Modeling antitumor activity by using a non-linear mixed-effects model

The response of solid tumors to antitumor treatment generally declines markedly with treatment time. Sometimes, a tumor regrows (rebounds) before the end of the treatment period. Studies of the patterns of tumor response to treatment are important, because they may provide useful information for clinical decision-making. We have investigated patterns of tumor response in mouse xenograft tumors by using data from a study conducted at St. Jude Children's Research Hospital. We applied a biexponential non-linear mixed-effects model to an analysis of changes in tumor volume over a given period of treatment. The model gives a good fit to the data, even for small sample sizes. We addressed the relation between the baseline tumor volumes and the decay rates of the first and second stages of the tumor's response to treatment, and we applied sensitive analysis to determine the effect of using different imputed values for missing data. We also proposed a novel approach to a comparison of the antitumor effects of three different treatments, and we used the data from a St. Jude study to demonstrate the potential of this comparison approach in cancer clinical decision-making.     

肿瘤表达谱基因芯片数据的混合效应模型分析

目的:研究混合效应模型(Mixed Effects Model)在肿瘤表达谱基因芯片数据分析中的检验效能,并探讨其分析效果。方法:采用混合效应模型分析肿瘤实例基因芯片数据,并以基因集富集分析方法(GSEA)作为参照比较分析结果的有效性和科学性,探讨其检验效果。结果:通过混合效应模型和基因集富集分析(GSEA)两种方法对肿瘤基因芯片数据的分析和比较,两种方法筛选出共同的差异表达通路外,混合效应模型额外地筛选出来GSEA未能检验到的8条差异表达通路,且得到文献支持;混和效应模型筛选出的前10个差异表达通路中有6个已有生物学证明而基因集富集分析方法(GSEA)筛选出的前10个差异表达通路中仅有4个已有生物学证明。结论:混合效应模型作为top-down方法中的典型代表,其优势在于通过构建潜变量达到降维目的,可有效地减少多个复杂的变异来源从而保证了结果的准确性和科学性,其检验效能优于基因集富集分析方法(GSEA),是一种行之有效的筛选肿瘤基因芯片数据的分析方法。     

A linear mixed-effects model for multivariate censored data

We apply a linear mixed-effects model to multivariate failure time data. Computation of the regression parameters involves the Buckley-James method in an iterated Monte Carlo expectation-maximization algorithm, wherein the Monte Carlo E-step is implemented using the Metropolis-Hastings algorithm. From simulation studies, this approach compares favorably with the marginal independence approach, especially when there is a strong within-cluster correlation.     

Linear mixed models for longitudinal shape data with applications to facial modeling

We present a novel application of methods for analysis of high-dimensional longitudinal data to a comparison of facial shape over time between babies with cleft lip and palate and similarly aged controls. A pairwise methodology is used that was introduced in Fieuws and Verbeke (2006) in order to apply a linear mixed-effects model to data of high dimensions, such as describe facial shape. The approach involves fitting bivariate linear mixed-effects models to all the pairwise combinations of responses, where the latter result from the individual coordinate positions, and aggregating the results across repeated parameter estimates (such as the random-effects variance for a particular coordinate). We describe one example using landmarks and another using facial curves from the cleft lip study, the latter using B-splines to provide an efficient parameterization. The results are presented in 2 dimensions, both in the profile and in the frontal views, with bivariate confidence intervals for the mean position of each landmark or curve, allowing objective assessment of significant differences in particular areas of the face between the 2 groups. Model comparison is performed using Wald and pseudolikelihood ratio tests.     

Marginalized binary mixed-effects models with covariate-dependent random effects and likelihood inference

Marginal models and conditional mixed-effects models are commonly used for clustered binary data. However, regression parameters and predictions in nonlinear mixed-effects models usually do not have a direct marginal interpretation, because the conditional functional form does not carry over to the margin. Because both marginal and conditional inferences are of interest, a unified approach is attractive. To this end, we investigate a parameterization of generalized linear mixed models with a structured random-intercept distribution that matches the conditional and marginal shapes. We model the marginal mean of response distribution and select the distribution of the random intercept to produce the match and also to model covariate-dependent random effects. We discuss the relation between this approach and some existing models and compare the approaches on two datasets.     

