This is a platform alteration: a trial management perspective on the operational aspects of adaptive and platform and umbrella protocols

<p><strong>BACKGROUND:</strong> There are limited research and literature on the trial management challenges encountered in running adaptive platform trials. This trial design allows both (1) the seamless addition of new research comparisons when compelling clinical and scientific...

Full description

Bibliographic Details
Main Authors: Schiavone, F, Bathia, R, Letchemanan, K, Masters, L, Amos, C, Bara, A, Brown, L, Gilson, C, Pugh, C, Atako, N, Hudson, F, Parmar, M, Langley, R, Kaplan, RS, Parker, C, Attard, G, Clarke, NW, Gillessen, S, James, ND, Maughan, T, Sydes, MR, The Stampede And Focus4 Trial Management Group
Format: Journal article
Language:English
Published: BioMed Central 2019
_version_ 1797080536373526528
author Schiavone, F
Bathia, R
Letchemanan, K
Masters, L
Amos, C
Bara, A
Brown, L
Gilson, C
Pugh, C
Atako, N
Hudson, F
Parmar, M
Langley, R
Kaplan, RS
Parker, C
Attard, G
Clarke, NW
Gillessen, S
James, ND
Maughan, T
Sydes, MR
The Stampede And Focus4 Trial Management Group
author_facet Schiavone, F
Bathia, R
Letchemanan, K
Masters, L
Amos, C
Bara, A
Brown, L
Gilson, C
Pugh, C
Atako, N
Hudson, F
Parmar, M
Langley, R
Kaplan, RS
Parker, C
Attard, G
Clarke, NW
Gillessen, S
James, ND
Maughan, T
Sydes, MR
The Stampede And Focus4 Trial Management Group
author_sort Schiavone, F
collection OXFORD
description <p><strong>BACKGROUND:</strong> There are limited research and literature on the trial management challenges encountered in running adaptive platform trials. This trial design allows both (1) the seamless addition of new research comparisons when compelling clinical and scientific research questions emerge, and (2) early stopping of accrual to individual comparisons that do not show sufficient activity without affecting other active comparisons. Adaptive platform design trials also offer many potential benefits over traditional trials, from faster time to accrual to contemporaneously recruiting multiple research comparisons, added flexibility to focus on more promising research comparisons via pre-planned interim analyses and potentially shorter time to primary results. We share here our experiences from a trial management perspective, highlighting the challenges and successes.</p> <p><strong>METHODS:</strong> We evaluated the operational aspects of making changes to these adaptive platform trials and identified both common and trial-specific challenges. The operational steps and challenges linked to both the addition of new research comparisons and stopping recruitment following pre-planned interim analysis were considered in our evaluation.</p> <p><strong>RESULTS:</strong> Specific operational challenges in these adaptive platform protocols, additional to those in traditional two-arm trials, were identified. Key lessons are presented describing some of the solutions and considerations over conducting these trials. Careful consideration on the practicality of the protocol structure (modular versus single protocol), the longevity and continuity of trial oversight committees, and having clear clinical and scientific criteria for the addition of new research comparisons were identified as some of the most common challenges.</p> <p><strong>CONCLUSIONS:</strong> Understanding the operational complexities associated with running adaptive platform protocols is paramount for their conduct, adaptive platform trials offer an efficient model to run randomised controlled trials and we are continuing to work to reduce further the effort required from an operational perspective.</p>
first_indexed 2024-03-07T01:01:32Z
format Journal article
id oxford-uuid:89e5e6d8-76fa-4728-93ed-3db7d7ae96c7
institution University of Oxford
language English
last_indexed 2024-03-07T01:01:32Z
publishDate 2019
publisher BioMed Central
record_format dspace
spelling oxford-uuid:89e5e6d8-76fa-4728-93ed-3db7d7ae96c72022-03-26T22:27:43ZThis is a platform alteration: a trial management perspective on the operational aspects of adaptive and platform and umbrella protocolsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:89e5e6d8-76fa-4728-93ed-3db7d7ae96c7EnglishSymplectic Elements at OxfordBioMed Central2019Schiavone, FBathia, RLetchemanan, KMasters, LAmos, CBara, ABrown, LGilson, CPugh, CAtako, NHudson, FParmar, MLangley, RKaplan, RSParker, CAttard, GClarke, NWGillessen, SJames, NDMaughan, TSydes, MRThe Stampede And Focus4 Trial Management Group<p><strong>BACKGROUND:</strong> There are limited research and literature on the trial management challenges encountered in running adaptive platform trials. This trial design allows both (1) the seamless addition of new research comparisons when compelling clinical and scientific research questions emerge, and (2) early stopping of accrual to individual comparisons that do not show sufficient activity without affecting other active comparisons. Adaptive platform design trials also offer many potential benefits over traditional trials, from faster time to accrual to contemporaneously recruiting multiple research comparisons, added flexibility to focus on more promising research comparisons via pre-planned interim analyses and potentially shorter time to primary results. We share here our experiences from a trial management perspective, highlighting the challenges and successes.