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Presentation: HIV-1 vaccines and adaptive trial designs

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HIV-1 vaccines and adaptive trial designs presented by Dr James Kublin, Executive Director, HVTN, Fred Hutchinson Cancer Research Center.

The presentation details the following:

Objectives of the Research Trial Design
·         Primary objective:  For each vaccine regimen, to evaluate VE against HIV infection within 18 months of randomization [i.e., VE(0-18)]
·         Secondary objectives:  
o   To evaluate durability of VE out to 36 months for each regimen showing reliable evidence for positive VE(0-18)
o   To expeditiously and rigorously evaluate immune correlates protection if any of the vaccine regimens show reliable evidence for VE(0-18) > 0%
o   To compare VE among the vaccine regimens
·         An adaptive 2-stage design for each vaccine regimen:
o   Stage 1 evaluates VE(0-18)
o   Stage 2 evaluates longer-term VE(t), and occurs if and only if the trial provides reliable evidence for VE(0-18) > 0%
 
The Adaptations Follow FDA Guidance Principles
 
·         Adaptations can be done safely without sacrificing design integrity if:
o   Planned: Adaptation triggered by pre-specified deterministic rules [may depend on VE]
o    Independent of treatment: Adaptation unplanned, but is based on treatment-blinded data
·         The developed designs are in the safe zone, adhering to the FDA guidance document Adaptive Design Clinical Trials for Drugsand Biologics February 2010

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