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Review

Recent developments in clinical trial designs for HIV vaccine research

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Pages 1022-1029 | Received 05 Sep 2014, Accepted 28 Nov 2014, Published online: 01 May 2015

Figures & data

Table 1. Overview of phase IIB and III trials of prophylactic HIV vaccine strategies

Figure 1. Schematic illustration of different trial designs. (A) Multi-arm design, Example of a design, comparing 3 different vaccine strategies to a common placebo arm. (B) Two-by-2 factorial 4-arm design. Example of a design evaluating a vaccine strategy, another intervention and the combination of both. The other intervention could for instance be pre-exposure prophylaxis (PrEP) in case of a HIV prevention trial or a drug to mobilize the viral reservoir in case of a therapeutic trial. (C) Two-arm group-sequential design Example of a design with one interim analysis and stopping rule (D) Seamless adaptive design. Example of an adaptive design with a seamless progression between phase II and phase III, integrating a selection of trial arms during phase II and additional design adaptations at the beginning of phase III.

Figure 1. Schematic illustration of different trial designs. (A) Multi-arm design, Example of a design, comparing 3 different vaccine strategies to a common placebo arm. (B) Two-by-2 factorial 4-arm design. Example of a design evaluating a vaccine strategy, another intervention and the combination of both. The other intervention could for instance be pre-exposure prophylaxis (PrEP) in case of a HIV prevention trial or a drug to mobilize the viral reservoir in case of a therapeutic trial. (C) Two-arm group-sequential design Example of a design with one interim analysis and stopping rule (D) Seamless adaptive design. Example of an adaptive design with a seamless progression between phase II and phase III, integrating a selection of trial arms during phase II and additional design adaptations at the beginning of phase III.

Figure 2. Illustration of a multi-arm phase I-II design evaluating 4 vaccine strategies in parallel and integrating an early safety decision rule for one of the vaccines (vaccine 1).

Figure 2. Illustration of a multi-arm phase I-II design evaluating 4 vaccine strategies in parallel and integrating an early safety decision rule for one of the vaccines (vaccine 1).

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