determine this quickly and terminate the clinical evaluation process to avoid wasting resources. Bayesian Designs for Phase I–II Clinical Trials describes how phase I–II designs can serve as a bridge or protective barrier between preclinical studies and large confirmatory clinical trials. It illustrates many of the severe drawbacks with conventional methods used for early-phase clinical trials and presents numerous Bayesian designs for human clinical trials of new experimental treatment regimes.Written by research leaders from the University of Texas MD Anderson Cancer Center, this book shows how Bayesian designs for early-phase clinical trials can explore, refine, and optimize new experimental treatments. It emphasizes the importance of basing decisions on both efficacy and toxicity.

Bayesian Precision Medicine presents modern Bayesian statistical models and methods for identifying treatments tailored to individual patients using their prognostic variables and predictive biomarkers. The process of evaluating and comparing treatments is explained and illustrated by practical examples, followed by a discussion of causal analysis and its relationship to statistical inference. A wide array of modern Bayesian clinical trial designs are presented, including applications to many oncology trials. The later chapters describe Bayesian nonparametric regression analyses of datasets arising from multistage chemotherapy for acute leukemia, allogeneic stem cell transplantation, and targeted agents for treating advanced breast cancer.Features:Describes the connection between causal analysis and statistical inferenceReviews modern personalized Bayesian clinical trial designs for dose-finding, treatment screening, basket trials, enrichment, incorporating historical data, and confirmatory treatment comparison, illustrated by real-world applicationsPresents adaptive methods for clustering similar patient subgroups to improve efficiencyDescribes Bayesian nonparametric regression analyses of real-world datasets from oncologyProvides pointers to software for implementationBayesian Precision Medicine is primarily aimed at biostatisticians and medical researchers who desire to apply modern Bayesian methods to their own clinical trials and data analyses. It also might be used to teach a special topics course on precision medicine using a Bayesian approach to postgraduate biostatistics students. The main goal of the book is to show how Bayesian thinking can provide a practical scientific basis for tailoring treatments to individual patients.

Clinical trials have two purposes -- to treat the patients in the trial, and to obtain information which increases our understanding of the disease and especially how patients respond to treatment. Statistical design provides a means to achieve both these aims, while statistical data analysis provides methods for extracting useful information from the trial data. Recent advances in statistical computing have enabled statisticians to implement very rapidly a broad array of methods which previously were either impractical or impossible. Biostatisticians are now able to provide much greater support to medical researchers working in both clinical and laboratory settings. As our collective toolkit of techniques for analyzing data has grown, it has become increasingly difficult for biostatisticians to keep up with all the developments in our own field. Recent Advances in Clinical Trial Design and Analysis brings together biostatisticians doing cutting-edge research and explains some of the more recent developments in biostatistics to clinicians and scientists who work in clinical trials.

Reliably optimizing a new treatment in humans is a critical first step in clinical evaluation since choosing a suboptimal dose or schedule may lead to failure in later trials. At the same time, if promising preclinical results do not translate into a real treatment advance, it is important to determine this quickly and terminate the clinical evaluation process to avoid wasting resources. Bayesian Designs for Phase I–II Clinical Trials describes how phase I–II designs can serve as a bridge or protective barrier between preclinical studies and large confirmatory clinical trials. It illustrates many of the severe drawbacks with conventional methods used for early-phase clinical trials and presents numerous Bayesian designs for human clinical trials of new experimental treatment regimes.Written by research leaders from the University of Texas MD Anderson Cancer Center, this book shows how Bayesian designs for early-phase clinical trials can explore, refine, and optimize new experimental treatments. It emphasizes the importance of basing decisions on both efficacy and toxicity.

This book illustrates numerous statistical practices that are commonly used by medical researchers, but which have severe flaws that may not be obvious.