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Lookup NU author(s): Mike Cole, Professor Fai NgORCiD, Dr Stefan Siebert, Dr Arthur PrattORCiD, Professor John IsaacsORCiD, Dr Deborah Stocken
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2021, The Author(s).Background: Adaptive model-based dose-finding designs have demonstrated advantages over traditional rule-based designs but have increased statistical complexity but uptake has been slow especially outside of cancer trials. TRAFIC is a multi-centre, early phase trial in rheumatoid arthritis incorporating a model-based design. Methods: A Bayesian adaptive dose-finding phase I trial rolling into a single-arm, single-stage phase II trial. Model parameters for phase I were chosen via Monte Carlo simulation evaluating objective performance measures under clinically relevant scenarios and incorporated stopping rules for early termination. Potential designs were further calibrated utilising dose transition pathways. Discussion: TRAFIC is an MRC-funded trial of a re-purposed treatment demonstrating that it is possible to design, fund and implement a model-based phase I trial in a non-cancer population within conventional research funding tracks and regulatory constraints. The phase I design allows borrowing of information from previous trials, all accumulated data to be utilised in decision-making, verification of operating characteristics through simulation, improved understanding for management and oversight teams through dose transition pathways. The rolling phase II design brings efficiencies in trial conduct including site and monitoring activities and cost. TRAFIC is the first funded model-based dose-finding trial in inflammatory disease demonstrating that small phase I/II trials can have an underlying statistical basis for decision-making and interpretation. Trial registration: Trials Registration: ISRCTN, ISRCTN36667085. Registered on September 26, 2014.
Author(s): Cole M, Yap C, Buckley C, Ng WF, McInnes I, Filer A, Siebert S, Pratt A, Isaacs JD, Stocken DD
Publication type: Article
Publication status: Published
Journal: Trials
Year: 2021
Volume: 22
Issue: 1
Print publication date: 01/12/2021
Online publication date: 06/07/2021
Acceptance date: 17/06/2021
Date deposited: 21/07/2021
ISSN (electronic): 1745-6215
Publisher: BioMed Central Ltd
URL: https://doi.org/10.1186/s13063-021-05384-5
DOI: 10.1186/s13063-021-05384-5
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