A Critical Assessment of Approaches to Improving the Efficiency of Cancer Clinical Trials
There are many reasons for focusing attention on the efficiency of clinical trials. First, improving the efficiency of clinical trials may expedite the finding of improved treatments. Developing an effective treatment may be a multistep process involving failures and partial successes along the way. Improving the efficiency of each component clinical trial expedites the entire process. The proliferation of new treatments derived from an improved understanding of tumor biology provides an additional inducement to improve the efficiency by which we screen and evaluate treatments. There are also often strong ethical motivations for conducting each clinical trial as efficiently as possible. If one treatment is more effective than the other, then certainly one wishes to expose as few patients as possible to the inferior treatment. If the treatments are of equivalent antitumor efficacy but the new experimental therapy is more toxic, as is often the case, then one would like to discard the new treatment as soon as possible. In addition to the opportunity cost and the ethical cost, there is also a monetary cost providing an incentive to improving efficiency.
KeywordsInterim Analysis Cancer Clinical Trial Response Surface Design Important Clinical Trial Drastic Simplification
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