Use of Bayesian approaches in oncology clinical trials: A cross-sectional analysis.

IF 4.4 2区 医学 Q1 PHARMACOLOGY & PHARMACY
Frontiers in Pharmacology Pub Date : 2025-03-25 eCollection Date: 2025-01-01 DOI:10.3389/fphar.2025.1548997
Borja G Lopez-Rey, Gerard Carot-Sans, Dan Ouchi, Ferran Torres, Caridad Pontes
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引用次数: 0

Abstract

Purpose: Bayesian approaches may improve the efficiency of trials and accelerate decision-making, but reluctance to depart from traditional frequentist statistics may limit their use. Because oncology trials generally involve severe conditions with no or limited therapeutic options, they are well-suited to applying Bayesian methodologies and are perceived as using these methods often in early phases.

Objectives: In this study, we aim to describe the use of Bayesian methods and designs in oncology clinical trials in the last 20 years.

Method: A cross-sectional observational study was conducted to identify oncology clinical trials using Bayesian approaches registered in clinicaltrials.gov between 2004 and 2024. Trials were searched in clinicaltrials.gov, PubMed, and through manual search of cross-references.

Results: Bayesian trials were retrieved, and their main characteristics were extracted using R and verified manually. Between 2004 and 2024, 384,298 trials were registered in clinicaltrials.gov; we identified 84,850 oncology clinical trials (22%), of which 640 (0.75%) used Bayesian approaches. The adoption of Bayesian trials increased significantly after 2011, but while half of all Bayesian studies started in the last 5 years, this paralleled the overall increase in oncology research rather than an increase in the proportion of Bayesian trials. The majority of Bayesian trials were phase 1 and phase 2 studies, and two-thirds of Bayesian trials with efficacy objectives had single-arm designs, often utilizing binary endpoints, such as overall response, as the primary measure.

Conclusion: The uptake of Bayesian methods in oncology clinical trials has flattened and is still scarce, and is mostly applied to the analysis of treatment efficacy in single-arm trials with binary endpoints. There is room for further uptake and use of their potential advantages in settings with small populations and severe conditions with unmet needs.

贝叶斯方法在肿瘤学临床试验中的应用:横断面分析。
目的:贝叶斯方法可以提高试验的效率和加速决策,但不愿脱离传统的频率统计可能会限制其使用。由于肿瘤试验通常涉及没有或有限的治疗选择的严重条件,因此非常适合应用贝叶斯方法,并且通常在早期阶段使用这些方法。目的:在本研究中,我们旨在描述在过去20年中贝叶斯方法和设计在肿瘤临床试验中的应用。方法:对2004年至2024年在clinicaltrials.gov上注册的使用贝叶斯方法的肿瘤临床试验进行横断面观察研究。在clinicaltrials.gov、PubMed和人工交叉参考文献中检索试验。结果:检索到贝叶斯试验,使用R提取其主要特征并进行人工验证。2004年至2024年间,在clinicaltrials.gov网站上注册了384,298项试验;我们确定了84,850个肿瘤学临床试验(22%),其中640个(0.75%)使用贝叶斯方法。2011年之后,贝叶斯试验的采用显著增加,但尽管所有贝叶斯研究中有一半是在过去5年开始的,但这与肿瘤学研究的总体增长而不是贝叶斯试验比例的增加是平行的。大多数贝叶斯试验是1期和2期研究,三分之二具有疗效目标的贝叶斯试验采用单臂设计,通常采用双终点,如总反应,作为主要衡量标准。结论:贝叶斯方法在肿瘤临床试验中的应用已经趋于平缓,并且仍然很少,并且主要应用于双终点的单臂试验的治疗疗效分析。在人口少、条件恶劣、需求未得到满足的情况下,有进一步吸收和利用其潜在优势的空间。
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来源期刊
Frontiers in Pharmacology
Frontiers in Pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
7.80
自引率
8.90%
发文量
5163
审稿时长
14 weeks
期刊介绍: Frontiers in Pharmacology is a leading journal in its field, publishing rigorously peer-reviewed research across disciplines, including basic and clinical pharmacology, medicinal chemistry, pharmacy and toxicology. Field Chief Editor Heike Wulff at UC Davis is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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