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This book presents the state of the art of biostatistical methods
and their applications in clinical oncology. Many methodologies
established today in biostatistics have been brought about through
its applications to the design and analysis of oncology clinical
studies. This field of oncology, now in the midst of evolution
owing to rapid advances in biotechnologies and cancer genomics, is
becoming one of the most promising disease fields in the shift
toward personalized medicine. Modern developments of diagnosis and
therapeutics of cancer have also been continuously fueled by recent
progress in establishing the infrastructure for conducting more
complex, large-scale clinical trials and observational studies. The
field of cancer clinical studies therefore will continue to provide
many new statistical challenges that warrant further progress in
the methodology and practice of biostatistics. This book provides a
systematic coverage of various stages of cancer clinical studies.
Topics from modern cancer clinical trials include phase I clinical
trials for combination therapies, exploratory phase II trials with
multiple endpoints/treatments, and confirmative biomarker-based
phase III trials with interim monitoring and adaptation. It also
covers important areas of cancer screening, prognostic analysis,
and the analysis of large-scale molecular data in the era of big
data.
Design and Analysis of Clinical Trials for Predictive Medicine
provides statistical guidance on conducting clinical trials for
predictive medicine. It covers statistical topics relevant to the
main clinical research phases for developing molecular diagnostics
and therapeutics-from identifying molecular biomarkers using DNA
microarrays to confirming their clinical utility in randomized
clinical trials. The foundation of modern clinical trials was laid
many years before modern developments in biotechnology and
genomics. Drug development in many diseases is now shifting to
molecularly targeted treatment. Confronted with such a major break
in the evolution toward personalized or predictive medicine, the
methodologies for design and analysis of clinical trials is now
evolving. This book is one of the first attempts to contribute to
this evolution by laying a foundation for the use of appropriate
statistical designs and methods in future clinical trials for
predictive medicine. It is a useful resource for clinical
biostatisticians, researchers focusing on predictive medicine,
clinical investigators, translational scientists, and graduate
biostatistics students.
Design and Analysis of Clinical Trials for Predictive Medicine
provides statistical guidance on conducting clinical trials for
predictive medicine. It covers statistical topics relevant to the
main clinical research phases for developing molecular diagnostics
and therapeutics-from identifying molecular biomarkers using DNA
microarrays to confirming their clinical utility in randomized
clinical trials. The foundation of modern clinical trials was laid
many years before modern developments in biotechnology and
genomics. Drug development in many diseases is now shifting to
molecularly targeted treatment. Confronted with such a major break
in the evolution toward personalized or predictive medicine, the
methodologies for design and analysis of clinical trials is now
evolving. This book is one of the first attempts to contribute to
this evolution by laying a foundation for the use of appropriate
statistical designs and methods in future clinical trials for
predictive medicine. It is a useful resource for clinical
biostatisticians, researchers focusing on predictive medicine,
clinical investigators, translational scientists, and graduate
biostatistics students.
This book provides a comprehensive introduction to statistical
methods for designing early phase dose-finding clinical trials. It
will serve as a textbook or handbook for graduate students and
practitioners in biostatistics and clinical investigators who are
involved in designing, conducting, monitoring, and analyzing
dose-finding trials. The book will also provide an overview of
advanced topics and discussions in this field for the benefit of
researchers in biostatistics and statistical science. Beginning
with backgrounds and fundamental notions on dose finding in early
phase clinical trials, the book then provides traditional and
recent dose-finding designs of phase I trials for, e.g., cytotoxic
agents in oncology, to evaluate toxicity outcome. Included are
rule-based and model-based designs, such as 3 + 3 designs,
accelerated titration designs, toxicity probability interval
designs, continual reassessment method and related designs, and
escalation overdose control designs. This book also covers more
complex and updated dose-finding designs of phase I-II and I/II
trials for cytotoxic agents, and cytostatic agents, focusing on
both toxicity and efficacy outcomes, such as designs with
covariates and drug combinations, maximum tolerated dose-schedule
finding designs, and so on.
This book introduces readers to advanced statistical methods for
analyzing survival data involving correlated endpoints. In
particular, it describes statistical methods for applying Cox
regression to two correlated endpoints by accounting for dependence
between the endpoints with the aid of copulas. The practical
advantages of employing copula-based models in medical research are
explained on the basis of case studies. In addition, the book
focuses on clustered survival data, especially data arising from
meta-analysis and multicenter analysis. Consequently, the
statistical approaches presented here employ a frailty term for
heterogeneity modeling. This brings the joint frailty-copula model,
which incorporates a frailty term and a copula, into a statistical
model. The book also discusses advanced techniques for dealing with
high-dimensional gene expressions and developing personalized
dynamic prediction tools under the joint frailty-copula model. To
help readers apply the statistical methods to real-world data, the
book provides case studies using the authors' original R software
package (freely available in CRAN). The emphasis is on clinical
survival data, involving time-to-tumor progression and overall
survival, collected on cancer patients. Hence, the book offers an
essential reference guide for medical statisticians and provides
researchers with advanced, innovative statistical tools. The book
also provides a concise introduction to basic multivariate survival
models.
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