Incorporating data from multiple ongoing trials for Bayesian two-stage phase II single-arm studies

Abstract

Background/Aim:

Basket designs have been utilized in recent oncology clinical trials due to an increased interest in precision medicine. One current successful basket trial is the American Society for Clinical Oncology Targeted Agent and Profiling Utilization Registry (TAPUR) study, a pragmatic phase II trial where patients are matched based on their tumor genomic profile to treatments that target specific genomic alterations. Despite its success, recruiting patients with rare genomic alterations remains challenging. This study aims to introduce and evaluate a Bayesian approach for integrating data from ongoing independent basket trials that share similar primary aims to improve interim decisions and final analyses and reduce necessary to evaluate treatments.

Methods:

We introduce a Bayesian two-stage phase II single-arm trial specifically for rare cancers utilizing a hierarchical Bayesian random effects model that incorporate data from ongoing trials. We compare this approach with the standard Simon two-stage design through extensive numerical simulations and apply it to real-world scenarios.

Results:

Simulation results demonstrate that in rare populations our Bayesian approach has attractive operating characteristics. The simulations show that our approach performs well across a broad set of scenarios with fixed and variable numbers of trials.

Conclusion:

Our proposed Bayesian two-stage approach effectively integrates data from multiple ongoing basket trials, enhancing the ability to recruit and analyze patients with rare genomic alterations. This approach improves the timing of interim decision-making and final analysis, making it a valuable tool for trials with slow accrual rates.