Adaptive Trial Designs Could Accelerate HIV Vaccine Development
NIH Scientists Review Lessons Learned from More than a Decade of Trials
April 20, 2011
In the past 12 years, four large-scale efficacy trials of HIV vaccines have been conducted in various populations. Results
from the most recent trial-the RV144 trial in Thailand, which found a 31 percent reduction in the rate of HIV
acquisition among vaccinated heterosexual men and women-have given scientists reason for cautious optimism. Yet
building on these findings could take years, given that traditional HIV vaccine clinical trials are lengthy,
and that it is still not known which immune system responses a vaccine needs to trigger to protect an individual from HIV infection.
To accelerate HIV vaccine development, scientists working at and funded by the National Institute of Allergy and Infectious Diseases
(NIAID), part of the National Institutes of Health, propose using adaptive clinical trial designs. These designs allow a trial to be
modified in response to data acquired during the study. Such trials would rapidly screen out poor vaccine candidates, enable
extended evaluation of promising candidates and provide key information on the immunological basis for HIV prevention.
The study was conducted by a team of scientists from the University of Nebraska Medical Center, Omaha, and the University of
Rochester Medical Center, N.Y. It was supported by the National Institute on Drug Abuse (NIDA), the National Institute of
Neurological Disorders and Stroke, the National Institute of Mental Health, and the National Center for Research Resources.
In a paper appearing this week in Science Translational Medicine, the scientists review the four major HIV vaccine trials undertaken
thus far and the scientific questions and challenges that remain. They describe what is needed to advance HIV vaccines through clinical
trials and how adaptive clinical trial designs may accelerate identification of an effective HIV vaccine.
ARTICLE: L Corey et al. HIV-1 vaccines and adaptive trial designs. Science Translational Medicine DOI: 10.1126/scitranslmed.3001863 (2011).
WHO: NIAID Director Anthony S. Fauci, M.D., co-author on the study, is available to comment on this article.
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