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DESCRIPTION:To&nbsp\;view&nbsp\;the slides from this meeting please click h
 ere. \nLondon Area Symposium: Statistical Innovations in Clinical Trials a
 t Amgen (Uxbridge) in collaboration with Cytel\nSpeakers are Peter Colman 
 (UCB) Cyrus Mehta (Cytel)\,&nbsp\;James Wason&nbsp\;(MRC Biostatistics Uni
 t\, Cambridge)\, Kevin Carroll (kjcstatistics)  9am Arrival and Coffee 9:3
 0am &ndash\; 11am : Statistical and Operational Challenges of VALOR\, an A
 daptive Phase-3 Trial for Acute Myeloid Leukemia.&nbsp\; Cyrus Mehta\, Cyt
 el Inc. The recently completed VALOR trial comparing vosaroxin to cytarabi
 ne in acute myeloid leukemia (ASH 2014) accrued 711 patients\, and compris
 es the largest body of evidence for AML from a randomized phase 3 clinical
  trial. This adaptive event driven trial was designed with an interim anal
 ysis that allowed for early efficacy stopping\, early futility stopping\, 
 unblinded sample size re-estimation\, or continuation as planned. The samp
 le size re-estimation option was implemented. We will present top-line res
 ults from the trial and discuss the operational\, regulatory and statistic
 al challenges that were faced along the way. To our knowledge this is the 
 first phase 3 confirmatory oncology trial in which unblinded sample size r
 e-estimation was implemented. Cyrus Mehta is President and co-founder of C
 ytel Corporation and Adjunct Professor of&nbsp\; Biostatistics\, Harvard U
 niversity. Cytel is a leading provider of software and services for the de
 sign\, interim monitoring and implementation of adaptive clinical trials. 
 Dr. Mehta consults extensively with the biopharmaceutical industry on grou
 p sequential and adaptive design\, offers workshops on these topics\, and 
 serves on data monitoring and steering committees for trials in many thera
 peutic areas including oncology\, cardiology\, neurology and metabolic dis
 ease. He has led the development of&nbsp\; the StatXact\, LogXact and East
  software packages that are widely used in the biopharmaceutical industry 
 and at academic research centers. He publishes his methodological research
  in leading statistics journals and is a past co-winner of&nbsp\; the Geor
 ge W. Snedecor Award from the American Statistical Association. He is a Fe
 llow of the American Statistical Association and an elected member of the 
 International Statistical Institute. He was named Mosteller Statistician o
 f the Year by the Massachusetts Chapter of the American Statistical Associ
 ation in 2000\, and Outstanding Zoroastrian Entrepreneur by the World Zoro
 astrian Chamber of Commerce in 2002. 11am-11:15am &ndash\; Coffee break 11
 :15am &ndash\; 12:45am: Innovative Considerations on a Phase 2a Dose-Findi
 ng Strategy Using Bayesian Methods and MCP-Mod.&nbsp\; James Wason (MRC Bi
 ostatistics Unit\, Cambridge\, UK)\, Julian Zhou (Roche Products\, Shangha
 i\, China) Early phase clinical trials in patients who are currently on tr
 eatments may be difficult to recruit for. Owing to this limited availabili
 ty of patients they often require the use of smaller numbers of patients a
 nd more innovative statistical methods.&nbsp\; Often single agents\, devel
 oped for the same disease of interest are not sufficient and may need be u
 sed in combination to be effective.&nbsp\; Appropriate decsisions may also
  have to be made for doses\, treatment duration and combinations with othe
 r compounds. The plan for the twelve-week phase 2a study in one such popul
 ation will involve an early futility look at week 2 based on a biomarker\,
  using Bayesian posterior probabilities.&nbsp\; This will be followed by u
 sing&nbsp\; MCP-Mod at the end of study on a clinical response\, in order 
 to investigate the dose response.&nbsp\;  At week 2\, a biomarker is measu
 red to see if there is a clinically meaningful effect at the&nbsp\; target
  for appropriated doses. If not then new doses may need to be added.&nbsp\
 ; The posterior probability of the meaningful effect will be used in the d
 ecision criteria. At the end of the study MCP-Mod will be used in order to
  investiagate the dose response.&nbsp\; MCP-Mod involves pre-specifying ca
 ndidate dose-reponse models followed by statistical testing for dose-respo
 nse signal whilst controlling the type I error.&nbsp\; The best fitting mo
 del is then selected\, and the target dose estimated\, which is then recom
 mended&nbsp\; for phase 2b and phase 3 studies. The method has been qualif
 ied by the EMA as an efficient method of dose finding.&nbsp\;&nbsp\;  Simu
 lations have been conducted to investigate the futility and dose finding d
 ecisions in phase 2a and understand the operating characteristics\, and co
 mparisons made to a traditional dose finding paradigm\, which might involv
 e fewer doses compared to a control using pairwise comparisons. Dr James W
 ason&nbsp\;is a senior investigator statistician at the MRC Biostatistics 
 unit (BSU) in Cambridge. He has been there since doing his Ph.D. in 2006. 
