Q#5 Best Overall Response (BOR) , Objective Response Rate (ORR) ,95% Confidence Interval (CI) &P-value Oncology
Definition of Best Overall Response (BOR) Best Overall Response (BOR) is the best treatment response a patient achieves during a clinical trial. It is determined based on tumor size changes and classified into four categories: 1.Complete Response (CR) – The tumor disappears completely. 2.Partial Response (PR) – The tumor shrinks significantly but is still present. 3.Stable Disease (SD) – The tumor neither shrinks nor grows significantly. 4.Progressive Disease (PD) – The tumor grows or worsens. Imagine 5 patients are taking a new cancer drug. Each patient’s response is tracked over time. •If a patient improves over time, the best response is counted (e.g., PR → CR → CR is recorded as CR). •If a patient worsens after improvement, the worst response is counted if the patient does not recover •(e.g., PR → PD is recorded as PD). Imagine 5 patients are taking a new cancer drug. Each patient’s response is tracked over time. •If a patient improves over time, the best response is counted (e.g., PR → CR → CR is recorded as CR). •If a patient worsens after improvement, the worst response is counted if the patient does not recover •(e.g., PR → PD is recorded as PD). Patient Response Type Best Overall Response (BOR) Patient 1 CR (Tumor disappeared) CR Patient 2 PR (Tumor shrank) PR Patient 3 SD (No significant change) SD Patient 4 PR first, then PD later PD (worst response counts) Patient 5 PR first, then CR later CR (best response counts) PR → CR → CR → CR 👉 BOR = CR (Best was 100%)SD → PR → PR → SD 👉 BOR = PR (Best was 80%)PR → SD → PD → PD 👉 BOR = PD (Got worse at the end)SD → SD → SD → SD 👉 BOR = SD (No change)PR → CR → PD 👉 BOR = PD (Got worse at the end)Definition of Objective Response Rate (ORR) Objective Response Rate (ORR) is a measure used in oncology clinical trials to assess how well a treatment works. It is the percentage of patients whose cancer shrinks (Partial Response – PR) or disappears (Complete Response – CR) after treatment. ORR does not include Stable Disease (SD) or Progressive Disease (PD). A 95% Confidence Interval (CI) is a range of values that tells us where the true result is likely to be. What is a 95% Confidence Interval (CI)? 95% Confidence Interval (CI) for Objective Response Rate •Drug A: (0.1941 – 0.993) → This means we are 95% sure that the true response rate for Drug A is between 19.41% and 99.3%. •Drug B: (0.0250 – 1.000) → The response rate for Drug B is between 2.5% and 100% (very wide range due to low patient count).95% Confidence Interval (CI) for Objective Response Rate •Drug A: (0.1941 – 0.993) → This means we are 95% sure that the true response rate for Drug A is between 19.41% and 99.3%. • •Drug B: (0.0250 – 1.000) → The response rate for Drug B is between 2.5% and 100% (very wide range due to low patient count).Difference in Objective Response Rate •0.75 (75%) → Drug A had a 75% higher response rate than Drug B.95% CI for the Difference in ORR •0.3257 → This means the actual difference could vary, but there’s a 32.57% chance that Drug A is better than Drug B.P-value •0.2207 → The p-value tells us if the difference between Drug A and Drug B is statistically significant. •Since 0.2207 > 0.05, this means the difference is not statistically significant, meaning we cannot be sure that Drug A is truly better than Drug B (the result could be due to chance).