Increased risk of type I errors in cluster randomised trials with small or medium numbers of clusters: a review,reanalysis, and simulation study

BackgroundCluster randomised trials (CRTs) are commonly analysed using mixed-effects models or generalised estimating equations (GEEs). However, these analyses do not always perform well with the small number of clusters typical of most CRTs. They can lead to increased risk of a type I error (finding a statistically significant treatment effect when it does not exist) if appropriate corrections are not used.MethodsWe conducted a small simulation study to evaluate the impact of using small-sample corrections for mixed-effects models or GEEs in CRTs with a small number of clusters. We then reanalysed data from TRIGGER, a CRT with six clusters, to determine the effect of using an inappropriate analysis method in practice. Finally, we reviewed 100 CRTs previously identified by a search on PubMed in order to assess whether trials were using appropriate methods of analysis. Trials were classified as at risk of an increased type I error rate if they did not report using an analysis method which accounted for clustering, or if they had fewer than 40 clusters and performed an individual-level analysis without reporting the use of an appropriate small-sample correction.ResultsOur simulation study found that using mixed-effects models or GEEs without an appropriate correction led to inflated type I error rates, even for as many as 70 clusters. Conversely, using small-sample corrections provided correct type I error rates across all scenarios. Reanalysis of the TRIGGER trial found that inappropriate methods of analysis gave much smaller P values (P ≤ 0.01) than appropriate methods (P = 0.04–0.15). In our review, of the 99 trials that reported the number of clusters, 64 (65 %) were at risk of an increased type I error rate; 14 trials did not report using an analysis method which accounted for clustering, and 50 trials with fewer than 40 clusters performed an individual-level analysis without reporting the use of an appropriate correction.ConclusionsCRTs with a small or medium number of clusters are at risk of an inflated type I error rate unless appropriate analysis methods are used. Investigators should consider using small-sample corrections with mixed-effects models or GEEs to ensure valid results.     

Retrospective Binary-Trait Association Test Elucidates Genetic Architecture of Crohn Disease

In genetic association testing, failure to properly control for population structure can lead to severely inflated type 1 error and power loss. Meanwhile, adjustment for relevant covariates is often desirable and sometimes necessary to protect against spurious association and to improve power. Many recent methods to account for population structure and covariates are based on linear mixed models (LMMs), which are primarily designed for quantitative traits. For binary traits, however, LMM is a misspecified model and can lead to deteriorated performance. We propose CARAT, a binary-trait association testing approach based on a mixed-effects quasi-likelihood framework, which exploits the dichotomous nature of the trait and achieves computational efficiency through estimating equations. We show in simulation studies that CARAT consistently outperforms existing methods and maintains high power in a wide range of population structure settings and trait models. Furthermore, CARAT is based on a retrospective approach, which is robust to misspecification of the phenotype model. We apply our approach to a genome-wide analysis of Crohn disease, in which we replicate association with 17 previously identified regions. Moreover, our analysis on 5p13.1, an extensively reported region of association, shows evidence for the presence of multiple independent association signals in the region. This example shows how CARAT can leverage known disease risk factors to shed light on the genetic architecture of complex traits.     

A two-stage model for multiple time series data of counts

We propose a two-stage model for time series data of counts from multiple locations. This method fits first-stage model(s) using the technique of iteratively weighted filtered least squares (IWFLS) to obtain location-specific intercepts and slopes, with possible lagged effects via polynomial distributed lag modeling. These slopes and/or intercepts are then taken to a second-stage mixed-effects meta-regression model in order to stabilize results from various locations. The representation of the models from the stages into a combined mixed-effects model, issues of inference and choices of the parameters in modeling the lag structure are discussed. We illustrate this proposed model via detailed analysis on the effect of air pollution on school absenteeism based on data from the Southern California Children's Health Study.     