 Since 2009 he has worked in the BSU&rsquo\;s Hub for Trials Methodology Re
 search\, directed by Adrian Mander. His main research interests are adapti
 ve designs for clinical trials\, efficient analysis of composite endpoints
 \, and the use of biomarkers in clinical trials. He is also the co-lead of
  the MRC Hub for Trials Methodology&rsquo\;s stratified medicine working g
 roup.\n12:45 noon- 1:45pm &ndash\; Lunch 1:45pm &ndash\; 3:15pm: Defining\
 , Understanding and Communicating Decision Criteria in Early Clinical Deve
 lopment.&nbsp\; Peter Colman (UCB) It is not uncommon to investigate multi
 ple indicators of potential clinical efficacy in an early study in patient
 s. A broad swathe of biomarkers may be nominated to ensure that evidence o
 f activity on the projected biochemical pathway is acquired and additional
  biomarkers may indicate the precursors of clinical benefit. Registration 
 endpoints\, surrogates thereof or less-qualified biomarkers of efficacy ma
 y also be captured. The number of endpoints may easily exceed the number o
 f subjects in the study and so it is vital that the properties of any deci
 sions are well understood and consistently communicated. We discuss one ap
 proach which elicits views on the combinations of results that would be co
 nsidered positive or encouraging and seeks to assess the likely false-posi
 tive rates associated with the consequent decision criteria.&nbsp\; We ill
 ustrate the ideas with some real examples. Peter spent the first 29 years 
 of his statistical career with Pfizer at their UK research site in Sandwic
 h. During this time he worked in Animal Health\, Clinical Pharmacology and
  Early Clinical Development. He also experienced a phase III project for 6
  months. For several years\, he led a group of statisticians focussing on 
 PK-PD Modelling &amp\; Simulation\, Genetics\, Clinical Technology and Out
 comes Research. He returned to mainstream\, hands-on project work and also
  contributed to a number of European collaborations (e.g. IMI SAFE-T). In 
 2011\, upon closure of the Sandwich site\, Peter moved to AZ at Alderley P
 ark\, where he worked on safety data and as a manager of statisticians in 
 the oncology and anti-infectives area. He joined the UCB early development
  statistics team at UCB in 2013 where he contributes to the design of stud
 ies in the immunology and neuroscience areas. In his spare time he plays c
 lassical double bass and he is currently the chair of Maidstone Orchestral
  Society. 3:15pm &ndash\; 3:30pm &ndash\; Coffee Break 3:30pm &ndash\; 5pm
 : Tackling Real Problems in Multi Regional Clinical Trials.&nbsp\; Kevin C
 arroll (KJCStatistics) MRCTs are an increasingly necessary feature of mode
 rn drug development.&nbsp\; In areas like diabetes and cardiovascular diso
 rders\, or early adjuvant oncologic disease settings\, or where there is a
  regulatory requirement to rule out small\, but important safety issues su
 ch as in the ongoing cluster of trials investigating long acting beta agon
 ists in the treatment of asthma\, &nbsp\;the demand for very large trials 
 drives the need for MRCTs.&nbsp\;&nbsp\; Such trials are needed to provide
  the power to address the underlying hypothesis of interest\, but can only
  do so under the assumption of no true regional heterogeneity.&nbsp\;This 
 talk will address the implications of true regional differences in MRCTs a
 nd will illustrate the real statistical and regulatory challenges faced by
  reference to recent case studies\, including the 18\,000 patient &lsquo\;
 PLATO&rsquo\; trial in acute coronary syndromes.&nbsp\;&nbsp\; Kevin Josep
 h Carroll\, PhD\, CStat\, CSci\, Honorary Senior Lecturer Medical Statisti
 cs is an Independent Statistical Consultant and owner of KJCStatistics Ltd
 .&nbsp\; Kevin has 26 years drug development of experience across all tria
 l phases and multiple therapeutic areas including Oncology\, CV\, Metaboli
 sm\, Respiratory\, CNS and GI.&nbsp\; Most recently Kevin held the positio
