What does this research mean for the field?

Sequential multiple adaptive randomized treatment (SMART) designs provide an efficient, valid, and robust framework for assessing the contribution of treatment phases in confirmatory oncology trials, offering higher power and controlled type I error compared to traditional multi-arm designs. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To establish a sequential multiple adaptive randomized treatment (SMART) framework that robustly evaluates the individual contribution of neoadjuvant and adjuvant phases in perioperative oncology.

September 2, 2026Clinical Trials

How to be SMART in oncology: A practical framework to assess the contribution of phase using sequential multiple adaptive randomized treatment designs

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Authors

KBKristine BroglioAstraZeneca (France)EKElizabeth F. KrakowFred Hutch Cancer Center EMErica E. M. MoodieMcGill University

Discussion

Member takes

Implication

Simulation study demonstrates enhanced statistical power and controlled error in perioperative oncology, indicating an efficient framework to isolate phase-specific treatment effects.

Key Points

To establish a sequential multiple adaptive randomized treatment (SMART) framework that robustly evaluates the individual contribution of neoadjuvant and adjuvant phases in perioperative oncology.
Defined intent-to-treat analytical sets for comparisons of perioperative-versus-control, neoadjuvant-only-versus-control, and the incremental benefit of the adjuvant phase.
Performed trial simulations modeled on perioperative immunotherapy for resectable non-small-cell lung cancer to evaluate performance against traditional multi-arm designs.
The SMART design expanded the number of events for regimen-versus-control evaluations and isolated an unbiased randomized comparison for the contribution of the adjuvant phase at the second randomization.
Simulations demonstrated well-controlled family-wise type I error (<0.05) and superior statistical power relative to conventional multi-arm trial structures.

Cite This Study

Broglio et al. (2026) studied this question.

synapsesocial.com/papers/6a97e305c562ede874ec7994 https://doi.org/10.1177/17407745261471462

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September 2, 2026Clinical Trials

How to be SMART in oncology: A practical framework to assess the contribution of phase using sequential multiple adaptive randomized treatment designs

View Full Paper

Ask AI

Bookmark

Authors

KBKristine BroglioAstraZeneca (France)EKElizabeth F. KrakowFred Hutch Cancer Center EMErica E. M. MoodieMcGill University

Discussion

Member takes

Implication

Simulation study demonstrates enhanced statistical power and controlled error in perioperative oncology, indicating an efficient framework to isolate phase-specific treatment effects.

Key Points

To establish a sequential multiple adaptive randomized treatment (SMART) framework that robustly evaluates the individual contribution of neoadjuvant and adjuvant phases in perioperative oncology.
Defined intent-to-treat analytical sets for comparisons of perioperative-versus-control, neoadjuvant-only-versus-control, and the incremental benefit of the adjuvant phase.
Performed trial simulations modeled on perioperative immunotherapy for resectable non-small-cell lung cancer to evaluate performance against traditional multi-arm designs.
The SMART design expanded the number of events for regimen-versus-control evaluations and isolated an unbiased randomized comparison for the contribution of the adjuvant phase at the second randomization.
Simulations demonstrated well-controlled family-wise type I error (<0.05) and superior statistical power relative to conventional multi-arm trial structures.

Cite This Study

Broglio et al. (2026) studied this question.

synapsesocial.com/papers/6a97e305c562ede874ec7994 https://doi.org/10.1177/17407745261471462

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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