Generalized Linear Mixed-Effects Models with a Finite-Support Random-Effects Distribution: A Maximum-Penalized-Likelihood Approach

We discuss a method for simultaneously estimating the fixed parameters of a generalized linear mixed-effects model and the random-effects distribution of which no parametric assumption is made. In addition, classifying subjects into clusters according to the random regression coefficients is a natural by-product of the proposed method. An alternative approach to maximum-likelihood method, maximum-penalized-likelihood method, is used to avoid estimating “too many” clusters. Consistency and asymptotic normality properties of the estimators are presented. We also provide robust variance estimators of the fixed parameters estimators which remain consistent even in presence of misspecification. The methodology is illustrated by an application to a weight loss study.     

Electrochemotherapy, a new antitumor treatment: first clinical trial]

Electrochemotherapy (ECT) is a new antitumor treatment which consists in delivering electric pulses to the tumor some minutes after an intravenous injection of bleomycin. We report here the first clinical trial of ECT, applied to patients with permeation nodules of head and neck squamous carcinomas. ECT was well tolerated by patients, no serious incident occurred and a clear antitumor efficiency was found.     

Joint inference for nonlinear mixed-effects models and time to event at the presence of missing data

In many longitudinal studies, the individual characteristics associated with the repeated measures may be possible covariates of the time to an event of interest, and thus, it is desirable to model the time-to-event process and the longitudinal process jointly. Statistical analyses may be further complicated in such studies with missing data such as informative dropouts. This article considers a nonlinear mixed-effects model for the longitudinal process and the Cox proportional hazards model for the time-to-event process. We provide a method for simultaneous likelihood inference on the 2 models and allow for nonignorable data missing. The approach is illustrated with a recent AIDS study by jointly modeling HIV viral dynamics and time to viral rebound.     

Generalized variance component models for clustered categorical response variables

A generalized variance component model is proposed for the analysis of a categorical response variable with extra-multinomial variation. Categorical data obtained from research designs such as randomized multicenter clinical trials or complex sample surveys with clustering frequently exhibit extra-variation resulting from intracluster correlation. General correlation patterns are accounted for by utilizing a mixed-effects modelling approach, estimating the cluster variance components through the method of moments and modelling functions of the observed proportions through the use of estimating equations. A flexible set of assumptions characterizing the underlying covariance structure for the proportions can be accommodated. The importance of accounting for extra-variation when performing hypothesis tests is highlighted with an application to data from a multi-investigator clinical trial.     

Synthesis and evaluation of novel alkannin and shikonin oxime derivatives as potent antitumor agents

A set of forty alkannin and shikonin oxime derivatives were firstly designed and synthesized. Their cytotoxicities against three kinds of tumor cells and a normal cell line were tested and compared with alkannin and shikonin. The cell-based investigation demonstrated that some oxime derivatives were more or comparatively effective to the lead compounds, especially their selective and excellent antitumor activities towards K562 cells with no toxicity in normal cells. We may conclude that oximate modification to the mother nucleus of alkannin and shikonin is an available approach to acquire potent antitumor agents.     

Induction of antigen-specific immune responses against malignant brain tumors by intramuscular injection of sindbis DNA encoding gp100 and IL-18

We constructed pSin-SV40-HDV-SV40pA, an improved Sindbis DNA expression vector, and evaluated the potential of this vector system for brain tumor therapy. We investigated whether immunizing mice with xenogeneic DNA encoding human gp100 and mouse IL-18 would enhance the antitumor responses. To study the immune mechanisms involved in tumor regression, we examined tumor growth in B16-gp100-implanted brain tumor models using T-cell subset-depleted and IFN-gamma-neutralized mice. Hugp100/mIL-18 vaccination was also investigated for its antitumor effects against the wild-type murine B16 tumor, which expresses the murine gp100 molecule. Genetic immunization using plasmid pSin 9001 DNA codelivery of human gp100 and mouse IL-18 resulted in enhanced protective and therapeutic effects on the malignant brain tumors. The antitumor and protective effects were mediated by both CD4(+)/CD8(+) T cells and IFN-gamma. Vaccination with hugp100/mIL-18 conferred a significant survival merit to wild-type B16 tumor-harboring mice. Immunogene therapy with the improved Sindbis virus vector expressing xenogeneic gp100 and syngeneic IL-18 may be an excellent approach for developing a new treatment protocol. Thus, the Sindbis DNA system may represent a novel approach for the treatment of malignant brain tumors.     