 ns of VP Statistics and Chief Statistician at AstraZeneca Pharmaceuticals 
 and Expert Statistician with Boehringer-Ingelheim.&nbsp\; Kevin has extens
 ive experience in the design\, conduct\, analysis and reporting of clinica
 l trials.&nbsp\; &nbsp\;&nbsp\;As a Consultant\, Kevin has gained experien
 ce in helping both small and large pharma and biotech companies tackle sta
 tistical issues in development\, including the application of innovative s
 tatistical approaches to trial design and analysis and regulatory product 
 license applications.&nbsp\; This includes the use of Bayesian decision-ba
 sed designs to expedite effective decision making\, and the use of complex
  staged designs in pivotal Phase II/III and Phase III trials to expedite o
 verall development times. Kevin retains a strong technical interest in are
 as such as parametric survival modelling\, group sequential analysis\, ada
 ptive designs and large outcomes trial design\, and a growing interest in 
 the statistical issues associated with health economic analyses and networ
 k meta-analyses.  Registration: &pound\;50
DTEND;VALUE=DATE:20150630
DTSTAMP:20260913T050540Z
DTSTART;VALUE=DATE:20150629
LOCATION:
SEQUENCE:0
SUMMARY:Statistical Innovations in Clinical Trials 
UID:RFCALITEM639248727400536569
X-ALT-DESC;FMTTYPE=text/html:<strong>To&nbsp\;view&nbsp\;the slides from th
 is meeting please <a href="http://www.cytel.com/20150629-statistical-innov
 ations-in-clinical-trials">click here</a>.<br /> <br />\nLondon Area Sympo
 sium: Statistical Innovations in Clinical Trials at Amgen (Uxbridge) in co
 llaboration with Cytel<br />\nSpeakers are Peter Colman (UCB) Cyrus Mehta 
 (Cytel)\,&nbsp\;James Wason&nbsp\;(MRC Biostatistics Unit\, Cambridge)\, K
 evin Carroll (kjcstatistics)<br /> </strong><br /> <p><strong>9am Arrival 
 and Coffee</strong></p> <p><strong>9:30am &ndash\; 11am : Statistical and 
 Operational Challenges of VALOR\, an Adaptive Phase-3 Trial for Acute Myel
 oid Leukemia.&nbsp\; Cyrus Mehta\, Cytel Inc.</strong></p> <p>The recently
  completed VALOR trial comparing vosaroxin to cytarabine in acute myeloid 
 leukemia (ASH 2014) accrued 711 patients\, and comprises the largest body 
 of evidence for AML from a randomized phase 3 clinical trial. This adaptiv
 e event driven trial was designed with an interim analysis that allowed fo
 r early efficacy stopping\, early futility stopping\, unblinded sample siz
 e re-estimation\, or continuation as planned. The sample size re-estimatio
 n option was implemented. We will present top-line results from the trial 
 and discuss the operational\, regulatory and statistical challenges that w
 ere faced along the way. To our knowledge this is the first phase 3 confir
 matory oncology trial in which unblinded sample size re-estimation was imp
 lemented.</p> <p>Cyrus Mehta is President and co-founder of Cytel Corporat
 ion and Adjunct Professor of&nbsp\; Biostatistics\, Harvard University. Cy
 tel is a leading provider of software and services for the design\, interi
 m monitoring and implementation of adaptive clinical trials. Dr. Mehta con
 sults extensively with the biopharmaceutical industry on group sequential 
 and adaptive design\, offers workshops on these topics\, and serves on dat
 a monitoring and steering committees for trials in many therapeutic areas 
 including oncology\, cardiology\, neurology and metabolic disease. He has 
 led the development of&nbsp\; the StatXact\, LogXact and East software pac
 kages that are widely used in the biopharmaceutical industry and at academ
 ic research centers. He publishes his methodological research in leading s
 tatistics journals and is a past co-winner of&nbsp\; the George W. Snedeco
 r Award from the American Statistical Association. He is a Fellow of the A
 merican Statistical Association and an elected member of the International
  Statistical Institute. He was named Mosteller Statistician of the Year by
  the Massachusetts Chapter of the American Statistical Association in 2000
