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Nicolas Loiseau

Publications and source records attributed to Nicolas Loiseau.

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Subgroup analysis methods for time-to-event outcomes in heterogeneous randomized controlled trials

Non-significant randomized control trials can hide subgroups of good responders to experimental drugs, thus hindering subsequent development. Identifying such heterogeneous treatment effects is key for precision medicine and many post-hoc analysis methods have been developed for that purpose. While several benchmarks have been carried out to identify the strengths and weaknesses of these methods, notably for binary and continuous endpoints, similar systematic empirical evaluation of subgroup analysis for time-to-event endpoints are lacking. This work aims to fill this gap by evaluating several subgroup analysis algorithms in the context of time-to-event outcomes, by means of three different research questions: Is there heterogeneity? What are the biomarkers responsible for such heterogeneity? Who are the good responders to treatment? In this context, we propose a new synthetic and semi-synthetic data generation process that allows one to explore a wide range of heterogeneity scenarios with precise control on the level of heterogeneity. We provide an open source Python package, available on Github, containing our generation process and our comprehensive benchmark framework. We hope this package will be useful to the research community for future investigations of heterogeneity of treatment effects and subgroup analysis methods benchmarking.

stat.ME

FedECA: Federated External Control Arms for Causal Inference with Time-To-Event Data in Distributed Settings

External control arms can inform early clinical development of experimental drugs and provide efficacy evidence for regulatory approval. However, accessing sufficient real-world or historical clinical trials data is challenging. Indeed, regulations protecting patients' rights by strictly controlling data processing make pooling data from multiple sources in a central server often difficult. To address these limitations, we develop a method that leverages federated learning to enable inverse probability of treatment weighting for time-to-event outcomes on separate cohorts without needing to pool data. To showcase its potential, we apply it in different settings of increasing complexity, culminating with a real-world use-case in which our method is used to compare the treatment effect of two approved chemotherapy regimens using data from three separate cohorts of patients with metastatic pancreatic cancer. By sharing our code, we hope it will foster the creation of federated research networks and thus accelerate drug development.

stat.ME