Study designs for clinical trials applied to personalised medicine: a scoping review. Issue 5 (6th May 2022)

• Record Type: Journal Article
• Authors: Superchi, Cecilia; Brion Bouvier, Florie; Gerardi, Chiara; Carmona, Montserrat; San Miguel, Lorena; Sánchez-Gómez, Luis María; Imaz-Iglesia, Iñaki; Garcia, Paula; Demotes, Jacques; Banzi, Rita; Porcher, Raphaël
• Other Names: author non-byline.; Andreu Antonio L author non-byline.; Bietrix Florence author non-byline.; Polo-de Santos Maria del Mar author non-byline.; Fratelli Maddalena author non-byline.; Fosse Vibeke author non-byline.; Glaab Enrico author non-byline.; Girgenrath Rainer author non-byline.; Grundmann Alexander author non-byline.; Haro Josep Maria author non-byline.; Hulstaert Frank author non-byline.; Jonckheer Pascale author non-byline.; Matos Setefilla Luengo author non-byline.; McCormack Emmet author non-byline.; Mula Anna Monistrol author non-byline.; Niubo Albert Sanchez author non-byline.; Oldoni Emanuela author non-byline.; Torres Teresa author non-byline.
• Is Part Of: BMJ open. Volume 12:Issue 5(2022)
• Publication Date: 2022-05-06
• Subjects: Precision medicine -- Clinical trial -- Study design -- Scoping review; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-052926
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: Personalised medicine (PM) allows treating patients based on their individual demographic, genomic or biological characteristics for tailoring the 'right treatment for the right person at the right time'. Robust methodology is required for PM clinical trials, to correctly identify groups of participants and treatments. As an initial step for the development of new recommendations on trial designs for PM, we aimed to present an overview of the study designs that have been used in this field. Design: Scoping review. Methods: We searched (April 2020) PubMed, Embase and the Cochrane Library for all reports in English, French, German, Italian and Spanish, describing study designs for clinical trials applied to PM. Study selection and data extraction were performed in duplicate resolving disagreements by consensus or by involving a third expert reviewer. We extracted information on the characteristics of trial designs and examples of current applications of these approaches. The extracted information was used to generate a new classification of trial designs for PM. Results: We identified 21 trial designs, 10 subtypes and 30 variations of trial designs applied to PM, which we classified into four core categories (namely, Master protocol, Randomise-all, Biomarker strategy and Enrichment). We found 131 clinical trials using these designs, of which the great majority were master protocols (86/131, 65.6%). Most of the trials were phase II studies (75/131, 57.2%) in the field of oncology (113/131, 86.3%). We identified 34 main features of trial designs regarding different aspects (eg, framework, control group, randomisation). The four core categories and 34 features were merged into a double-entry table to create a new classification of trial designs for PM. Conclusions: A variety of trial designs exists and is applied to PM. A new classification of trial designs is proposed to help readers to navigate the complex field of PM clinical trials.