Clinical study design

Intensive care medicine

Phase (matter)

Engineering

Reliability engineering

Clinical trial

Computer science

Adaptive design

Phases of clinical research

Drug

Organic chemistry

Drug development

Internal medicine

Drug trial

Pharmacology

Medicine

Chemistry

JACC Basic to Translational Science

Phase II clinical studies represent a critical point in determining drug costs, and phase II is a poor predictor of drug success: >30% of drugs entering phase II studies fail to progress, and >58% of drugs go on to fail in phase III. Adaptive clinical trial design has been proposed as a way to reduce the costs of phase II testing by providing earlier determination of futility and prediction of phase III success, reducing overall phase II and III trial sizes, and shortening overall drug development time. This review examines issues in phase II testing and adaptive trial design.

Phase II Trials in Drug Development and Adaptive Trial Design