Cure models with adaptive activation for modeling cancer survival

Stat Methods Med Res. 2024 Feb;33(2):227-242. doi: 10.1177/09622802231224647. Epub 2024 Jan 31.

Abstract

We propose a class of cure rate models motivated by analysis of colon cancer and triple-negative breast cancer survival data. This class is indexed by an adaptive activation parameter and a function. We establish that the class is stochastically ordered in the activation parameter and also establish two identifiability results for this class. The first- and last-activation models are members of this class whereas many cure rate models proposed in the literature are also part of this class. We illustrate that while first- and last-activation models may perform poorly under model misspecifications, the proposed model with adaptive activation provides appropriate inference in these cases. We apply the proposed approach to assess treatment-sex interaction on cure rate in a colon cancer study and to assess role of tumor heterogeneity and ethnic disparity in breast cancer.

Keywords: Bayesian survival analysis; breast cancer; colon cancer; identifiability; mixture cure model; stochastic ordering; triple-negative breast cancer.

MeSH terms

  • Bayes Theorem
  • Colonic Neoplasms*
  • Humans
  • Models, Statistical
  • Research
  • Survival Analysis
  • Triple Negative Breast Neoplasms*