 \, and Outstanding Zoroastrian Entrepreneur by the World Zoroastrian Chamb
 er of Commerce in 2002.</p> <p><strong>11am-11:15am &ndash\; Coffee break<
 /strong></p> <p><strong>11:15am &ndash\; 12:45am: </strong><strong>Innovat
 ive Considerations on a Phase 2a Dose-Finding Strategy Using Bayesian Meth
 ods and MCP-Mod.&nbsp\; James Wason (MRC Biostatistics Unit\, Cambridge\, 
 UK)\, Julian Zhou (Roche Products\, Shanghai\, China)</strong></p> <p>Earl
 y phase clinical trials in patients who are currently on treatments may be
  difficult to recruit for. Owing to this limited availability of patients 
 they often require the use of smaller numbers of patients and more innovat
 ive statistical methods.&nbsp\; Often single agents\, developed for the sa
 me disease of interest are not sufficient and may need be used in combinat
 ion to be effective.&nbsp\; Appropriate decsisions may also have to be mad
 e for doses\, treatment duration and combinations with other compounds.</p
 > <p>The plan for the twelve-week phase 2a study in one such population wi
 ll involve an early futility look at week 2 based on a biomarker\, using B
 ayesian posterior probabilities.&nbsp\; This will be followed by using&nbs
 p\; MCP-Mod at the end of study on a clinical response\, in order to inves
 tigate the dose response.&nbsp\; </p> <p>At week 2\, a biomarker is measur
 ed to see if there is a clinically meaningful effect at the&nbsp\; target 
 for appropriated doses. If not then new doses may need to be added.&nbsp\;
  The posterior probability of the meaningful effect will be used in the de
 cision criteria.</p> <p>At the end of the study MCP-Mod will be used in or
 der to investiagate the dose response.&nbsp\; MCP-Mod involves pre-specify
 ing candidate dose-reponse models followed by statistical testing for dose
 -response signal whilst controlling the type I error.&nbsp\; The best fitt
 ing model is then selected\, and the target dose estimated\, which is then
  recommended&nbsp\; for phase 2b and phase 3 studies. The method has been 
 qualified by the EMA as an efficient method of dose finding.&nbsp\;&nbsp\;
  </p> <p>Simulations have been conducted to investigate the futility and d
 ose finding decisions in phase 2a and understand the operating characteris
 tics\, and comparisons made to a traditional dose finding paradigm\, which
  might involve fewer doses compared to a control using pairwise comparison
 s.</p> <strong>Dr James Wason</strong>&nbsp\;is a senior investigator stat
 istician at the MRC Biostatistics unit (BSU) in Cambridge. He has been the
 re since doing his Ph.D. in 2006. Since 2009 he has worked in the BSU&rsqu
 o\;s Hub for Trials Methodology Research\, directed by Adrian Mander. His 
 main research interests are adaptive designs for clinical trials\, efficie
 nt analysis of composite endpoints\, and the use of biomarkers in clinical
  trials. He is also the co-lead of the MRC Hub for Trials Methodology&rsqu
 o\;s stratified medicine working group.\n<p><strong>12:45 noon- 1:45pm &nd
 ash\; Lunch</strong></p> <p><strong>1:45pm &ndash\; 3:15pm: Defining\, Und
 erstanding and Communicating Decision Criteria in Early Clinical Developme
 nt.&nbsp\; Peter Colman (UCB)</strong></p> <p>It is not uncommon to invest
 igate multiple indicators of potential clinical efficacy in an early study
  in patients. A broad swathe of biomarkers may be nominated to ensure that
  evidence of activity on the projected biochemical pathway is acquired and
  additional biomarkers may indicate the precursors of clinical benefit. Re
 gistration endpoints\, surrogates thereof or less-qualified biomarkers of 
 efficacy may also be captured. The number of endpoints may easily exceed t
 he number of subjects in the study and so it is vital that the properties 
 of any decisions are well understood and consistently communicated. We dis
 cuss one approach which elicits views on the combinations of results that 
