Background: A common feature of many recent trials evaluating the effects of immunotherapy on survival is that non-proportional hazards can be anticipated at the design stage. This raises the possibility to use a statistical method tailored towards testing the purported long-term benefit, rather than applying the more standard log-rank test and/or Cox model. Many such proposals have been made in recent years, but there remains a lack of practical guidance on implementation, particularly in the context of group-sequential designs. In this article, we aim to fill this gap. Methods: We illustrate how the POPLAR trial, which compared immunotherapy versus chemotherapy in non-small-cell lung cancer, might have been re-designed to be more robust to the presence of a delayed effect using the modestly-weighted log-rank test in a group-sequential setting. Conclusion: We provide step-by-step instructions on how to analyse a hypothetical realization of the trial, based on this new design. Basic theory on weighted log-rank tests and group-sequential methods is covered, and an accompanying R package (including vignette) is provided.

Design and analysis of group-sequential clinical trials based on a modestly weighted log-rank test in anticipation of a delayed separation of survival curves: A practical guidance / Dominic, Magirr; JIMENEZ MORO, JOSE LUIS. - In: CLINICAL TRIALS. - ISSN 1740-7745. - 19:2(2022), pp. 201-210. [10.1177/17407745211072848]

Design and analysis of group-sequential clinical trials based on a modestly weighted log-rank test in anticipation of a delayed separation of survival curves: A practical guidance

Jose Luis Jiménez Moro
2022

Abstract

Background: A common feature of many recent trials evaluating the effects of immunotherapy on survival is that non-proportional hazards can be anticipated at the design stage. This raises the possibility to use a statistical method tailored towards testing the purported long-term benefit, rather than applying the more standard log-rank test and/or Cox model. Many such proposals have been made in recent years, but there remains a lack of practical guidance on implementation, particularly in the context of group-sequential designs. In this article, we aim to fill this gap. Methods: We illustrate how the POPLAR trial, which compared immunotherapy versus chemotherapy in non-small-cell lung cancer, might have been re-designed to be more robust to the presence of a delayed effect using the modestly-weighted log-rank test in a group-sequential setting. Conclusion: We provide step-by-step instructions on how to analyse a hypothetical realization of the trial, based on this new design. Basic theory on weighted log-rank tests and group-sequential methods is covered, and an accompanying R package (including vignette) is provided.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11583/2970000