Journal Article

Recent innovations in adaptive trial designs: A review of design opportunities in translational research

Roberts, Samantha C., Xiao, Mengli, Belli, Hayley M., Wild, Jessica, Wogu, Adane F., Ma, Zhongyang, Sabo, Roy T., Nicklawsky, Andrew G., Kaizer, Alexander M.

2023

Overview

Clinical trials are constantly evolving in the context of increasingly complex research questions and potentially limited resources. In this review article, we discuss the emergence of “adaptive” clinical trials that allow for the preplanned modification of an ongoing clinical trial based on the accumulating evidence with application across translational research. These modifications may include terminating a trial before completion due to futility or efficacy, re-estimating the needed sample size to ensure adequate power, enriching the target population enrolled in the study, selecting across multiple treatment arms, revising allocation ratios used for randomization, or selecting the most appropriate endpoint. Emerging topics related to borrowing information from historic or supplemental data sources, sequential multiple assignment randomized trials (SMART), master protocol and seamless designs, and phase I dose-finding studies are also presented. Each design element includes a brief overview with an accompanying case study to illustrate the design method in practice. We close with brief discussions relating to the statistical considerations for these contemporary designs.

• Publisher: Cambridge University Press
• Subject: Adaptation / Adaptive trials / Case studies / Clinical trials / Design / Innovations for Enhancing the Informativeness and Quality of Clinical Trials / Intervention / master protocols / Patients / Population studies / Review / sample size re-estimation / smart designs / Translation / Translational Research, Design and Analysis / treatment arm selection