General Departmental Seminar Series
THE ABBOTT LABORATORIES DISTINGUISHED LECTURESHIP IN PHARMACEUTICAL APPLICATIONS -- Evaluating Multiple Treatment Courses in Clinical Trials
Peter F. Thall, Biostatistics Department
M.D. Anderson Cancer Center, Houston, Texas
January 26, 2000, 4:00-5:00 pm
1221 Comp Sci/Stat Center, 1210 W. Dayton
In oncology, a patient's treatment often involves multiple courses of chemotherapy. Physicians typically repeat a treatment that is successful in a given course and otherwise switch to a different treatment. Patient outcome thus consists of a sequence of non-independent, outcome variables and corresponding treatments. Despite the widespread use of such adaptive "play-the-winner-and-drop-the-loser" algorithms in medical settings involving multiple treatment courses, most statistical methods for treatment evaluation in such settings characterize early patient outcome as a single response to a single treatment. This may waste essential information. In this talk, I will provide a statistical framework for multi-course clinical trials involving some variant of the play-the-winner-and-drop-the-loser strategy. The method is illustrated by application to two randomized phase II trials: the first involves four treatments for androgen independent prostate cancer, and the second is a two course chemotherapy trial in acute leukemia with threatment selection based on the probabilities of efficacy and death.
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