</p> <p><strong>METHODS:</strong> We evaluated the operational aspects of making changes to these adaptive platform trials and identified both common and trial-specific challenges. The operational steps and challenges linked to both the addition of new research comparisons and stopping recruitment following pre-planned interim analysis were considered in our evaluation.</p> <p><strong>RESULTS:</strong> Specific operational challenges in these adaptive platform protocols, additional to those in traditional two-arm trials, were identified. Key lessons are presented describing some of the solutions and considerations over conducting these trials. Careful consideration on the practicality of the protocol structure (modular versus single protocol), the longevity and continuity of trial oversight committees, and having clear clinical and scientific criteria for the addition of new research comparisons were identified as some of the most common challenges.</p> <p><strong>CONCLUSIONS:</strong> Understanding the operational complexities associated with running adaptive platform protocols is paramount for their conduct, adaptive platform trials offer an efficient model to run randomised controlled trials and we are continuing to work to reduce further the effort required from an operational perspective.</p>
spellingShingle Schiavone, F
Bathia, R
Letchemanan, K
Masters, L
Amos, C
Bara, A
Brown, L
Gilson, C
Pugh, C
Atako, N
Hudson, F
Parmar, M
Langley, R
Kaplan, RS
Parker, C
Attard, G
Clarke, NW
Gillessen, S
James, ND
Maughan, T
Sydes, MR
The Stampede And Focus4 Trial Management Group
This is a platform alteration: a trial management perspective on the operational aspects of adaptive and platform and umbrella protocols
title This is a platform alteration: a trial management perspective on the operational aspects of adaptive and platform and umbrella protocols
title_full This is a platform alteration: a trial management perspective on the operational aspects of adaptive and platform and umbrella protocols
title_fullStr This is a platform alteration: a trial management perspective on the operational aspects of adaptive and platform and umbrella protocols
title_full_unstemmed This is a platform alteration: a trial management perspective on the operational aspects of adaptive and platform and umbrella protocols
title_short This is a platform alteration: a trial management perspective on the operational aspects of adaptive and platform and umbrella protocols
title_sort this is a platform alteration a trial management perspective on the operational aspects of adaptive and platform and umbrella protocols
work_keys_str_mv AT schiavonef thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT bathiar thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT letchemanank thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT mastersl thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT amosc thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT baraa thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT brownl thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT gilsonc thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT pughc thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT atakon thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT hudsonf thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT parmarm thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT langleyr thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT kaplanrs thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT parkerc thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT attardg thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT clarkenw thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT gillessens thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT jamesnd thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT maughant thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT sydesmr thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols
AT thestampedeandfocus4trialmanagementgroup thisisaplatformalterationatrialmanagementperspectiveontheoperationalaspectsofadaptiveandplatformandumbrellaprotocols