Effect of levan's branching structure on antitumor activity

Levan produced from Microbacterium laevaniformans KCTC 9732 (M-levan) was isolated and treated with an inulinase to modify its branching structure. The chemical structures of levans were characterized, and the modified levans were applied on animal tumor cells to evaluate their antitumor activity. The GC-MS analysis indicated that beta-(2,1)-linked branches of M-levan were specifically hydrolyzed. As the ratio of applied inulinase to levan increased, the branching degree decreased proportionally. Sequential degrees of branching were obtained from 12.3 to 4.2%. Strong levan-induced inhibition of cell growth was detected on SNU-1 and HepG2 tumor cell lines. As the branching degree of M-levan reduced, antitumor activity on SNU-1 linearly decreased (r2=0.96). In HepG2, the antitumor activity rapidly dropped when the branching reached up to 9.3%, then slightly increased as the branching degree of M-levan further decreased. These results suggested that the branch structure would play a crucial role in levan's antitumor activity.     

Bayesian inference for prevalence in longitudinal two-phase studies

We consider Bayesian inference and model selection for prevalence estimation using a longitudinal two-phase design in which subjects initially receive a low-cost screening test followed by an expensive diagnostic test conducted on several occasions. The change in the subject's diagnostic probability over time is described using four mixed-effects probit models in which the subject-specific effects are captured by latent variables. The computations are performed using Markov chain Monte Carlo methods. These models are then compared using the deviance information criterion. The methodology is illustrated with an analysis of alcohol and drug use in adolescents using data from the Great Smoky Mountains Study.     

An integrated approach to identify spatiotemporal and individual-level determinants of animal home range size

Animal home range use is a central focus of ecological research. However, how and why home range size varies between individuals is not well studied or understood for most species. We develop a hierarchical analytical approach--using generalized linear mixed-effects modeling of time series of home range sizes--that allows variance in home range size to be decomposed into components due to variation in temporal, spatial, and individual-level processes, also facilitating intra- and interspecific comparative analyses. We applied the approach to data from a roe deer population radiotracked in central Italy. Over multiple timescales, temporal variation is explained by photoperiod and climate and spatial variation by the distribution of habitat types and spatial variance in radiotracking error. Differences between individuals explained a substantial amount of variance in home range size, but only a relatively minor part was explained by the individual attributes of sex and age. We conclude that the choice of temporal scale at which data are collected and the definition of home range can significantly influence biological inference. We suggest that the appropriate choice of scale and definition requires a good understanding of the ecology and life history of the study species. Our findings contrast with several common assumptions about roe deer behavior.     

Discriminant analysis for longitudinal data with multiple continuous responses and possibly missing data

Summary .  Multiple outcomes are often used to properly characterize an effect of interest. This article discusses model-based statistical methods for the classification of units into one of two or more groups where, for each unit, repeated measurements over time are obtained on each outcome. We relate the observed outcomes using multivariate nonlinear mixed-effects models to describe evolutions in different groups. Due to its flexibility, the random-effects approach for the joint modeling of multiple outcomes can be used to estimate population parameters for a discriminant model that classifies units into distinct predefined groups or populations. Parameter estimation is done via the expectation-maximization algorithm with a linear approximation step. We conduct a simulation study that sheds light on the effect that the linear approximation has on classification results. We present an example using data from a study in 161 pregnant women in Santiago, Chile, where the main interest is to predict normal versus abnormal pregnancy outcomes.