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Printable Handouts
Navigable Slide Index
- Introduction
- Outline
- Background - objective of phase II trials
- Traditional paradigm of drug development
- Drug development of imatinib
- What is the purpose of a phase II trial?
- Ultimate goals
- U.S. drug development
- Clinical trial endpoints
- Endpoints in phase II trial design
- Measurement of response
- Immune related response iRECIST
- RR as a primary endpoint in phase II trials
- Variability in lung tumor measurements
- RR as a primary endpoint - assumptions
- Graphical representations of tumor response
- Waterfall plots
- Spider plots
- Swimmer plots
- Response rate is not a perfect endpoint
- Response rate is useful for screening
- RR as a primary endpoint: advantages
- Alternative endpoints for single arm trials
- Immunotherapy trials
- Time to event endpoints
- Alternative endpoints: biological endpoints
- Correlative studies in phase II
- Correlative studies – caveats
- Quality of Life (QoL) in phase II studies
- The difficulty in picking an endpoint
- Phase II trial designs
- The dangers of skipping phase II
- Traditional single arm phase II trial
- Single arm phase II trial
- Key components
- Online phase II design calculators
- Example: “classic” single arm phase II trial
- Bevacizumab + gemcitabine in cancer
- Advantages and disadvantages
- Modifications of the single arm trial
- Adaptive (Bayesian) trial designs
- Adaptive trial designs
- Summary of single arm phase II trials
- Phase I/II studies
- Randomized phase II trials
- Example of a randomized phase II trial
- Correlation of single arm vs. randomized
- Phase II/III trials
- Randomized discontinuation
- Randomized discontinuation example
- Disadvantages of the RDD
- RDD examples
- Molecular selection of patients
- Problems with molecular selection
- Summary: randomized phase II trials
- Master protocols in precision oncology
- Basket trial
- NCI-MATCH
- NCI-MATCH accrual summary
- SHIVA trial
- SHIVA trial - baseline characteristics
- SHIVA trial - results
- Primary features of umbrella trial
- I-SPY 2
- I-SPY 2 design
- I-SPY 2 results
- I-SPY
- Summary: advantages and disadvantages
- Summary
Topics Covered
- Clinical trial endpoints
- Response rate
- Progression-free survival
- Phase II trial designs
- Randomized phase II
- Enrichment
- Basket and umbrella trials
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Tang, P. (2021, June 29). Phase II trials [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 21, 2024, from https://doi.org/10.69645/HDAQ5256.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Patricia Tang has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Oncology
Transcript
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0:00
This talk is on phase II clinical trial design.
My name is Patricia Tang,
I'm a medical oncologist at the Tom Baker Cancer Centre in Calgary, Alberta, Canada,
and I'm a clinical associate professor in the medical school.
0:17
Today we'll go over the objective of phase II trials,
the clinical trial endpoints for the trials,
as well as different phase II trial designs, including single-arm phase II trials,
randomized phase II trials, phase II/III or phase I/II trials, as well as enrichment designs.
0:40
Background. We'll go over the objective of phase II trials.
0:46
The traditional paradigm of drug development moves from phase I,
where a new drug is evaluated for the appropriate dose,
scheduling of delivery, as well as toxicity,
and at the end of the phase I trial, we arrive at the recommended phase II dose,
which is sometimes also called the maximum tolerated dose.
The phase II trial objective, which is the topic of today,
is a signal of drug activity, worthy of moving forward to phase III.
In a phase III clinical trial, we evaluate the superiority of a novel agent
or regimen on patient outcomes, compared to the standard therapy.
Phase IV trials are sometimes conducted as a post-marketing evaluation.
As we move from phase I to IV, this requires an increasing number of patients, and of course, cost.
The number of drugs that are successful through each phase of drug development decreases.