 would be considered positive or encouraging and seeks to assess the likely
  false-positive rates associated with the consequent decision criteria.&nb
 sp\; We illustrate the ideas with some real examples.</p> <p>Peter spent t
 he first 29 years of his statistical career with Pfizer at their UK resear
 ch site in Sandwich. During this time he worked in Animal Health\, Clinica
 l Pharmacology and Early Clinical Development. He also experienced a phase
  III project for 6 months. For several years\, he led a group of statistic
 ians focussing on PK-PD Modelling &amp\; Simulation\, Genetics\, Clinical 
 Technology and Outcomes Research. He returned to mainstream\, hands-on pro
 ject work and also contributed to a number of European collaborations (e.g
 . IMI SAFE-T). In 2011\, upon closure of the Sandwich site\, Peter moved t
 o AZ at Alderley Park\, where he worked on safety data and as a manager of
  statisticians in the oncology and anti-infectives area. He joined the UCB
  early development statistics team at UCB in 2013 where he contributes to 
 the design of studies in the immunology and neuroscience areas. In his spa
 re time he plays classical double bass and he is currently the chair of Ma
 idstone Orchestral Society.</p> <p><strong>3:15pm &ndash\; 3:30pm &ndash\;
  Coffee Break</strong></p> <p><strong>3:30pm &ndash\; 5pm: Tackling Real P
 roblems in Multi Regional Clinical Trials.&nbsp\; Kevin Carroll (KJCStatis
 tics)</strong></p> <p>MRCTs are an increasingly necessary feature of moder
 n drug development.&nbsp\; In areas like diabetes and cardiovascular disor
 ders\, or early adjuvant oncologic disease settings\, or where there is a 
 regulatory requirement to rule out small\, but important safety issues suc
 h as in the ongoing cluster of trials investigating long acting beta agoni
 sts in the treatment of asthma\, &nbsp\;the demand for very large trials d
 rives the need for MRCTs.&nbsp\;&nbsp\; Such trials are needed to provide 
 the power to address the underlying hypothesis of interest\, but can only 
 do so under the assumption of no true regional heterogeneity.&nbsp\;This t
 alk will address the implications of true regional differences in MRCTs an
 d will illustrate the real statistical and regulatory challenges faced by 
 reference to recent case studies\, including the 18\,000 patient &lsquo\;P
 LATO&rsquo\; trial in acute coronary syndromes.&nbsp\;&nbsp\;</p> <p><stro
 ng>Kevin Joseph Carroll</strong>\, PhD\, CStat\, CSci\, Honorary Senior Le
 cturer Medical Statistics is an Independent Statistical Consultant and own
 er of KJCStatistics Ltd.&nbsp\; Kevin has 26 years drug development of exp
 erience across all trial phases and multiple therapeutic areas including O
 ncology\, CV\, Metabolism\, Respiratory\, CNS and GI.&nbsp\; Most recently
  Kevin held the positions of VP Statistics and Chief Statistician at Astra
 Zeneca Pharmaceuticals and Expert Statistician with Boehringer-Ingelheim.&
 nbsp\; Kevin has extensive experience in the design\, conduct\, analysis a
 nd reporting of clinical trials.&nbsp\; &nbsp\;&nbsp\;As a Consultant\, Ke
 vin has gained experience in helping both small and large pharma and biote
 ch companies tackle statistical issues in development\, including the appl
 ication of innovative statistical approaches to trial design and analysis 
 and regulatory product license applications.&nbsp\; This includes the use 
 of Bayesian decision-based designs to expedite effective decision making\,
  and the use of complex staged designs in pivotal Phase II/III and Phase I
 II trials to expedite overall development times. Kevin retains a strong te
 chnical interest in areas such as parametric survival modelling\, group se
 quential analysis\, adaptive designs and large outcomes trial design\, and
  a growing interest in the statistical issues associated with health econo
 mic analyses and network meta-analyses.<br /> <br /> <strong>Registration:
  &pound\;50</strong></p>
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