Evaluating Clinical Benefit in I-SPY 2

Abstract

There are limited methods to analyze both efficacy of a drug and toxicity to a patient in response to treatment. We have developed a metric, the clinical benefit index (CBI) which is quantitative, and a scalable way to integrate patient-reported side effects and efficacy for adaptive randomization. Instead of using efficacy as a singular attribute in decision making for agent selection, we will consider the impact on QoL since many of the newer agents will be less toxic. This will be developed in effort to standardize PRO analysis methods. The clinical benefit index provides an alternative framework for evaluation and would help us to develop a regulatory model for approval of those drugs that have less toxicity by providing a replicable model for measuring toxicity and integrating it with efficacy. Reporting of clinical data can inform the management of toxicity and the integration into a clinical benefit index will help promote regulatory evaluation and preference for less toxic drug/combinations.